Why would someone assume that a rabbi is equipped to handle marital issues?
If a spouse is abusive, is a rav going to convince him/her to stop by citing Torah sources why it’s forbidden?
What training does a rav have to recognize deeper issues than surface conflict? Can a rav recognize a personality disorder? How about a mood disorder? Would a rav be able to state the criteria by which a person would be categorized as being bipolar, and possibly needing medication?
There are situations where a rav can help, but very often conflicts run deeper and need a very different kind of intervention.