Those undertaking therapy with couples will undoubtedly at some point during their work encounter the technically challenging question of deciding how best to proceed when the couple therapist's designated patient, that is the couple, fails to attend and instead the therapist is confronted with the presence of only one of the partners. Equally, couple therapists must also consider under what circumstances, if any, it is advisable to see and work with only one of the partners. This paper is therefore concerned with exploring the complexity involved in undertaking couple therapy in the presence of only one of the partners and the implications of this for the therapy as a whole. Given the importance of this topic for couple therapists, it seems surprising that there is such a paucity of literature on the matter, and so this paper is attempting to address a gap in thinking and practice for those undertaking couple therapy.