When helping clients strengthen their relationships, Emotionally Focused Therapy (EFT) is a powerful tool. This therapeutic approach has been proven effective in addressing attachment and intimacy issues and helping patients improve communication and reduce conflict.
In this guide, we’ll explain what EFT is, how it works, and why it can benefit both clients and practitioners alike. We’ll also discuss the research that supports its effectiveness so you can decide if EFT is suitable for your practice.
What is Emotionally Focused Therapy?
Emotions play an integral role in human experience, as they are both an indicator of our internal state and a driving force for our behavior. Emotions provide information about the self, helping us identify our thoughts, feelings, and beliefs. In addition, emotions can also provide social cues that enable us to interact more effectively with others.
Emotionally Focused Therapy (EFT) is an evidence-based psychotherapy approach that emphasizes the central role of emotions in human experience. Developed by Dr. Sue Johnson in the 1980s, EFT is grounded in Attachment Theory and Emotion Regulation Theory. EFT is designed to help individuals, families, and couples identify, express, and regulate their emotions to promote emotional and relational well-being.
According to Johnson's (2019) perspective, the quality of the therapist-client relationship plays a crucial role in the effectiveness of EFT. Creating a safe and supportive environment for clients to explore their emotions and work towards developing secure attachment bonds is emphasized as a critical element in this therapeutic approach.
For example, in Emotionally Focused Individual Therapy, the therapist acts as a secure base, offering acceptance and guidance to the client. This allows the client to build trust and explore their emotions without fear of judgment.
Johnson believes the process is collaborative, with the therapist and client identifying and addressing the underlying emotions and relational patterns causing distress.
The Underpinnings of EFT
Emotionally Focused Therapy is grounded in two psychological theories:
Attachment theory suggests humans have an innate need for emotional connection with others. It affirms that disruptions in attachment relationships can lead to emotional and behavioral problems (Bowlby, 1969).
EFT draws on Attachment Theory to help clients identify patterns of attachment-related behavior that may be causing distress in their relationships. EFT therapists work to help clients create more secure attachment bonds with their partners by focusing on emotional regulation, empathic communication, and understanding each other's emotional experiences (Johnson, 1996).
Developing a more secure attachment bond can lead to various positive outcomes for clients, such as enhanced emotional security, better communication, and a more profound sense of intimacy.
Emotion Regulation Theory
James Gross' Emotion Regulation Theory emphasizes the importance of regulating emotions in mental health and well-being. The theory proposes that emotion regulation involves a combination of cognitive and behavioral processes that can be conscious or unconscious (Gross, 1998). The regulation of emotions can be influenced by the individual's environment, situation, and temperament.
One key element of the theory integrated into EFT is that emotions serve an adaptive purpose and can provide important information about an individual's needs and goals. In EFT, therapists work with clients to identify and understand the underlying emotions contributing to relationship distress.
Gaining this understanding can assist clients in managing their emotions more efficiently, thereby enhancing their emotional well-being and capacity to establish secure attachments.
The Three Stages of Emotionally Focused Therapy
Emotionally Focused Therapy has three stages (Johnson, 1996), each designed to help clients build stronger, more positive relationships. These stages are:
Assessment and De-escalation
During this stage, the therapist helps clients identify the negative patterns of communication and behavior that are causing distress. The therapist works with the client to identify the underlying emotions driving the negative patterns and helps them to de-escalate conflicts by slowing down their interactions. This stage is crucial in helping clients gain insight into their relationship patterns and identify what needs to change.
At this stage, the therapist helps clients to develop new patterns of interaction that are more positive and fulfilling. The therapist guides clients to identify their unmet attachment needs and teaches them how to communicate them.
In addition, clients acquire skills in expressing their emotions in a non-judgmental manner. At the same time, the therapist facilitates the development of new ways of interacting characterized by tremendous respect and support.
Consolidation and Integration
During this stage, the therapist helps clients consolidate their progress in therapy and integrate it into their daily lives. Clients learn to maintain their new communication and behavior patterns and build stronger emotional bonds with their partners or family members.
This stage is essential in helping clients solidify their gains in therapy and continue improving their relationships.
When is Emotionally Focused Therapy Used?
Emotionally Focused Therapy is often used to treat couples, families, and individuals struggling with relationship distress. It can help them to:
Improve communication and empathy
Through EFT, clients can learn to communicate more effectively with their partners and family members, allowing them to express their feelings in a non-judgmental way and understand each other’s perspectives more clearly.
