The most important contraindication for marital therapy is?

• A. The couple is not married
• B. The therapist's inability to prevent a partner from using sessions to attack the other
• C. One partner refuses to attend
• D. Severe financial stress

Answer: (B)

Marital therapy works best when the environment is safe, respectful, and oriented toward joint problem-solving. If one partner can use the sessions to attack or demean the other, the setting ceases to be therapeutic and can actually increase harm. The therapist must be able to intervene to maintain boundaries and protect both individuals; when that ability is compromised, continuing couples work is inappropriate because it undermines trust and effective change. In such situations, safety and individual treatment considerations come first, with possible referrals for individual therapy or crisis resources.

Other common barriers, like not being married, one partner refusing to attend, or severe financial stress, pose real challenges to therapy but do not by themselves make couples work contraindicated. They may limit effectiveness or require alternative arrangements, but they are not as inherently unsafe as a setup in which sessions are used to attack a partner.