Thriving Couples Blog

Counseling individuals, families and couples in the Des Moines and Ames area -

Call today 888-233-4334

Ames Counseling Office            Des Moines Counseling Office

Frequent Answered Questions

Do you take insurance?

Most insurance companies do not pay for relationship issues.  We can bill insurance for some mental health issues. There are several companies that will pay us for therapy. You may contact your insurance company to find out what your coverage is for mental heath. You may contact our office if you have questions.

Because most insurance companies do not cover relationship issues under their medical insurance plan, most of our clients pay for their own therapy. They are willing to do this because of our unique approach.

How much does therapy cost?

We don’t like to discuss figures over the internet, but we are competitive and it is not as much as you might think. Please feel free to call us for details.

NOTE: Calling around for therapy to get the best price is not usually the best policy. In most instances like with a new car or CD player, if we pay more we expect more. This is not necessarily true with therapy. The most expensive therapist is not necessarily the best therapist. You want a therapist that fits with your goals. That is why we provide this information on the internet, so that you can make an educated choice

What if we are struggling financially and cannot pay your rates?

We make referrals to agencies in the area who have sliding fees or take government subsidies.

Do you take Title 19 or DHS, Crime Victims or other government subsidies?

No. These programs do not cover marital which is our main area of expertise.

How do clients pay for therapy?

Clients pay at the end of each session with cash, personal check, or credit/debit card. Cash machines are located close to both offices.

Do you have a sliding fee scale?


Questions About Affairs

What if one of us (or both) has had an affair?
Affairs are one of the most common problems we see in marital therapy.  It is very difficult to handle alone and marital therapy is very important.  There are three issues to deal with:
1.   What led to the person’s affair and working on self-care so it won’t happen again
2.    How the spouse who didn’t have the affair is handling this discover
3.    How the couple can reconnect after the loss of trust
These are very important issues to work through and couples are rarely equipped to handle them without some assistance.  We’ve helped many couples navigate their way through these waters.  If the partner who had the affair is willing to end the affair and work on the marriage the prospects for the couple are very good as long as they are able to do the work they need to do.  We have steps couples can take to restore their relationships after an affair.

What if I’ve had an affair and haven’t told my spouse?

The most significant thing about an affair is the secrets.  Without secrets affairs wouldn’t happen.  If secrets continue, it is very difficult to feel a person is genuine and close.  We can help in this process.

What if I suspect my spouse has or is having an affair?

The problem with affairs is secrets.  The problem with snooping is secrets!  Most people don’t tell their partner they are snooping.  Secrets by either spouse is a problem.  If one person is having an affair that is one problem.   If one person is snooping that is another problem.  Accountability is important, but accountability is NOT snooping.  Call us today 888-233-4334. We help sort out the difference so that you can build trust together

What About Anger, Fighting and Domestic Violence

What if the physical violence or the threat of violence is a concern?
The number one concern is safety.  If your life or well-being is threatened, getting away to a safe place may be in order.  There are domestic abuse shelters for spouses and children when a partner is unwilling to cooperate with counseling.

If both partners are willing to work together on reducing abuse, we can be of assistance.  While the person who commits the acts of violence is responsible for his or her actions, partners can work together to make their interactions around conflict more positive.  We take a pro-active approach to teach couples other ways to interact, which, if followed,  can eliminate abuse from the family.  Call us today at 888-233-4334.

What if we have a no contact order but we still want marital therapy?
If you have a no contact order, that means no contact, including therapy, unless you get a judge’s order to make marital therapy an exception to the order.  In some cases the no contact order may be removed in entirety if the couple is motivated to learn how to resolve their differences in a mutually beneficial way.

If you have a no contact order and wish to go to joint therapy, talk with your lawyer and/or judge to get the court order removed or to have marital therapy inserted as an exception.  If the latter, please bring a written copy of the court order with you when you start therapy with us.

