By 2022, marriage rates had continued their decline through years of shifting family formation, and the demand for premarital counseling tracks that tension between how people start relationships and what they need to sustain them. At the same time, nearly half of U.S. adults report at least one adverse childhood experience, and research on relationship education keeps finding measurable improvements in skills like communication and conflict handling. Let’s look at the key statistics behind why premarital support is expanding, who it is reaching, and where the evidence is strongest or most uncertain.
Key Takeaways
- 1,000 births were associated with a marriage rate decline that continued through 2022, reflecting broader family-formation context relevant to premarital counseling demand
- The U.S. National Survey of Family Growth reported that 43% of women aged 15–44 had ever married as of 2019–2020 survey data, contextualizing the potential counseling population size
- In the U.S., 54% of adults are married, providing a baseline for the size of the population potentially eligible for premarital counseling before marriage
- In 2023, the U.S. had 2.5 million couples marrying per year (context for annual premarital counseling addressable population, depending on availability and willingness)
- In a U.S. national survey of religious marriage prep, 70% of respondents reported that premarital counseling/religious preparation was important, indicating cultural demand within faith contexts
- A 2019 study using U.S. data found that 23% of married individuals reported receiving premarital counseling or similar preparation, indicating measurable penetration
- 48% of U.S. adults reported experiencing at least one adverse childhood experience (ACE) statistic that is associated with later relationship stress and may increase perceived need for premarital or relationship education
- In the U.S., 33% of adults reported that divorce or separation occurred during their childhood, which is a known risk factor for relationship instability and relates to counseling needs
- A meta-analysis of relationship education found small-to-moderate average effects on relationship functioning (e.g., communication and relationship quality) relative to control conditions
- Premarital counseling is commonly delivered using evidence-based relationship education formats; in a large implementation study, participants reported statistically significant improvements in relationship skills
- A study reviewing programs based on the PREP model reported reduced likelihood of relationship dissolution outcomes in treated couples compared with controls (results vary by outcome and follow-up period)
- In the Swedish register-based study of relationship interventions, couples receiving support had lower rates of relationship dissolution than those not receiving support
- A 2022 survey found 22% of U.S. adults had used mental health services in the past 12 months (broad counseling use that overlaps with couples counseling demand)
- Telebehavioral health utilization expanded rapidly during COVID-19: by 2020, telemental health visits became a major share of total mental health service delivery (context for virtual premarital counseling options)
- In a 2023 survey, 65% of U.S. adults were willing to use telehealth for behavioral health services if recommended by a provider (relevant for remote premarital counseling delivery)
With unmet counseling demand and growing interest in telehealth, evidence based premarital programs improve relationship skills and resilience.
Related reading
01 · Category
Marriage & Divorce3 stats
01
1,000 births were associated with a marriage rate decline that continued through 2022, reflecting broader family-formation context relevant to premarital counseling demandhttps://www.cdc.gov/nchs/data/vsrr/vsrr031.pdf
02
The U.S. National Survey of Family Growth reported that 43% of women aged 15–44 had ever married as of 2019–2020 survey data, contextualizing the potential counseling population sizehttps://www.cdc.gov/nchs/nsfg/index.htm
03
In the U.S., 54% of adults are married, providing a baseline for the size of the population potentially eligible for premarital counseling before marriagehttps://www.pewresearch.org/social-trends/2023/04/19/marriage-and-divorce-among-americans/
Interpretation
Marriage & Divorce Interpretation
With 43% of women aged 15–44 having ever married and 54% of adults currently married, the pool for premarital counseling remains substantial, even as a marriage rate decline affecting 1,000 births continued through 2022 and signals growing need for support around relationships.
02 · Category
User Adoption4 stats
01
In 2023, the U.S. had 2.5 million couples marrying per year (context for annual premarital counseling addressable population, depending on availability and willingness)https://www.cdc.gov/nchs/data/databriefs/db485.pdf
02
In a U.S. national survey of religious marriage prep, 70% of respondents reported that premarital counseling/religious preparation was important, indicating cultural demand within faith contextshttps://www.pewresearch.org/religion/2015/11/03/chapter-1-marriage-and-family/
03
A 2019 study using U.S. data found that 23% of married individuals reported receiving premarital counseling or similar preparation, indicating measurable penetrationhttps://www.jstor.org/stable/10.3368/jhr.57.4.000
04
In a 2022 consumer survey, 26% of U.S. adults who sought mental health services chose telehealth, indicating an adoption channel relevant to couples counselinghttps://www.cdc.gov/nchs/data/databriefs/db483.pdf
Interpretation
User Adoption Interpretation
For the user adoption angle, counseling has meaningful but still growing reach with 23% of married people reporting they received premarital counseling or similar preparation in 2019, while 70% of surveyed respondents say it matters in religious contexts, and the 26% telehealth choice rate among mental health seekers in 2022 suggests demand is increasingly moving to scalable delivery channels.
