Emotionally Focussed Therapy (EFT)

Emotionally Focused Therapy (EFT) is a short-term form of therapy that focuses on adult relationships and attachment/bonding.

The therapist and clients look at patterns in the relationship and take steps to create a more secure bond and develop more trust to move the relationship in a healthier, more positive direction.

EFT is one of the most researched methods In the field of psychotherapy it is a proven treatment for couples and families.1, 2

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Emotionally Focussed Therapy (EFT)

WHAT IS EMOTIONALLY FOCUSSED THERAPY (EFT)?

Emotionally focused therapy, an intervention based on scientific study of adult love and bonding processes in couples, is designed to address distress in the intimate relationships of adults.

Strategies from emotionally focused therapy can also be used in family therapy to help family members connect and improve emotional attachment. Couples seeking counselling to improve their relationships may find this method a beneficial approach, as it can help people better understand both their own emotional responses and those of significant people in their lives. 

Therapists who provide emotionally focused couples therapy (as the approach is also known) typically work with couples and families to help facilitate the creation of secure, lasting bonds between intimate partners and family members and reinforce any preexisting positive bonds, with the goal of helping those in treatment increase security, closeness, and connection in intimate relationships. 

The overarching goals of EFT are straightforward and focused, providing clients with consistent direction during what is often a tumultuous adventure :

  • Creating secure attachment for both partners
  • Developing new interaction patterns that nurture and support each partner
  • Increasing direct expression of emotions, especially those related to attachment needs

HOW DOES EFT WORK? 

Emotionally focused therapy involves nine treatment steps. In the initial sessions of treatment (the first four steps), the therapist will assess interaction styles of the couple and help deescalate conflict. In the middle phases of treatment (steps five, six, and seven), the therapist and the couple work together to find ways to form new, stronger bonds in the relationship. Changes are consolidated in steps seven through nine as treatment concludes. 

A couple might start therapy by learning ways to deescalate conflict about a commonly debated topic, such as finances, for example. Then, the couple begins to learn ways to express deeper feelings often covered up by common relationship conflicts, such as a lack of trust. When couples are able to identify and discuss these deeper feelings with compassion, they are often able to form deeper bonds. The final stages of therapy help couples become better able to independently identify the attachment issues underlying conflict and to express related emotions in future interactions. The therapy is considered complete when couples can reliably engage in changed interaction patterns learned in therapy outside of the therapy environment.  

The stages and steps of emotionally focused therapy are outlined below: Emotionally focused therapy can help people address attachment-related insecurities and learn how to interact with their romantic partners in more loving, responsive, and emotionally connected ways, which can result in a more secure attachment. 

Stage One: Cycle Deescalation

  • Step 1: Identify key issues of concern. 
  • Step 2: Identify ways negative patterns of interaction increase conflict when key issues arise.
  • Step 3: The therapist assists in the identification of unacknowledged fears and negative emotions related to attachment underlying negative interaction patterns. 
  • Step 4: The therapist reframes key issues for the couple in terms of negative patterns of interaction, underlying emotions and fears, and each individual’s attachment needs.

Stage Two: Changing Interaction Patterns

  • Step 5: Individuals are assisted in voicing both their attachment needs and deep emotions. 
  • Step 6: Partners are coached in ways to express acceptance and compassion for a partner’s attachment needs and deep emotions.
  • Step 7: Partners are coached in the expression of attachment needs and emotions while also learning ways to discuss those issues likely to cause conflict. 

Stage Three: Consolidation and Integration

  • Step 8: The therapist coaches the couple in the use of new communication styles to talk about old problems and develop new solutions.
  • Step 9: The couple learns ways to use skills practiced in therapy outside of session and develops a plan to make new interaction patterns a consistent part of life after therapy. 

EFT FOR COUPLES

Couples in distress can benefit from EFT and learn to improve their relationships. Often, clients are dealing with anger, fear, loss of trust, or sense of betrayal in their relationship. EFT has also been proven effective for couples who are having trouble coping with their own illness or that of a child. In addition to helping the distressed relationship, EFT can also help reduce individual symptoms of depression or trauma.

EFT for couples is completed in three phases. During the first stage of treatment, the therapist identifies the couple’s behavioural interactional patterns and determines perceptions, emotions, and underlying attachment needs (need for safe connection) that fuel the problematic behavioural interactions. In the second stage of treatment, the therapist fundamentally helps the couple rearrange their interactions so that each partner can experience security and connection with the other to get attachment needs met. In the third and final phase of therapy, the therapist helps the couple reinforce the new patterns. 

The method is generally brief (about 8 to 12 sessions), 70% to 73% of couples resolving issues and recovering from distress, 86% of people showed a significant improvement in 12 sessions. 

Although most investigations are conducted between couples, the same principles and techniques can also be used for family therapy.

EFT FOR FAMILIES

Emotionally focused therapy has been expanded and developed as a type of family therapy. The approach has proven successful in increasing attachment and a sense of belonging among members of families. Accessing the emotions underlying interaction patterns between family members is a key goal in emotionally focused therapy for families. All family members participating in the therapy are coached in the identification and expression of attachment-related emotions linked to conflict within the family, acceptance and compassion toward the emotions of others, and healthy, positive expression of personal needs and desires. 

IS EFT EFFECTIVE? 

Emotionally focused therapy has been studied extensively, and a strong empirical base of evidence supports the intervention, which is based on research that has identified differences in how couples relate to each other and how these differences are critical to relationship distress and success. Research examining outcomes for couples who have participated in emotionally focused therapy shows the therapy decreases distress within relationships and partners interact in more successful ways. Follow-up studies conducted with those who participated in emotionally focused therapy showed the positive effects of the treatment continued for years after the therapy concluded. 

References

  1. Dankoski, M. E. (2003). Pulling on the heart strings: An emotionally focused approach to family life cycle transitions. Journal of Martial and Family Therapy, 27, 177-187. 
  2. Johnson, S. M. (2008). Emotionally focused couple therapy. In A. S. Gurman (Ed.), Clinical handbook of couple therapy (pp. 107-137). New York, NY: The Guildford Press. 
  3. Johnson, S. M. (2008). My, how couples therapy has changed! Attachment, love and science. Retrieved from https://www.psychotherapy.net/article/couples-therapy-attachment
  4. Johnson, S. M., Maddeaux, C., & Blouin, J. (1998). Emotionally focused family therapy for bulimia. Psychotherapy, 35, 238-247.
  5. EFT Research. (2015, April). Retrieved from http://www.iceeft.com/images/PDFs/EFTResearch.pdf
  6. Yalom, V. (2011). Sue Johnson on emotionally focused therapy. Retrieved from https://www.psychotherapy.net/interview/sue-johnson-interview