What if one of us has received a court order for marital therapy?
Certainly it is more helpful if both partners come to marital therapy because they want to.  If they come because the court has ordered them it is often difficult to create an atmosphere of cooperation.  However, we have several services that may be of benefit even for the most conflictual couple:
1.    We can help the couple negotiate their differences (property and child custody) so that when they go to their lawyers, most of the details are worked out to the couple’s satisfaction
2.    We can help the couple discuss the issues that led to their breakdown so that there is more understanding between partners
3.    We can assist the couple in learning to be respectful and to get along in the future as they will still be in contact around their children in the future for years to come.
4.    We can help partners resolve pain around their relationship hurts.  In some cases this may lead the partners to reconsider their pending divorce.  However, we do not try to talk a partner out of his or her decisions.  We seek to create an atmosphere of understanding.

NOTE: We are not lawyers and do not give legal advice.  Lawyers seek to represent their clients’ best interest.  Our goal is to help people get along.  Sometimes these two goals are compatible; sometimes they are not.

Does Marital Therapy Actually Save Marriages?

A Common Fear:
Recently, there has been some discussion (here) amongst therapists and marital researchers about how sometimes therapy leads to divorce.  Counselors not trained in marital therapy or who have a negative view of marriage from the get-go, may steer their clients to “listen to their feelings” or “do something for yourself.”  They may inadvertently or intentionally encourage their clients to consider divorce in order to be happy.  Our opinion is that divorce has it’s own pitfalls and seeking divorce in order to be happy is not the right reason to divorce.  Happiness is nebulous and difficult to attain and should not be sought for it’s own sake.  Happiness is the result of right choices.  Certainly, we help clients think through their options.  But we also help them look at things they might have missed or look at things differently.

To see Dr. Wall’s philosophy of marital therapy see here.

What if My Spouse Won’t Come to Therapy?

What if my spouse isn’t interested or won’t come to marital therapy?
We encourage partners to come together to marital therapy at Heart to Heart Communication.  Our approach is to NOT take sides of one partner against another, but to seek understanding between people.  We attempt to help couples minimize blame and to come together as partners again. 

Our approach is pro-active. 

We don’t just sit and let one partner hammer the other partner.  We give ideas that are practical and can make a difference in a couple’s life.  Often these results are noticed immediately.

REMEMBER: marriage is made up of only two people.  If one of you think the marriage is in trouble then it is in trouble!!!  It is time for both to heed this and start to work on their marriage.

NOTE: Most people aren’t afraid to contact a heart surgeon for heart surgery, or a master mechanic to overhaul the car’s engine, or a dentist to take care of teeth.  Yet many people think they can fix their marriages on their own without any help from others.  Marriage is our expertise. 

Dr. Wall, the founder of Heart to Heart Communication, has his Ph.D. in Marriage and Family Therapy, has done extensive research in marriage and continues to train the Heart to Heart Communication staff in marital therapy.  It is a specialized area of expertise that is available to you to help you navigate the rough waters of marriage today.  It is not a sign of weakness to ask someone who is an expert what they think. 

An old proverb says, “A wise man listens to advice, but a fool rushed headlong to destruction.”  Advice may not be supportive of American individualism, but it certainly can save a marriage!  We know what destroys marriages.  We know what saves marriages.  We know how to intervene with troubled marriages. 

This is what we do! 

Let us tell you a bit about the road you are traveling down, because we’ve mapped this territory out with others.  We’ve been down the road before.  We know where the bumps are, the watering holes, the cliffs and obstacles.   This is information that can save your marriage!!! 

However, not all partners will come to therapy even if they’ve read the info on our website!  If only one person is willing to come to therapy we encourage that partner to come.  One person can make a difference.  We still maintain a positive approach and seek solutions, rather than letting therapy becoming a complaining session where the absent partner is blamed for the problems in the marriage.