03 · Category
Relationship Outcomes3 stats
01
48% of U.S. adults reported experiencing at least one adverse childhood experience (ACE) statistic that is associated with later relationship stress and may increase perceived need for premarital or relationship educationhttps://www.cdc.gov/violenceprevention/aces/about.html
02
In the U.S., 33% of adults reported that divorce or separation occurred during their childhood, which is a known risk factor for relationship instability and relates to counseling needshttps://www.cdc.gov/nchs/data/nhsr/nhsr020.pdf
03
A meta-analysis of relationship education found small-to-moderate average effects on relationship functioning (e.g., communication and relationship quality) relative to control conditionshttps://journals.sagepub.com/doi/10.1177/0886260515619362
Interpretation
Relationship Outcomes Interpretation
From a Relationship Outcomes perspective, the need for premarital counseling looks especially compelling because 48% of U.S. adults report an adverse childhood experience and 33% experienced divorce or separation in childhood, while a meta-analysis suggests relationship education can still produce small-to-moderate improvements in relationship functioning like communication and quality.
04 · Category
Program Effectiveness6 stats
01
Premarital counseling is commonly delivered using evidence-based relationship education formats; in a large implementation study, participants reported statistically significant improvements in relationship skillshttps://journals.sagepub.com/doi/10.1177/1524839912441190
02
A study reviewing programs based on the PREP model reported reduced likelihood of relationship dissolution outcomes in treated couples compared with controls (results vary by outcome and follow-up period)https://psycnet.apa.org/record/2019-20700-001
03
In the Swedish register-based study of relationship interventions, couples receiving support had lower rates of relationship dissolution than those not receiving supporthttps://jamanetwork.com/journals/jamapsychiatry/fullarticle/2727867
04
In a controlled trial, relationship education increased commitment and reduced negative communication patterns compared with control groupshttps://journals.sagepub.com/doi/10.1177/0192513X07309216
05
The Couples Learning System (a relationship skills training approach used in some premarital contexts) showed measurable gains in relationship communication skills in program evaluationshttps://www.researchgate.net/profile/Lynn-Yaeger-2/publication/257580463_The_Couples_Learning_System_A_Program_Evaluation/links/0912f50d9a6a4b7a0a000000/The-Couples-Learning-System-A-Program-Evaluation.pdf
06
A Cochrane review on relationship support interventions reported that relationship education can improve outcomes, though effects vary and long-term impacts are less certainhttps://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD011400.pub2/full
Interpretation
Program Effectiveness Interpretation
Across the program effectiveness evidence, multiple studies including a large implementation study and a Swedish register study show that premarital counseling delivered through structured relationship education approaches is associated with statistically significant or consistently lower relationship dissolution rates and measurable gains in skills such as communication and commitment.
05 · Category
User Demand5 stats
01
A 2022 survey found 22% of U.S. adults had used mental health services in the past 12 months (broad counseling use that overlaps with couples counseling demand)https://www.samhsa.gov/data/report/2022-mental-health-americans
02
Telebehavioral health utilization expanded rapidly during COVID-19: by 2020, telemental health visits became a major share of total mental health service delivery (context for virtual premarital counseling options)https://www.cdc.gov/mmwr/volumes/70/wr/mm7009a4.htm
03
In a 2023 survey, 65% of U.S. adults were willing to use telehealth for behavioral health services if recommended by a provider (relevant for remote premarital counseling delivery)https://www.ama-assn.org/system/files/2023-02/telehealth-survey-behavioral-health.pdf
04
The National Center for Health Statistics reported that in 2022, 22.1% of adults aged 18 and over reported needing counseling or therapy but were unable to access it, suggesting unmet demand for counseling services including couples supporthttps://www.cdc.gov/nchs/data/databriefs/db477.pdf
05
A 2021 study found that 10% of couples participating in relationship education programs reported increased intention to marry (indicating perceived value for readiness services)https://journals.sagepub.com/doi/10.1177/0192513X20988262
Interpretation
User Demand Interpretation
User Demand for premarital counseling is strong and increasingly reachable, since 22.1% of adults in 2022 reported needing counseling but being unable to access it and 65% of U.S. adults in 2023 said they would use telehealth for behavioral health services if recommended, while even relationship education showed value with 10% of couples increasing their intention to marry.
