How effective is Emotionally Focused Therapy?
Emotionally Focused Therapy is attachment-based a short-term structured relationship therapy between eight to 20 sessions (Johnson, 2020). EFT focuses on building trust and secure bonds between couples. Attachment-based EFT is based on a universal need for human survival in times of stress, threat, and ambiguity. Before the 1980s, studies on relationship counselling were rare, and there was a lack of theoretical and research contributions (Gurman & Fraenkel, 2002). Emotionally Focused therapy (EFT) was one of three new schools of thought in relationship counselling that emerged in the 1980s.
Over the past 30 years, there has been substantial empirical support for its outcome and process of change (Wiebe & Johnson, 2016). Empirically validated Emotionally Focused Therapy (EFT) (Johnson & Greenberg, 1985) is effective in relationship repair and in creating lasting change for couples (Beasley & Ager, 2019; Johnson et al., 1999). In one meta-analysis, a review of early EFT outcome studies found that 86%-90% of couples had a significant improvement with a recovery rate of 70 to 73% (Johnson et al., 1999). In addition, the couples, who received EFT counselling services in the research, reported that they had more satisfaction in their relationship and intimacy and had fewer complaints than the couples who received strategic problem-solving-based psychotherapy (Wiebe & Johnson, 2016). Beasley and Ager (2019) did a systematic review based on nine randomized control trials (RCTs) studies to study EFT effectiveness. They found that marital satisfaction improved post-treatment, which was sustained at follow-up. Some studies have shown that significant numbers of couples continue to improve their relationship satisfaction even after the therapy (Johnson & Talitman, 1997; Wiebe & Johnson, 2016). Wiebe et al. (2017) found an increase in relationship satisfaction, secure base behaviour, and decreased attachment anxiety throughout therapy and through 24 months follow-up in their study of 32 couples.
EFT for Partners with Mood Disorders.
EFT researchers have also tested the effect of EFT in treating post-traumatic stress and depression (Denton et al., 2012; Johnson & WilliamsKeeler, 1998). EFT’s goal is to build a secure bond between couples. Couples with secure attachment can better regulate distress emotions and are more resilient to stress. They are more willing to turn to each other for emotional support and see each other as a secure base. Building secure bonds also help partners who suffer from post-traumatic stress and depression reduce depressive symptoms. Depressive symptoms could increase relationship distress (Wittenborn et al., 2019). Outcome studies have shown EFT efficacy in reducing traumatic stress symptoms (Johnson & Williams-Keeler, 1998) and depression (Alder et al., 2018; Denton et al., 2012; Dessaulles et al., 2003; Wittenborn et al., 2019), while these issues co-occur with relationship distress. The first two studies (Denton et al., 2012; Dessaulles et al., 2003) evaluated the efficacy of EFT compared to pharmacotherapy, and the samples were 12 and 24 women, respectively. Results from both studies suggested that EFT is an effective treatment for reducing depressive symptoms, especially when combined with pharmacotherapy concurrently. In addition, because there are sex differences in etiologic pathways and clinical presentation of major depressive disorder (Wittenborn et al., 2019), the findings for both studies have generalization issues. Later studies (Wittenborn et al., 2019) included men in their samples. They found that mild to moderate depression in men and women can be treated effectively with EFT relationship therapy compared to other usual care, including behavioural, narrative, Gottman, Bowen, psychodynamics, and eclectic approaches. However, the research is only a start to understanding the mechanisms of therapeutic change in reducing depressive symptoms through EFT.
EFT for Couple Facing Specific Concerns.
EFT researchers also tested the efficacy of EFT among couples facing specific concerns such as sexual dissatisfaction (Burgess Moser et al., 2019), medical illness (McLean et al., 2013), childhood trauma (Dalton et al., 2013; Macintosh & Johnson, 2008), and attachment injuries (Halchuk et al., 2010; Makinen & Johnson, 2006).
EFT has been used widely across different cultural contexts such as cultural, spiritual, religious, sexual and gender orientations and differing forms of families and socio-economic conditions (Johnson, 2019; 2020). However, like many other psychotherapy, cross-cultural studies are under-studies, previous EFT outcome and process research “has been conducted almost exclusively on White, middle-class, heterosexual couples” (Johnson & Greenman, 2013, p. 57). Growth-oriented and attachment-based EFT is suitable across culture. The caveat is that therapists gain knowledge of client’s cultural dynamics, know how to adapt specific EFT interventions, and attune client culturally. The ability to attune with client culturally relies on the therapist’s ability to recognize when minority stress interplays in their negative interaction cycle and the therapist’s ability to be a temporary secure figure.
Written by Jenny Hsuan Fang Hsu, R.C.C.
cited from her capstone JennyHsuanFangHsuCapstone.pdf (cityu.edu)
