Emotionally focused therapy (emotion-focused therapy)

Emotionally focused therapy (EFT) is a type of psychotherapy primarily utilized by adult couples or families looking to improve their relationships. This type of therapy is usually meant to be short-term and has three stages: de-escalation, changing interaction patterns, and consolidation and integration. Originally designed as a type of marital therapy, EFT has expanded to include family therapy. The EFT approach builds off the psychological study of adult attachment and bonding. Therapists and patients discuss various patterns in the patients' relationships and focus on creating a more stable and trusting bond. The goal is to give the relationship a more positive and healthier direction. EFT is related to but distinct from emotion-focused therapy, also abbreviated as EFT. EFT has been widely studied, and evidence has supported its claims of success. Research has shown EFT helps decrease relationship distress and improves partner interaction. Follow-up studies have also shown EFT positively affected relationships years after therapy was completed.

Background

Therapists began applying EFT methods to their sessions in the 1980s. Psychologists Susan M. Johnson and Leslie S. Greenberg, who observed a growth in marital therapy over the previous decade, developed the approach. Both psychologists had been trained in the experiential approach to individual therapy and had experience in systemic family therapy. As more patients experiencing intimate relationship issues emerged, Johnson and Greenberg found themselves at a therapeutic standstill. Unable to successfully draw upon an existing therapeutic approach for marital therapy, the duo began creating their own model to address issues specific to intimate relationship counseling. They recorded their marital sessions and tried to observe what therapeutic approaches led to positive outcomes. They soon identified a pattern of attachment-themed fears in their recordings and reviewed what methods quelled said fears and promoted bond strengthening. The pair published a book about their new approach, titled Emotionally Focused Therapy for Couples, in 1988.

The EFT approach combines focuses from both individual and family therapy practices, specifically from the experiential and systemic approaches. The experiential focus of EFT encourages clients to allow themselves to experience their emotions as they feel them. The systemic focus homes in on patterns and cycles observed through patient interactions that could potentially be identified as detriments to relationship development. EFT emphasizes the power of emotional experiences in relationships and believes this power is useful in rebuilding intimate bonds. The goal of EFT is to incorporate emotional expression and any ensuing revelations into the relationship, creating a more adaptive and flexible relationship.

Johnson and Greenberg further developed their EFT approach in different ways. Greenberg concentrated his continued research on what he referred to as emotion-focused therapy, which was meant to be applied to individual therapy rather than joint therapy. Johnson continued to expand upon emotionally focused therapy, which she primarily applied to marital and familial therapy. Johnson's EFT came to emphasize a psychological model known as attachment theory, which examines how humans respond to threats to their relationships. Attachment theory holds that people need to feel safe in their connections to others to develop healthy relationships. Improving a client's emotional attachment to their partner is of central importance to the EFT approach.

Overview

Couples and families experiencing emotional distress are encouraged to try EFT to help mend their relationships. EFT often deals with relationship issues related to fear, anger, betrayal, and distrust. The EFT approach can also be applied to relationships experiencing difficulty due to the illness of a partner or family member. In addition, EFT can benefit clients experiencing depression or trauma related to relationship issues.

During EFT therapy, a therapist observes interactions between clients and connects their dynamics in the therapy setting to their dynamics in their home life. The therapist then uses these observations to prompt new conversations based in honest feelings. The clients' feelings play an important role in EFT. Therapists often ask their clients to examine their current emotional problems so they can identify feelings they may not initially recognize. Therapists encourage patients to mine for hidden emotions, which may be obstructed by the emotions they feel most strongly. The discovery of concealed emotions can help clients identify vulnerabilities that affect their relationships. Once identified, the therapist helps clients learn how to express these unearthed emotions in ways that foster better relationships with their partners or family members. Clients are also taught how to listen to their partners' or family members' feelings and respond in a productive manner.

EFT focuses on making changes in the present, which involves three stages. The first stage is de-escalating the clients' cycle of negative interactions that blind them to the root of their issues. The next stage reorganizes these interactions and gives clients the opportunity to discuss their fears. The therapist instructs clients to use language that strengthens their bond, refraining from conversation that hinders effective communication. The goal of this phase is to prevent clients from expressing their feelings in ways that push them away from each other. Clients learn to openly discuss their needs and, in turn, become more responsive to these needs. The final stage of EFT is consolidation and integration, during which the therapist reviews the clients' progress up until that point. The therapist highlights the negative patterns the clients exhibited at the beginning of therapy and shows the clients how they have changed these patterns over time. The clients are instructed to consolidate these lessons and integrate them into their home life so they may continue having these kinds of conversations in the future.

Bibliography

Budman, Simon H., et al., editors. The First Session in Brief Therapy. Guildford Press, 1992.

"Emotionally Focused Therapy." Psychology Today, www.psychologytoday.com/therapy-types/emotionally-focused-therapy. Accessed 25 Sept. 2024.

Freeman, Alan. "Psychologist Sue Johnson Started a Global Movement with Her 'Emotionally Focused Therapy.'" The Globe and Mail, 2 May 2024, www.theglobeandmail.com/canada/article-psychologist-sue-johnson-started-a-global-movement-with-her/. Accessed 25 Sept. 2024.

Greenberg, Leslie S.,‎ and Susan M. Johnson. Emotionally Focused Therapy for Couples. Guilford Press, 1988.

Johnson, Susan M. Emotionally Focused Couple Therapy with Trauma Survivors: Strengthening Attachment Bonds. Guilford Press, 2002.

Levy, Terry M., editor. Handbook of Attachment Interventions. Academic Press, 2000.

"What Is EFT?" International Centre for Excellence in Emotionally Focused Therapy, www.iceeft.com/index.php/about-us/what-is-eft. Accessed 25 Sept. 2024.