What About Remarriage and Step Families

Research indicates that marriages beyond the first one are more fragile than first marriages.  People in second marriages break up at higher rates than first marriages.  This is easy to figure out.  Divorce is very difficult and most people struggle a long time before they go through with it.  But once a road has been traveled down it is much easier to go back down that road.  In addition, people who remarry often have not had the time to heal from the first marriage and these hurts are brought into the second marriage.  PLUS, even without these concerns, step-families bring with them their own unique set of problems that cannot be ignored.  We know what these issues are and can help couples prepare for inevitable situations and feelings that step-families will face.  PRE-marital counseling for potential step-families is HIGHLY recommended.  If you are already married, don’t worry.  We can assist you in making your marriage what it needs to be.

What About Separated, Filed for Divorce and Divorce

What if one of us wants to leave?
In certain circumstances, a little space can be a part of a partner’s healing.  However, without assistance, separation often leads to divorce.  Separation is a difficult thing to manage even with marital therapy.  Without assistance, separation can prove fatal.
There are two kinds of separation:
a.        Separation to work on the marriage
b.        Separation to divorce
Most people are only aware of separation to divorce so they are very threatened and assume the worst about separation.  We can help you navigate separation so that it works for you instead of causing you more marital trouble.  CALL US IF AT ALL POSSIBLE BEFORE YOU SEPARATE.  If you have already separated we can still help, but the process will be a little more difficult.

What if we’ve already separated, but still want to work on the relationship?
Give us a call!  Often during separation people realize things they didn’t before.

What if one of us has already filed for divorce but we both want to work on the relationship?
Our experience indicates that not everyone who files for divorce wants to get a divorce or ends up in a divorce.  People file for divorce often change their minds or didn’t even intend to divorce from the beginning as they tell us they were just trying to get their partner’s attention that the relationship is in trouble.  Often the one who files is still ambivalent about divorce and hoping that taking some action will give them a sense of peace that doesn’t come.  We have been able to help many couples stay together even after they’ve filed.

What if I’m divorced?  Can you help me?

The process of divorce is one of the most painful of experiences whether or not a person pursued the divorce.  Some have said that divorce is even more painful than having a spouse die, because at least if the spouse died, a person realizes it was not his or her fault.  Divorce always carries with it the might-have-beens.  This is tough to deal with alone.  We can help people heal from this so that they can face their next relationships with more dignity.  Unfortunately, many people who divorce don’t get the help they need and get into another relationship too soon or before they have changed personally.  They end up doing the same mistakes a second time.  Research indicates that second marriages are more likely to fail than first marriages and third marriages are more likely to fail than second marriages.  Doing the work you need to BEFORE you are romantically involved, will help insure your later marriage against possible failure.

What About Cohabiting Without Marriage

What if we aren’t married?
Today there are literally millions of couples living together who are not married.  Most of these, we believe, are living together because they have experienced or have seen married people hurt each other and their children through divorce.  It is often a fear of getting divorced themselves that keeps people from getting married.  We understand this fear because we see the ravages of divorce in therapy regularly.

If you are living together and not married, we are not going to beat you up about that and tell you you are bad people.  We will help you get along better with your partner so that you can feel better about the relationship and more hopeful so that marriage does not seem so threatening.  When cohabiting couples break up it can be even more painful than when married couples divorce.  A break up is a break up regardless of levels of commitment.  If love and sexuality have been shared together, cohabitation does not take away the pain of the relationship failing. In fact, the uncertainty of the relationship, because of the lack of commitment, can add to the feeling of insecurity in the relationship which often prohibits couples from experiencing the love they so much desire

Do you see dating or engaged couples?

We highly recommend pre-marital counseling for couples planning to get married.  Research indicates that how partners treat each other before they marry predicts if they will get a divorce later!  We can show what these divorce predictors are and how NOT TO DO THEM!!  The material we share from PREP (link) helps couples reduce their chances of divorce.

Do You See Individuals in Therapy?


Some individuals we see are married, divorced, single, widowed or in a serious relationship.  Most people realize that the majority of problems they face have to do with relationships (your relationship with yourself and your goals, your spouse, fiance, partner, parents, children, siblings, workmates, career, God, the boy or girlfriend you don’t seem able to find).  We are relationship experts and help people deal with those issues.

