The situation is a common one. A client comes for individual counselling or psychotherapy but either at the start or as the therapy progresses their partner also appears to be part of the struggle. Perhaps the client’s presenting problem appears closely intertwined with their significant other; for example, feeling depressed as a result of constant fighting at home. Maybe the client makes progress in their individual therapy but their partner struggles to accommodate their changing loved one. As a result the therapist may be left wondering if it would be helpful to include the partner in the therapy. However, most trainings – because they tend to concentrate on either individual or couple therapy – provide little guidance on how to manage these situations; either introducing the partner into the therapy dyad and thus changing to couple therapy, or adding a simultaneous individual or couple therapy to the original format. Without guidance it is likely the therapist will then either continue with what is familiar, hoping that it is adequate, or be faced with unknown territory if altering the therapy format is deemed necessary. This article explores that unknown territory in order to put together some best practice guidelines for managing these scenarios.