Reduce family conflict
Although EFT is commonly used for individuals and couples, it also applies to families. Emotionally Focused Family Therapy focuses on strengthening emotional bonds and improving communication within the family unit. By promoting emotional expression and increasing empathy between family members, EFFT can help reduce conflict and improve family relationships.
Understanding the underlying emotions contributing to relationship distress allows clients to experience greater emotional security, improved communication, and a more profound sense of intimacy. EFT, especially Emotionally Focused Couples Therapy, can help couples to build a stronger emotional bond and create a more fulfilling relationship.
Strengthen emotional bonds
EFT can assist clients in identifying and comprehending the emotional motivations behind their behavior, which can strengthen their emotional connection with their partner or family members, thereby promoting more fulfilling and supportive relationships.
Process past experiences
For individuals who have unresolved issues from the past, EFT can provide a safe space to explore those issues and develop ways of coping with them. Patients can explore their past experiences without fear of judgment or criticism, which can help them develop healthier relationships.
Create healthier relationship patterns
Through EFT, clients can cultivate healthier modes of interaction with their partners and family members, transitioning from harmful patterns of communication and behavior to more constructive, secure, and emotionally gratifying relationships.
Benefits of Emotionally Focused Therapy
EFT's efficacy has been proven in numerous clinical studies. It is particularly effective in helping couples, individuals, and families to improve their relationships and communication. Here are some of the benefits of this approach, according to research:
It helps improve relationship satisfaction
Emotionally Focused Threrapy can provide significant benefits for couples experiencing distress. A research study by Rathgeber and colleagues in 2019 showed that this therapy effectively improves how satisfied couples feel with their relationships. The study found that couples who underwent EFT felt less stressed and had better relationships. The benefits of the therapy were also maintained for at least six months after the treatment.
EFT can enhance emotional bonding and communication in couples, which in turn can aid in resolving conflicts and improving relationships. This can lead to greater satisfaction and overall well-being for the couples involved.
It helps strengthen emotional ties
In a 2022 study, Greenman and Johnson found that Emotionally Focused Therapy provides a framework for enhancing emotional ties and a subjective sense of social connectedness, thereby helping to restore emotional balance and protect against chronic feelings of isolation and associated health problems.
For families, EFT can be particularly beneficial as it focuses on strengthening emotional bonds and improving communication within the unit. EFT can enhance family relationships by encouraging emotional expression and fostering empathy among family members, effectively decreasing conflict.
It can help patients resolve emotional attachment issues
Emotionally Focused Therapy can provide a safe and supportive environment to process these feelings without fear of judgment or criticism.
According to Greenberg, Warwar, and Malcolm (2008), using empty-chair dialogue was more effective than psychoeducation treatment in improving forgiveness, letting go, global symptoms, and key target complaints. This suggests that EFT can effectively address emotional and psychological difficulties related to unresolved emotional attachment issues.
EFT can help individuals process and overcome emotional pain by facilitating emotional expression and communication, leading to greater emotional well-being and improved overall functioning.
Emotionally Focused Therapy App – How Can Carepatron Help?
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Bowlby, J. (1969). Attachment and loss: Vol. 1. Attachment. Basic Books.
Greenberg, L. J., Warwar, S. H., & Malcolm, W. M. (2008). Differential effects of emotion-focused therapy and psychoeducation in facilitating forgiveness and letting go of emotional injuries. Journal of Counseling Psychology, 55(2), 185–196. https://doi.org/10.1037/0022-0184.108.40.206
Greeman, P., Johnson, S. (2022). Emotionally focused therapy: Attachment, connection, and health. Current Opinion in Psychology, 43, 146-150. ISSN 2352-250X. https://doi.org/10.1016/j.copsyc.2021.06.015.
Gross, J. J. (1998). The Emerging Field of Emotion Regulation: An Integrative Review. Review of General Psychology, 2(3), 271–299. https://doi.org/10.1037/1089-26220.127.116.111
Johnson, S. (2019). Attachment theory in practice: Emotionally focused therapy (EFT) with individuals, couples, and families. Guilford Press.
Johnson, S. M. (1996). The practice of emotionally focused couple therapy: Creating connection. Routledge.
Rathgeber, M., Bürkner, P.-C., Schiller, E.-M., Holling, H. (2019). The Efficacy of Emotionally Focused Couples Therapy and Behavioral Couples Therapy: A Meta-Analysis. Journal of Marital and Family Therapy, 45, 447– 463. https://doi.org/10.1111/jmft.12336