The term “Emotion Focused Therapy” may sound a little redundant.
After all, what kind of therapy ignores the client’s emotions? A therapy that ignored the emotions of those who participated will probably not be very effective.
While many other kinds of therapy focus on the emotions of clients, both intra- and interpersonal, the emphasis on adult attachment and bonding theory is what sets emotion-focused therapy apart.
This article contains:
What is Emotion Focused Therapy? A Definition
Emotion Focused Therapy, or EFT, is based on the idea that emotions are not the only important factors in our lives, but the key to who we are. The theory behind EFT posits that we construct our very selves based on emotion (Greenberg, 2004).
This theory has a lot of backing from emotion researchers, but it also makes intuitive sense. After all, emotions play a wide variety of important roles in our lives, including:
- Informing people that an important goal or need can be pursued or inhibited in the current situation
- Contributing to goal setting
- Contributing to the appraisal of the self and the environment
- Communicating intentions to others and regulating interactions
- Informs decision making
- Alerting people to threats (Greenberg, 2004)
Emotions are not only an important part of our daily lives, they also contribute to our identities, helping us to understand who we are and share who we are with others.
Emotion Focused Therapy recognizes the importance of emotions and places them front and center in therapy sessions.
This renewed focus on emotions in therapy started in the 1980s when Dr. Sue Johnson realized that many popular relationship interventions basically ignored emotions (Good Therapy, 2016). Later, Dr. Leslie Greenberg and Robert Elliot continued the development of this new therapy, this time targeting individual clients instead of couples (Good Therapy, 2016).
According to Dr. Greenberg, emotion-focused therapy is based on three empirically supported therapeutic principles. These three principles form a guide to working effectively with emotions:
- Increasing awareness of emotion
- Enhancing emotion regulation
- Transforming emotion (Greenberg, 2004)
Increasing awareness of emotion is fairly straightforward – this is the first goal of EFT and must be achieved, at least to some degree, before moving on to the next goals.
Enhancing emotion regulation is a vital part of EFT. We all feel various emotions throughout a normal day, some that are adaptive and help us reach our goals, and some that are maladaptive and hinder us from getting where we want to be. Learning to regulate and cope with difficult or intense emotions is a valuable skill to have, and EFT can help clients acquire this skill.
Finally, emotion transformation refers to the process of changing or transforming one emotion into another. The ability to transform a maladaptive emotion into an adaptive one is clearly a valuable skill, and research suggests that this is a purely emotion-based skill (Greenberg, 2004). Reasoning that an emotion should be transformed and deciding to change it is not sufficient for the emotion to actually change. In other words, fire (emotion) must be fought with fire (emotion).
To sum up, Emotion Focused Therapy can be defined as a type of therapy based on attachment and bonding theories that aim to help clients gain a greater awareness of their emotions and provide strategies to effectively cope with, regulate, and transform their emotions (Good Therapy, 2017).
Emotion Focused Therapy: Stages and Steps
The steps or stages of EFT for couples may vary slightly depending on who you ask, but they will always fall into three main phases (Jones, 2009):
- Phase One – Assess and Deescalate Phase
- Phase Two – Change Events Phase
- Phase Three – Consolidation of Change Phase
In phase one, the goal is to uncover the underlying emotional problem and begin to change the way clients perceive it.
Phase two is focused on creating new emotional experiences to replace the negative experiences and setting the clients up for more effective communication.
Phase three wraps up the EFT experience through resolving old problems and creating a plan for continued success outside of the therapist’s office.
If you’re interested in diving into these phases in more detail, see below for EFT therapist Dr. Konstantin Lukin’s (2017) outline of these three phases and the steps that compose each phase.
Phase One is comprised of the first four steps:
1. Identify the conflict
In step one, the therapist will help the couple identify the issues that are occurring and assess the affect the problem(s) is having on the relationship.
2. Identify the cycle where conflict is expressed
Step two is where the therapist and clients dig deep to find the root of the problem(s).
3. Access unacknowledged emotions
In step three, the therapist will guide the clients through discussion of what each partner is feeling in relation to the conflict cycle, with special attention paid to any emotions that had not previously been brought up between the clients.
Reframing refers to seeing the problem(s) from a different perspective. This step is meant to help the clients view the problem from their partner’s point of view, which will help each partner to understand the other’s emotions and needs.
Once the problem is identified and the clients are successfully seeing the problem from their partner’s perspective, therapy can progress to Phase Two.