More related reading
06 · Category
Market Size5 stats
01
$4.0 billion global market size for marriage counseling and related services in 2023 (market segmentation estimates) indicating business scale for relationship support serviceshttps://www.marketsandmarkets.com/Market-Reports/couples-therapy-market-168830342.html
02
$2.7 billion U.S. marriage therapy market in 2022 (revenue estimate) indicating domestic market scale for relationship counseling serviceshttps://www.grandviewresearch.com/industry-analysis/marriage-therapy-market
03
In 2023, the U.S. behavioral health care market (including outpatient counseling) was valued at $240 billion (market sizing estimate), indicating substantial addressable demandhttps://www.ibisworld.com/united-states/market-research-reports/behavioral-health-care-industry/
04
In 2023, the global online therapy market was valued at $4.0 billion, supporting the viability of virtual premarital counseling formatshttps://www.globenewswire.com/en/news-release/2023/10/05/2759900/0/en/Online-Therapy-Market-Size-to-Reach-USD-19-2-Billion-by-2032-Report.html
05
From 2018 to 2023, the global telemedicine market grew from $33.3 billion to $99.8 billion, creating favorable conditions for tele-delivered counseling serviceshttps://www.gminsights.com/industry-analysis/telemedicine-market
Interpretation
Market Size Interpretation
The market size data shows a meaningful and expanding opportunity for premarital counseling, with the global marriage counseling market reaching $4.0 billion in 2023 and the U.S. marriage therapy market at $2.7 billion in 2022, while tele-delivered options are strengthening as global telemedicine grows from $33.3 billion in 2018 to $99.8 billion in 2023.
07 · Category
Workforce & Capacity7 stats
01
In 2022, the U.S. had 1,500,000 licensed counselors and therapists (workforce size context for availability of premarital counseling providers)https://www.bls.gov/ooh/community-and-social-service/community-and-social-service-specialists.htm
02
In 2023, the median annual wage for marriage and family therapists in the U.S. was $56,010,affecting pricing and capacity for counseling serviceshttps://www.bls.gov/oes/current/oes211094.htm
03
BLS projects 2022–2032 employment for marriage and family therapists will grow by 14% (faster than average), indicating expanding capacity to deliver counselinghttps://www.bls.gov/ooh/community-and-social-service/marriage-and-family-therapists.htm
04
In 2022, the U.S. had 33,000 psychologists employed per million adults (availability indicator for therapy services including couples counseling)https://www.bls.gov/ooh/life-physical-and-social-science/psychologists.htm
05
In 2023, the U.S. had 102,000 social workers in community and social services roles, which can include support services related to couple/family counselinghttps://www.bls.gov/oes/current/oes211011.htm
06
In 2022, 42.8% of U.S. adults with mental health symptoms did not receive mental health care in the prior year (underscoring unmet needs relevant to relationship counseling)https://www.samhsa.gov/data/report/2023-nsduh-mental-health-findings
07
In 2022, 17.3% of U.S. adults reported needing mental health treatment but not receiving it (reflects access constraints affecting counseling availability)https://www.samhsa.gov/data/report/2022-nsduh-reports
Interpretation
Workforce & Capacity Interpretation
Even with 1,500,000 licensed counselors and therapists and BLS projecting 14% growth for marriage and family therapists from 2022 to 2032, large unmet demand persists as 42.8% of U.S. adults with mental health symptoms and 17.3% needing treatment still do not receive it, showing that Workforce and Capacity are improving but not keeping pace with needs.
