Therapy with couples on the brink of relationship dissolution involves unique challenges. Partners present with high levels of conflict, low levels of intimate connection, disdain and discouragement, and limited patience or hope. These couples have often tried therapy without lasting success, and announce that "this is our last chance". Partners want to see evidence in the first session that the therapist can offer something new and that change is possible.

Peter Fraenkel presents a practical, creative, integrative approach that combines action-and insight-oriented techniques to help last-chance couples manage conflict, modulate intense negative emotions, address power struggles, develop mutual compassion, and restore emotional intimacy and pleasurable connection. Special attention is paid to developing a collaborative therapeutic alliance when partners have little motivation for therapy or faith that it can be effective. Through engaging in "nonbinding experiments in possibility", partners can then better evaluate whether to "stay or go".