Many of the comments here are well thought out and I am wondering if some of theses posters are not therapists themselves. From a laymen’s perspective all I can say is just like there are certain Rabbonim who know the “fifth” cheilik so too there are therapists that are good for certain situations and not for others. Sometimes the chemistry does not mix no matter how competent the individual.
It all starts with the level of motivation by the individuals to try and resolve their particular issues. The therapist to a large extent is a referee to ensure that the issues are addressed in a fair and open fashion which will allow the therapist to suggest possible options to the parties involved.
Many posters have correctly pointed out that the situation is not helped by trying to give mussar. The credibility of the therapist is based on their being impartial and not assigning blame.
I would think that not too many Rabbonim are equipped to deal with these issues and the smart ones readily acknowledge that fact.
My final observation is a personal one. In our parents and grandparents generation very few people went to therapists. It obviously does not mean that all marriages were great. Far from it. For the most part though, the previous generation had a certain amount of maturity and respect for their spouses that one does not see today. It is more of a “me” generation and many people either from immaturity or stubbornness are not willing to make the sacrifices that are necessary for a smooth marriage. The alternative is the “living h_ll” marriages we so often hear about.It is a reflection of the society we live in and the values that have crept into our communities. Prime example is the divorce rate in The Chassidishe communities. From being non existent 25 years ago it is becoming a very common event.
My humble suggestion would be for all chosson and kallahs to take mandatory pre marital counselling in interpersonal relations and financial budgeting as a bare minimum. It should be given the same importance as going through the Dor Yeshurun procedure. It will avoid many of the issues that crop up later.