Phase Two involves three steps:
5. Promote identification of disowned needs
This vital step is where the therapist helps the couple to understand both their own wants and needs and their partner’s wants and needs. Basically, this phase acknowledges that in order to meet your partner’s needs, you must first understand them, and in order for your partner to meet your needs, you must first share these needs with him or her.
6. Promote partner acceptance
Step six encourages each partner to accept the other’s emotional experience and acknowledge their changing experiences.
7. Facilitate expression of needs and wants
The therapist will guide each partner in learning how to interact more positively in step seven. This step may be accompanied by a bonding exercise to help the couple promote a healthy new connection.
8. New solutions
In step eight, the therapist and clients will come up with new solutions to the original problem. With the new, more positive foundation in place, solving this problem should be much easier than it seemed back in step one.
In consolidation, the couple will take what they have learned in the therapist’s office home to continue developing effective ways to interact and new, more adaptive behaviors.
Emotion Focused Therapy: Who is it For?
While Emotion Focused Therapy began as a form of therapy for couples, the principles of EFT can be applied to other therapy modes as well.
Emotion Focused Therapy for Couples
As described earlier, EFT has been applied with great success to couples struggling with problems in their relationship.
EFT can help couples understand themselves and their partner better, which makes it easier to interact positively with one another. Beyond learning skills like deescalating conflicts and keeping arguments healthy and constructive (which are also great skills to learn!), EFT can help couples strengthen their very foundation through deeper and more resilient emotional bonds.
Emotion Focused Therapy for Individuals
In general, the goals and interventions of EFT for individuals is the same as those for couples. The main difference is that the focus is on emotion awareness, regulating, and transformation for the individual only.
Of course, the client will likely learn about how to interact and share emotions with others in a healthy way, but the focus of this therapy will be on intrapersonal rather than interpersonal emotional learning and skill building.
The therapist will lead the client through discussions and exercises aimed at enhancing their understanding of their own personal emotions and their emotional responses (Good Therapy, 2016).
Emotion Focused Therapy for Families
Emotion Focused Therapy can also be applied in a family setting as well. Participating in EFT can help family members feel more connected with one another and instill or enhance the sense of belonging in the family (Good Therapy, 2016).
The therapist will help each family member learn about their own emotions, understand the emotions of the other family members, and coach them on more effective interaction and communication.
EFT may be particularly effective for families dealing with the following issues (Good Therapy, 2016):
- Child(ren) reaching adolescence
- New blended family (step-parents, step-siblings coming into the family)
- Eating disorders
- Behavioral problems in teens, adolescents, and children
How EFT Works: Techniques and Interventions
The bulk of techniques and interventions in EFT center around the principles of person-centered therapy (any kind of therapy in which the client is considered the expert in his or her own life rather than a naïve patient) and emotion coaching (helping clients more effectively understand and regulate their emotions).
The EFT therapist will use several different techniques or interventions at different points throughout the course of therapy, depending on which are appropriate in each situation.
In the beginning, the therapist may use the techniques or principles listed below to engage with the client and build a positive relationship:
- Empathetic listening: this is a central tenet of person-centered or client-centered therapy, in which the therapist attempts to connect with the client(s) and see things from his or her perspective.
- Genuine interaction: this is another important value in person-centered therapy, as forming an authentic bond between client(s) and therapist is key.
- Normalizing, mirroring, or reflecting: this technique helps the client see that he or she is not “crazy” and that he or she is understood; this is essential to helping the client progress in their healing or growth.
- Reframing individual experiences: the therapist will put their reframing skills to use to ensure that he or she understands the problem correctly and to encourage clients in seeing problems from each other’s perspective.
- Track and reflect the problem cycle(s): another vital factor in EFT is recognizing and understanding the problem cycle that repeats; whether in individual therapy, couples therapy, or family therapy, the therapist will piece together relevant details from the client(s) and identify the cycle for discussion with the client(s).
- Interrupt and redirect: this skill is a very important one for an EFT therapist, or a therapist of any kind because clients in therapy have a tendency to get off the most important track. It’s easy to devolve into listing the things that are bothering you or get stuck on a particular instance, but a good therapist will guide the client(s) back to the track leading to the root of the problem.
Once the clients are “warmed up” to EFT and discussing the problems they are experiencing, the therapist may begin to use techniques like:
- Validation: each client needs to feel that their emotions and experiences are understood, leading them away from the pit that self-blame can dig.