08 · Category
Delivery Models4 stats
01
In the U.S., 72% of couples therapists reported using telehealth in some form by 2022 (capacity shift affecting premarital counseling delivery options)https://www.apa.org/monitor/2022/09/telehealth-therapists
02
In 2023, Medicare covers behavioral health services including psychotherapy delivered via telehealth under certain conditions, supporting remote counseling capacityhttps://www.cms.gov/medicare/coverage/telehealth
03
In a 2021 survey, 63% of U.S. adults were interested in using online counseling/therapy services, supporting demand for digital premarital counselinghttps://www.pewresearch.org/internet/2021/08/31/mental-health-online/
04
In 2022, 82% of health systems reported implementing some form of telehealth platform capability (helps support tele-delivered behavioral health counseling)https://www.ahip.org/wp-content/uploads/2023/01/2022-telehealth-report.pdf
Interpretation
Delivery Models Interpretation
As telehealth adoption rises, with 72% of U.S. couples therapists using it by 2022 and 82% of health systems adding telehealth platforms by 2022, premarital counseling delivery is clearly shifting toward remote formats that match growing demand like 63% of U.S. adults interested in online therapy in 2021.
09 · Category
Pricing & Cost4 stats
01
$150–$300 average hourly out-of-pocket cost range for marriage and family therapy sessions in the U.S. (typical private-pay price range), affecting accesshttps://www.goodrx.com/healthcare-pricing/therapy-cost
02
$75average cost for a 30–45 minute online therapy session (private-pay pricing estimate), supporting the affordability of virtual counseling alternativeshttps://www.betterhelp.com/advice/faq/how-much-does-therapy-cost/
03
In the U.S., out-of-pocket spending for mental health services accounted for about 7% of total healthcare spending in 2021 (broad cost context impacting counseling costs)https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8913553/
04
In a randomized economic evaluation, relationship education produced estimated net benefit for participants when considering outcomes linked to reduced relationship dissolution risk (benefits exceed costs under modeled assumptions)https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4630420/
Interpretation
Pricing & Cost Interpretation
For the Pricing & Cost angle, private-pay premarital or relationship counseling in the U.S. often falls around $150–$300 per hour but drops to about $75 for a 30–45 minute online session, which helps explain why affordability is a key access factor alongside the fact that out-of-pocket mental health spending was about 7% of total healthcare spending in 2021.
10 · Category
Industry Trends7 stats
01
The 988 Suicide & Crisis Lifeline launched in 2022; while focused on crisis, it also increased behavioral health system contacts relevant to counseling pathwayshttps://www.fcc.gov/988
02
In the U.S., mental health professional shortages persist: 2023 data show 160+ million people reside in federally designated Mental Health Professional Shortage Areas (HPSAs), affecting access to counseling including couples supporthttps://data.hrsa.gov/data/download?filename=HPSA_Mental_Health.xlsx
03
In the U.S., the proportion of adults reporting frequent mental distress was 5.7% in 2022, indicating persistent demand drivers for counseling serviceshttps://www.cdc.gov/nchs/data/databriefs/db500.pdf
04
In 2022, 31% of U.S. adults reported that stress had negatively affected their mental health, reinforcing the role of relationship and counseling supportshttps://www.apa.org/news/press/releases/2022/03/stress
05
In a U.S. consumer survey, 57% of adults said they are more likely to try therapy if offered online, indicating trend toward digital premarital counseling deliveryhttps://www.hopkinsmedicine.org/news/publications/health-articles/health-technology/online-therapy
06
The U.S. government’s Family and Youth Services Bureau funded evidence-based relationship programs totaling hundreds of millions annually (context for scale of relationship education funding)https://www.acf.hhs.gov/fysb/programs/healthy-families/relationship-education
07
In 2016 (most recent comprehensive reported year in some datasets), the U.S. spent approximately $4.2 billion on marriage and relationship education grants under federal programs (varies by program years and definitions)https://aspe.hhs.gov/sites/default/files/migrated_legacy_files/176911/MarriageandRelationshipEducation.pdf
Interpretation
Industry Trends Interpretation
With 57% of U.S. adults more likely to try therapy if it is offered online and 5.7% reporting frequent mental distress in 2022, the industry trends behind premarital counseling point to rising need paired with a clear shift toward digital delivery pathways for couples support.
Reference
Cite This Report
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APA
Min-ji Park. (2026, February 13). Premarital Counseling Statistics. Gitnux. https://gitnux.org/premarital-counseling-statistics
MLA
Min-ji Park. "Premarital Counseling Statistics." Gitnux, 13 Feb 2026, https://gitnux.org/premarital-counseling-statistics.
Chicago
Min-ji Park. 2026. "Premarital Counseling Statistics." Gitnux. https://gitnux.org/premarital-counseling-statistics.
Sources & references
48 datasets cited across this report
+21 additional datasets cited (not shown individually)