Emotionally Focused Therapy

Emotionally focused therapy (EFT) is a treatment developed by Dr. Sue Johnson. Sometimes called EFT therapy, this reflective approach often focuses on the connection between emotional responses and physical needs in relationships. It may help you with control and navigating unhelpful emotions. Emotion focused therapy primarily focuses on adult relationships, including marital distress and relationships with family members, as well as secure attachment and bonding.

The core principles of emotionally focused therapy (EFT) hold that short-term therapy can change problematic interpersonal relationships, improve negative interaction patterns, and help individuals deal with an insecure attachment bond.  

A substantial body of EFT research shows that this therapeutic approach is highly effective, and EFT patients can demonstrate remarkable improvement. Emotionally focused therapy can be explored in person or through online methods. Emotionally focused therapy can be either an individual therapy experience or undertaken with others; emotionally focused therapy can be a way to repair family bonds, while emotionally focused couples therapy can be a helpful couple intervention that may help both people with increasing awareness of their feelings and restructuring interactions with each other.

Emotionally focused therapy: emotions and health

Emotionally focused therapy: an active process

Emotionally focused therapy typically includes nine steps. During a emotionally focused therapy session, individuals, couples, or families may explore the experience and corresponding behaviors, which could help identify roles played in relationships. The effect of specific actions on the connection might also be discussed.

In couples therapy, the emotionally focused therapist may assess how a couple interacts. The therapist may develop and encourage a change process to form a secure base and stronger adult attachment bonds between the individuals. Negative cycle interactions are de-escalated and changed through this method. Therapeutic approaches to emotionally focused therapy interventions with couples typically involve providing a safe haven where couples can have a non-judgmental, open discussion and can express their feelings without fear.

At the beginning of emotionally focused therapy, you may identify primary concerns in a relationship and establish the triggers for conflict. You may discuss arguments, attachment theory, and the process of coming to an agreement. At this stage, the therapist might identify any fears and unpleasant feelings contributing to negativity or conflict. Emotionally focused therapy practitioners may help you describe your desires and come up with new ways to see negative feelings. Your therapist may also recommend resources like the Hold Me Tight book, which discusses emotionally focused therapy couples and family therapy options.

Next, the therapist might help a couple change negative patterns by allowing them to voice their feelings. Distressed couples are then taught how to express and accept the other party's needs. The final stage is when the couples are shown new communication methods to voice their problems and develop new solutions. Finally, the couple may learn how to use their newly acquired skills outside the therapy session.

Emotionally focused therapy may improve romantic relationships

Emotionally focused couples therapy is often one of the most effective methods of reducing conflict in relationships and may help couples confront communication issues. Emotionally focused couples therapy may be utilized for the following conflicts:  

• Intimacy issues
• Insecure attachment
• Commitment issues 
• Difficulty communicating 
• Emotional suppression 
• Misunderstandings
• Marital conflict
• Divorce
• Differing values 
• Impulse control

In many instances, when couples deal with significant relationship concerns, they experience anger and resentment. Through emotionally focused therapy, couples may become more aware of their feelings, the effect of their actions on the relationship, and how they can overcome conflict and communicate in a healthy way.  

Emotionally focused therapy applies principles from attachment theory. As outlined in a book called Attachment theory in practice: Emotionally focused therapy (EFT) with individuals, couples, and families by Johnson, S.M., attachment styles formed in infancy later affect how individuals bond as adults. The healthiest attachment style is secure attachment. Individuals who struggle with insecure attachment styles can work toward a more secure attachment style through therapy. The International Centre for Excellence in Emotionally Focused Therapy states that emotionally focused therapy is “uniquely capable of establishing and restoring supportive bonds among individuals, couples, and families.”

Feeling self-reliant 

Emotionally focused therapy may be used to work with individuals. It can help someone become more self-assured or confident in relationships. This focus therapy may also help individuals expand and broaden their responses in their key relationships. 

If an individual has attachment issues, trauma, or a personality disorder, this emotionally focused therapy may benefit them by helping them notice their feelings in response to triggers and memories. 

If you are experiencing trauma, support is available. Please see our Get Help Now page for more resources.

Improving family communication

Families may utilize Emotionally Focused Therapy. Therapists may work to assess the underlying feelings in the family's interaction patterns and help them communicate based on these observations. Emotionally focused therapy may improve the family process for navigating conflict. It may help each family member understand how to compromise and validate others in the family. In the family setting, emotionally focused therapy may be valuable in dealing with complex situations such as divorce, blended families, or behavioral problems in teens.

Strengths of emotionally focused therapy

Emotionally focused therapy may help clients increase their awareness and learn how to deal with their hidden feelings instead of avoiding them. Emotionally focused therapy is performed by certified therapists who typically undergo specialized training at university training centers and are required to stay updated on the latest empirical research around developing emotionally focused therapy techniques. Additionally, studies support the effectiveness of emotionally focused therapy for individuals, families, and couples. Though emotionally focused therapy is commonly used for improving adult relationships, it can also be effective for treating mental health problems such as PTSD. 

Some other therapists have criticized emotionally focused therapy, arguing that more research is needed to determine its effectiveness. This critique is not uncommon for a therapeutic technique – within the field of psychological research, there are often ongoing discussions and studies addressing the efficacy of various treatments. 

Emotionally focused therapy focuses primarily on relational and attachment-based difficulties. It may not benefit those seeking support for individual concerns or non-interpersonal conflicts. Additionally, the process of understanding your emotions better is typically a lifelong learning endeavor, so understand that emotionally focused therapy will likely not “fix” all of your relationships. Discuss your options with a medical professional when making a choice about which technique is best for you.

Finding emotionally focused therapists

There are many ways of finding an emotionally focused therapist, whether in non-public practice or otherwise. When searching for a therapist, ask about a potential therapist's training and level of education regarding EFT. Emotionally focused therapists often understand that knowing their background can be crucial to patients and may be willing to talk with you about their area of study. 

If you face barriers to treatment, such as distance, costs, or availability, online therapy platforms like BetterHelp may benefit you. With online therapy, you won't have to commute to the clinical practice or try to fit your appointment in with a busy schedule. You can meet a therapist anytime, including at night or early in the morning. Studies show that online therapy is as effective as in-person therapy in treating many conditions. Additionally, if you're looking for online couples therapy, platforms like Regain may offer value.