EMOTIONALLY FOCUSED COUPLES THERAPY (EFT)
THEORISTS: SUSAN JOHNSON & LES GREENBERG
Deriving from Bowlby’s attachment, EFT therapists view attachment needs for contact, comfort, security, and closeness as adaptive and inherently human, rather than a reflection of immaturity or pathology. EFT is geared toward couples and focuses on the obstacles standing in the way of secure attachment. According to Johnson, EFT is unique because it focuses on emotion as a powerful and necessary agent of change and maintains that positive and secure attachments provide a strong base from which individuals can explore their worlds and respond adaptively to their environments. EFT works best for couples that still have an emotional investment in the relationship and some willingness to engage in therapy.
- To access a client’s deepest emotions and strengthen the sense of connectedness between partners
- To create a shift in the client’s interactional cycle and to foster the creation of a new and secure bond between partners
ASSESSMENT AND TREATMENT
- Assessment is not separated from treatment in EFT
- EFT has 9 treatment steps:
- Steps 1-4
- Assessment and de-escalation of the conflictual interactional cycle
- Steps 5-7
- Shifting the client interactional positions, and creation of new bonding experiences
- Steps 8-9
- Integrating change into the daily life of the couple
- Steps 1-4
9 STEPS of EFT:
- Assessment/Cycle De-escalation
- Step 1: Create a therapeutic alliance while inquiring about marital issues that are currently causing conflict
- Step 2: Identify the problem interactional cycle
- Step 3: Accessing the unacknowledged emotions
- Step 4: Reframing the problem in terms of the cycle, underlying emotions, and attachment needs
- NOTE: The first shift typically happens following the completion of step 4. Cycle de-escalation is considered first order change. The couple begins to view the cycle as the enemy, rather than the other spouse. This shift prepares the couple for second order change, and allows for the reorganization of the “interactional dance” moving toward safe attachment.
- Changing interactional positions
- Step 5: Guiding individuals to access both their attachment needs and deepest emotions
- Step 6: Promoting acceptance of the partner’s attachment needs and deepest emotions
- Step 7: Facilitating the expression of specific needs and wants while also learning new communication skills
- NOTE: In the middle stages (5-7), there are two crucial turning points: First, the previously critical partner changes his/her interactions and becomes more accessible to his/her partner. Second, the partners begin to express vulnerabilities and will engage more trustingly with each other.
- Consolidation/ Integration
- Step 8: Facilitating the development of new solutions
- Step 9: Consolidating new positions and new cycles of attachment behavior into their daily lives
- NOTE: The final stages are highlighted by initiation of a new cycle by now-accessible partners. Former problems are more easily and naturally solved due to the deeper emotional attachment of the partners.
- Contraindication for EFT
- EFT is NOT used for couples where abuse is present and continuing in the relationship. Abusive partners are referred to group or individual therapy. Only after this is completed, EFT is offered (when the abused partner is no longer at risk).
- NOTE FOR EXAM:
- EFT is effective with issues of depression, trust, and intimacy.
- Acronym for things therapist does in EFT: R-I-S-S-S-C
- R (repeat key words and phrases)
- I (images of client’s problems that evoke honest emotions)
- S (simple and concise words or phrases)
- S (slow down process and therapist speech)
- S (soft and soothing tones)
- C (client’s words are used to validate)
STANCE OF THE THERAPIST
- Focus on process over content
- Focus on the necessity for a safe, collaborative therapeutic alliance
- Focus on emotion as a target and an agent of change
- Focus on a corrective emotional experience