- Heightening of emotions: a therapist may find it necessary to encourage or stimulate certain emotions in his or her client(s); in therapy, the client(s) must be willing to become vulnerable in order for anything to change. Enhancing vulnerable emotions can lead to the high arousal state that pushes the client(s) towards greater understanding of themselves and others.
- Evocative responding: this technique involves probing the client(s) on sensitive or particularly emotional experiences, with the intention of clarifying vague or unclear aspects of the experience.
- Empathic speculation: the EFT therapist may put empathic speculation to use to help clients open up and forge ahead. The therapist must take care not to push a label or idea onto the client, but instead to encourage more intense experiencing in-session.
- Restructuring: restructuring refers to the therapist’s attempts to provoke new emotional experiences and lay the foundations for new, more healthy interactions using the knowledge and skills gained in therapy so far. The therapist may encourage the client(s) to do this restructuring, or the therapist may initiate the restructuring and check in with the clients on how accurate or helpful the new “structure” is.
- Encouragement and support: another classic technique in all kinds of therapy, the therapist will frequently focus on providing encouragement and support to the client(s), no matter where they are in the process or how far they have to go.
- Redirection: the EFT therapist will teach clients how to catch themselves in the negative interactional cycle and apply the new strategies they have learned.
Towards the end of therapy, the therapist will use end-game techniques like:
- Encouragement and support: it is never a bad time to offer encouragement and support to clients; the therapist will take time in each stage of treatment to encourage the client(s) to continue in their self-discovery and sharing, and support clients in the process.
- Aftercare teaching: a good EFT therapist will ensure that clients have a plan for positive interaction going forward, to ensure that clients do not backslide as soon as they leave the therapist’s office.
All of these techniques and more can be found, with examples of how to apply them, in this emotion-focused therapy manual from Margaret K. Keiley.
In addition to the techniques that therapists put to use in the therapy session, there are several exercises or worksheets that clients can complete to supplement their treatment.
Couple Satisfaction Checklist
This checklist would be most effectively applied with the help of a therapist, but it can be completed individually for those who are curious how they would rank.
The checklist outlines 12 aspects of a relationship with a romantic partner, as well as a global consideration of the relationship, for each partner to rate in terms of satisfaction.
The 13 aspects are:
1. A degree of closeness, openness, confiding, sharing, and comforting
2. Expression of affection and caring
3. Satisfaction with sexual intimacy
4. Handling conflicts and arguments
5. Expression of anger, criticism, or blame
6. Handling family finances
7. Handling of parenting issues
8. Handling of household tasks
9. Common interests and social life
10. A degree of respect and admiration for your partner
11. Satisfaction with your role in the relationship
12. Satisfaction with your partner’s role in the relationship
13. Overall satisfaction with your relationship
The satisfaction levels each respondent can choose from are:
- Very Dissatisfied
- Moderately Dissatisfied
- Slightly Dissatisfied
- Slightly Satisfied
- Moderately Satisfied
- Very Satisfied
Each partner will read through the 13 aspects and decide how satisfied or dissatisfied they are with each aspect. Afterward, each partner will place a check mark by the three aspects they would most like to work on changing.
If you’d like to view this worksheet or download it for you or your clients, click here.
Individual Problem Checklist
Like the previous worksheet, this worksheet will help clients and therapists understand where they are experiencing the most troubling issues in their life and/or relationships.
The worksheet includes a checklist of potential issues in six different categories:
- Emotional Concerns
- Behavioral and Physical Concerns
- Intimate Relationship Concerns
- Sexual Concerns
- When Growing Up to Present Time
- Stresses During the Past Several Years
In each category, there are several different potential problems for the client to consider. If the problem is present in the client’s life and/or relationship, the client should indicate that with a check mark.
For example, the client should read through the list of potential problems in the Emotional Concerns category, including “feeling anxious or uptight,” “feeling guilty,” and “thoughts of hurting yourself.”
In the Behavioral and Physical Concerns, there are problems like “trouble falling asleep,” “not having leisure activities,” and “using alcohol too much.”
The Intimate Relationship Concerns category includes potential problems like “feeling misunderstood in relationship,” “not a trusting partner,” and “problems with in-laws.”
Sexual Concerns includes “not able to become pregnant,” “not enjoying sexual affection,” and “feeling negatively about sex.”
