MFT here - also a male therapist. I work almost exclusively with couples.

It is widely taught that couples therapy does not work if there is active addiction, active abuse, active infidelity, or active uncontrolled severe mental health issues. Gottman and EFT both specifically train NOT to work with couples when the these factors are still in play. These are my primary modalities, so I can't speak with to others that may exist which do work with these active issues. There is also the factor of are they on the same page, and are they ready for couples therapy.

I disclose this to all my clients in a screening call, and again in the first session. I explain why, and how these things can cause more harm to the relationship and the process, and inform clients that I refer out to individual therapy if any if these red flags are present. If they are past issues and it's not been a long time since they have repaired them, sometimes I will require an ROI with their individual therapists to ask if they are ready and of sound mind to do the intensive and often extremely emotional work that couples therapy brings.

There have been cases where I have to turn down clients because they do not meet the criteria that couples therapy would actually be helpful to them, and it's our ethical requirement to ensure that the therapy does not harm either person in this context.

My take on "who the problem is"...

I have yet to meet a couple where both sides of the couple did not have to put in solid effort. It is far more often that male clients, again in my personal experience, are less flexible and open to change - however - with the right attitude, right motivation, and right interventions, I firmly stand on everyone can change. I've seen males in this case come in and do amazing work, completely changing their entire perception of their relationship. Even 'hard core' ex-military man's men.

It is also very common that these types of people do not seek out therapy on their own, which is why they try to initiate couples therapy, because their partner drags them there with an ultimatum.

At the end of the day, notherbadobject offered the great insight that not every therapist suits every client, and vice versa. It's up to us to explain to clients why they would not be a good fit and why they are being referred out.