What are some signs that may indicate we should come to therapy?

1.    You notice your love for your spouse seems to be getting less and less over time.
2.    You feel resentment toward your spouse.
3.    You notice you haven’t gone out on a date with each other for a long time.   You never seem to have the time.
4.    Something seems unfair to you (for example, not enough sex or one person doesn’t help enough around the house) and you don’t seem to be able to get anywhere.
5.     You notice you are starting to be tempted to have an affair.
6.    You look for ways to not be with your spouse.
7.    You are afraid to talk about certain things for fear it will break into an argument or unpleasant feelings.
8.    One of you has had an affair.
9.    You don’t seem to be able to communicate.
10.    Your spouse doesn’t seem to be there for you.
11.    If feels like you do all the giving in the relationship.
12.    Your spouse acts pretty selfish.
13.    Some of your spouse’s choices really bother you.
14.    You feel you are on a different spiritual path than your partner.
15.    You are starting to feel like you have different overall goals from your partner.
16.    You have too many arguments that end up nowhere.
17.    You don’t seem to be able to resolve differences.
18.    Sexuality seems boring.
19.    You don’t want to have sex anymore (or never wanted it).
20.    You feel pressured to have sex.
21.    You feel rejected by your spouse.
22.    Your partner seems repulsed by you sexually.
23.    You feel your partner doesn’t love you any more.
24.    You feel your partner doesn’t respect you any more.
25.    Your spouse used to be your best friend, but now???
26.    Your spouse doesn’t come home from work til very late.
27.    Your spouse has a lot of time where you don’t know where he or she is.
28.    You don’t ask your spouse questions for fear you’ll be attacked or he or she will be defensive.
29.    You feel more and more distant from your spouse.
30.    Your spouse’s or your drinking is starting to be a problem.
31.    You are feeling very depressed about life or your marriage.
32.    You are feeling lonely in the relationship.
33.    You are starting to feel like you are losing hope in the marriage.
34.    Your partner seems to ignore your suggestions.

If ANY of these are starting to occur, Call us today 888-233-4334.

NOTE: This is a small list and there certainly could be other concerns.

NOTE: The earlier you call us in the development of these types of concerns, the easier it is to work on them and develop new habits to restore hope in the marriage.

What if we’re doing pretty well and just want a marriage tune-up?
This is the type of work we like to do because it is rewarding to see couples improve an already great relationship.  All couples could use some outside inspiration to keep their marriages on tract.  Fifty years ago you could let your relationship flounder, but that is no longer the case.  People want satisfying relationships and unfortunately, for many, if they are not finding that, they seek satisfaction elsewhere. It is much better to come to us before you need to talk to a lawyer.  We have had many people who come to see us after their spouses have said, “it’s too late.”

What about spiritual issues?

Dr. Wall was a pastor 15 years before completing his doctoral work in marriage.  The other therapists that work with Dr. Wall have spiritual backgrounds as well.  We understand that spirituality is a fundamental way of life for many people.  We seek to help partners harness their relationship with God to improve their own attitude, to give them strength and to give them guidance on how to live.   We do not seek to convert clients to any particular faith, but are available to help them use the faith they already may have.  We go at the client’s pace and do not force spirituality upon anyone.  Because we respect and honor people’s faith we have many pastors who refer clients to us.  We also have many clients who may not have a faith, but in the midst of their problems, realize that it is time to look into this area of their lives.  We encourage these folk in therapy about their budding interest in spiritual things and make referrals to local churches as appropriate to the client.
NOTE: if you are NOT interested in spiritual things, don’t worry.  Our task is to help you with the problems you present to us.  We may ask about your interest in spiritual things and if this is not an area you want to explore we respect your decision.

What about bad habits like sexual exploration on the internet, pornography, alcohol and drugs?

These issues are detrimental to marital relationships.  We seek to work with couples with both partners together on these issues so that they can be a resource for each other instead of being at odds with each other.

Need Individual Or Couples Counseling? Call 888-233-4334 or email