Women are the main drivers of couples therapy, because that's how women operate. They use social pressure to get their way.

Looking at couples therapy from perspective of game theory(PUA game theory NOT "game theory"), it's mostly a puzzle of group dynamics. Therapist is an authority figure and thus has higher value than both hubby and wifey.

Since women have lots of hormonal fluctuations that creates emotional swings, they tend to need external structure to feel comfortable. Ideally that structure is provided by a man with a strong frame. Women don't like to be made to feel guilty about feeling certain emotions simply because they genuinely don't have complete control over their emotions.

But men with strong frames are not widely available and women hitch up with a nice guy who just doesn't understand that his wife's emotions are not his fault. So he take them personally and as a result makes his wife feels guilty about something she can't control. Thus making her feel insecure in herself.

But women have created a defense mechanism around this, "just blame the husband". So basically, nag on husband so that he lose confidence in himself and just avoid and then nag him on avoiding. So now, her emotions are a result of incompetence of her husband, and not her responsibility.

But even women know that its bullshit, so they create support groups to reinforce those beliefs. But women are not stupid, even they know that their marriage is failing because of it so they drag their husbands to couples therapy because that's the thing they were taught.

Couples therapists know that they will only earn money as long as couples keep coming. So they again reinforce women's point of view. Because women are the one to advocate for couples therapy, therapists know that they need to keep women happy.

Therapist also shames husband to keep him in line. They use their status of authority figure to play both husband and wife so that they can extract as much value as possible from the couple before they inevitably divorce.

Therapists just don't have the incentive to tell women that their emotions are their own problem to deal with. Esther Perel on the other hand says that to women and she has saved a lot of relationships.

Couples therapy is just exploitative and ineffective because the wife and therapist dont have incentive to actually improve things.

Wife doesn't want to address her faults and therapist doesn't wanna risk telling women her faults are causing problems, not her husband.

It's not just a waste of money, it's psychologically abusive, and extension of pathology that women experience while in relationships with a weak man.