Couples Therapy & Relationship Counseling
Telehealth across Vermont and Massachusetts · Private pay
Telehealth couples therapy for partners in Massachusetts and Vermont, with Maxwell Crystal, LICSW. Sessions are 50 minutes by secure video and cost $200, private pay. The first step is a free 15-minute phone call, and you're welcome to be on it together.
Most couples don't arrive in therapy because they've stopped caring. They arrive because the same arguments keep cycling, because distance has grown quietly over years, or because something happened that changed everything. The relationship still matters — but something has broken down in how you're navigating it together.
This is structured, direct work. Sessions are focused, not open-ended. You'll leave each one knowing what was examined and what to do differently.
What brings couples to therapy
Relationships run into trouble in predictable ways. Common reasons people reach out:
Recurring conflict — The same fights, different day. Arguments that escalate fast or go nowhere, leaving both people exhausted and unheard.
Communication that's stopped working — One or both partners has gone quiet, or conversations consistently turn into confrontations.
Major life transitions — A move, a job loss, a new child, a health crisis, grief. Stress that strains the relationship and creates distance at exactly the wrong time.
Betrayal and trust repair — Infidelity, dishonesty, or a significant rupture. Working through this requires structure and honesty — it's possible, but it's not easy.
Growing apart — No single crisis, just increasing disconnection. The relationship has drifted and neither of you is sure how to find your way back.
Addiction, recovery, or a loss — One partner's drinking or use, early recovery, or a death in the family has changed how the relationship works. Both are a large part of my work: see addiction and recovery and grief therapy.
Not sure it's time yet? Start with How Do You Know It's Time for Couples Therapy? 7 Signs Worth Taking Seriously. Stuck in the same fight? Read Why Do We Keep Having the Same Argument?
What therapy looks like
Sessions are 50 minutes via telehealth — you each join from wherever you are in Vermont or Massachusetts. There's no couch, no soft music. It's a working conversation with structure and direction.
In early sessions, we slow things down to understand what's actually happening: what each person needs, where the relationship is stuck, and what both of you are willing to do differently. From there, sessions focus on what matters most — building new patterns rather than endlessly processing old ones.
I use an approach grounded in family systems thinking, which means I'm paying attention to dynamics, not just content. The goal isn't to assign blame or declare a winner. It's to understand the system you've built together and change the parts that aren't working.
Most couples I work with have been managing this for a long time before reaching out. The work moves faster than you'd expect when the focus is right. If you're wondering what the first session is actually like, I wrote about it here: What Actually Happens in the First Couples Therapy Session.
What I bring to couples work
Before private practice, I was Clinical Director of Sana at Stowe, a residential addiction treatment program, and Bereavement Program Coordinator for BAYADA Hospice. In both roles I worked every day with people at the edges of what relationships can hold. That shapes how I work with couples: I know what escalation looks like, what sustains it, and what actually creates change.
Couples often arrive with something heavier underneath the conflict — a partner's drinking or recovery, a death in the family, a betrayal. That's familiar ground for me, and you won't need to soften it. If loss is part of your story, When Grief Strains Your Relationship is a good place to start.
Common questions about couples therapy
What if my partner doesn't want to come?
That's a common starting point. You can begin on your own: individual work focused on the relationship changes your half of the pattern, and that changes the pattern. The free call is also an easy first step for a hesitant partner, and you're welcome to be on it together. More in How to Get Your Partner to Agree to Couples Therapy and How to Talk to Your Partner About Couples Therapy.
Do we both need to be in Massachusetts or Vermont?
Yes. Each of you needs to be in Massachusetts or Vermont during sessions, because that's where I'm licensed. You can join from the same room, from two rooms, or from two different towns.
Does couples therapy work by video?
Yes, and for many couples it's easier. You each join from where you're comfortable, there's no commute to coordinate, and a session after the kids are in bed becomes possible. The structure of the session is the same as in person.
How long does couples therapy take?
Most couples do meaningful work in 12 to 20 sessions over four to six months, though it varies. We'll have a clearer picture together after the first three or four sessions. If it isn't working, I'd rather we name that early: How to Know When Couples Therapy Isn't Working.
What if we're not sure we want to stay together?
You don't need to have decided. Being unsure whether the relationship can be repaired, or whether you want it to be, is a common place to start, and getting clear on that is part of the early work.
Do you work with couples where one partner is drinking, using, or in recovery?
Yes. Before private practice I directed a residential addiction treatment program. Sobriety doesn't automatically restore trust, and the relationship usually needs its own attention alongside the recovery. Family and couples therapy for addiction and recovery →
Do you take insurance?
No. I'm private pay. Most insurance plans don't cover couples therapy anyway, because they require a mental health diagnosis for one partner. HSA and FSA cards work, and I can provide a superbill if your plan has out-of-network benefits. How much couples therapy costs in Massachusetts →
Fees and how to start
$200 per 50-minute couples session; 90-minute sessions are $250
Private pay. Superbills available for out-of-network reimbursement, HSA and FSA cards accepted, and a limited number of sliding-scale spots. Pricing and payment options →
Telehealth by secure video. Both partners need to be in Massachusetts or Vermont during sessions. I work with couples in Beverly, Salem, Newburyport, Marblehead, Gloucester, and across the North Shore, and in Stowe and Burlington.
How to start:
Free 15-minute phone call. Book a time and I'll call you. You can be on the call together or on your own.
A clear direction. You'll know whether I'm the right fit and what the first sessions would focus on.
Begin therapy. Structured sessions focused on your specific pattern, not a generic process.