In the When Growing Up to Present Time category, problems can be “having a parent with emotional problems,” “being sexually abused,” or “having an unhappy childhood.”
Finally, the client will find problems like “being harassed or assaulted,” “separation/divorce,” and “financial trouble” in the Stresses During the Past Several Years category.
For each problem that the client experienced or is currently experiencing, he or she is instructed to indicate how intense the problem is on the following scale: 1 – mildly, 2 – moderately, and 3 – severely.
Once the client has made it through each section, there is space to write down up to three goals for therapy. It is vital to identify one’s goals since they must be known before you can work towards them.
This worksheet is available at this link for viewing, printing, or downloading.
When We Are Not Getting Along: My Feelings, Thoughts, and Behaviors
This is an excellent worksheet to use when working with couples or families who are experiencing increased conflict.
Similar to the other worksheets, this worksheet presents a list of potential thoughts, feelings, and behaviors that a person may experience when fighting with his or her partner or another family member.
These experiences are separated into four categories:
- What I Do…
- What I Feel
- In My Body I Feel…
- How We Interact During Conflict
In the first category, the client will find actions like:
- I criticize
- I get quiet
- I avoid conflict
The second category includes feelings like:
- I feel let down
- I feel disconnected
- I feel abandoned
The third category includes physical sensations such as:
- I feel my heart speeding up
- I feel uneasy in my stomach
- I feel tightness in my throat
Finally, the fourth category includes statements like:
- During an argument, I become silent, withdrawn, and don’t want to discuss things.
- I often want to push my partner to talk about our relationship.
- My partner withdraws a lot and won’t face an issue when I want to talk.
The client is instructed to place a check mark by each feeling, thought, and behavior that he or she experiences when in conflict with the partner or family member. When they have finished working through each potential item, they should look back at the items they marked and circle three or four to indicate the most important ones.
To view, print, or download this worksheet, click here.
How EFT Relates to Positive Psychology
Emotion Focused Therapy was developed before positive psychology was formally established (EFT in the 1980s, PP in 1998), but EFT fits nicely into the positive psychology milieu.
Positive psychology is not the only field or subfield that has encouraged and promoted the study of emotions as a serious and important topic, but it is one of the more recent and effective movements to do so. Emotions were long considered secondary to reason and still are in many circles, making the study of emotions a less prestigious (and less lucrative) investment of one’s time and energy.
However, there has been a long, slow shift towards recognizing the importance of emotions, one that positive psychology has continued over the past two decades. Positive psychology has been productive in terms of research on the antecedents, roles, and functions of emotion, opening up new avenues of research and challenging the “Pollyanna” stereotype that has long plagued those who study positive emotions.
EFT’s focus on both positive and negative emotions and the regulation and transformation of such emotions make it right at home in positive psychology. It fits in quite well with some of positive psychology’s most popular and most promising threads of research and inquiry, including the focus on strengths and appreciative inquiry, the positive application of negative emotions, and the importance of building strong, positive relationships.
If you are interested in learning more about emotionally focused therapy or applying it in your own practice, you can find an online course here.
A Take Home Message
My intention in this piece was to provide you with a working understanding of Emotion Focused Therapy and to introduce you to some of the techniques and exercises applied in EFT.
You may not hear much about EFT, given that it is not a hot, new type of therapy, but it is still an effective and evidence-backed method of enhancing clients’ emotional awareness and improving their interactions with others.
I hope you enjoyed this dive into EFT, and I’d love to hear what you think of it! Have you ever tried EFT? Have you ever participated in EFT through your own practice? What do you think about its efficacy?
Thanks for reading!
- Good Therapy. (2016). Emotionally focused therapy. GoodTherapy. Retrieved from https://www.goodtherapy.org/learn-about-therapy/types/emotionally-focused-therapy
- Good Therapy. (2017). Emotion-focused therapy. GoodTherapy. Retrieved from https://www.goodtherapy.org/learn-about-therapy/types/emotion-focused-therapy
- Greenberg, L. S. (2004). Emotion-focused therapy. Clinical Psychology and Psychotherapy 11, 3-16. doi:10.1002/cpp.388
- Jones, L. K. (2009). Emotionally focused therapy with couples – The social work connection. Social Work Today 9, 18.
- Lukin, K. (2017, March 1). The nine steps of emotionally focused therapy for couples. Lukin Center for Psychotherapy. Retrieved from http://info.lukincenter.com/blog/emotionally-focused-therapy-for-couples