Relaxed person sits calmly in lawn chair on overgrown lawn, eyes closed, hand dangling to sideEmotion-focused therapy (EFT) is an approach to therapeutic treatment based on the premise that our emotions are a key to our identity and a guide for individual choice and decision making. This type of therapy assumes that when we lack awareness of our emotions or avoid unpleasant emotions, we are unable to use the important information provided by these emotions.

Therapists qualified in EFT can often be of assistance to individuals seeking help for a variety of concerns by helping them learn how to gain a greater awareness of their emotions, become better at using information provided by adaptive emotions, and cope with and decrease any negative effects of maladaptive emotions. 

History and Development

Developed primarily by Leslie Greenberg, EFT is a humanistic approach to treatment designed to help people become better able to accept, regulate, understand, and express their emotions. Greenberg did not set out to develop the approach intentionally; rather, he began studying the ways in which people change. The process of the treatment's development encompassed nearly three decades, with the first related materials published in 1979. 

An empirically-based approach that draws from principles of cognitive behavioral, person-centered, and Gestalt therapies, EFT also incorporates aspects of Piaget's studies on how people solve problems as well as interactional systemic perspectives, when the approach is directed toward the treatment of a couple. 

EFT attempts to help individuals look inside themselves and better understand their own emotions. While emotionally focused therapy has a similar name, it differs from EFT in that it is an intervention designed to help couples and family members better understand the emotions of significant others in their lives, and the two approaches are separate—though the process of coming to better understand one's emotions may, in turn, facilitate better relationships with others. 

Emotion-Focused Therapy Theory

In this approach to treatment, the therapist and the individual seeking therapy collaborate in an active process, where both are viewed as equal contributors. The person seeking treatment, not the therapist, is seen as the person most capable of interpreting their emotional experience.

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Founded in the idea that emotions should be used to guide healthy, meaningful lives, EFT theory is based on a scientific inquiry into the human emotional experience. Scientific study of human emotion has provided information about how emotions are produced, their importance to human functioning, and how they are related to thought and behavior.

Emotion schemes, the core concept of EFT, was developed largely from these theories of human emotion. These emotion schemes are models that outline the ways in which emotion can be experienced physically, cause physiologic changes, influence thinking, and guide future action. EFT works by helping individuals both accept and change their personal emotion schemes. 

Techniques Used In Emotion-Focused Therapy 

EFT sessions typically center around the development of two key skills. The first is arriving at one's emotions through increased awareness and acceptance, and the second involves learning to transform emotions and better use the information they provide to avoid negative or harmful behaviors or other effects of certain emotions. 

Therapists practicing this method take a compassionate, non-judgmental, and reflective approach to listening and questioning in order to best help the individual in therapy arrive at a better understanding of their emotions. Then, various therapeutic techniques known as emotion coaching are utilized to enable people to learn new ways to use healthy emotions to guide their actions. Emotion coaching may further help individuals transform and move on from emotions that have caused challenges in the past.

Initial sessions of therapy, which focus on helping people arrive at emotions, typically include one or more of the following goals in each session: 

  • Become more aware of emotions
  • Learn to welcome, allow, and regulate emotions
  • Learn to describe emotions clearly and in detail
  • Increase awareness of the multiple layers of emotional experiences and learn to identify the most primary and direct reaction 

The next phase of treatment focuses on leaving and is likely to include the following goals: 

  • Evaluate whether emotions are helpful or unhelpful in various situations
  • Learn to use helpful emotions to guide action
  • Identify the source of unhelpful emotions
  • Learn to change unhelpful emotions
  • Develop alternative, healthy ways of coping with situations that often elicit maladaptive emotions
  • Form personal scripts that help challenge the destructive thoughts that may be associated with unhelpful or maladaptive emotions

EFT is generally considered to have been successful when the individual in treatment has developed an increased awareness of their emotional experience, improved their ability to regulate emotions, and become capable of transforming unhelpful emotions. 

How Can Emotion-Focused Therapy Help?

Many different issues that bring individuals to therapy may be exacerbated and/or maintained by unsuccessful attempts to control emotions. People who experience depression, for example, may spend a significant portion of their time avoiding, or trying to escape, situations that cause them to feel sadness or otherwise experience a low mood. Individuals who experience anxiety might frequently feel debilitated by their attempts to reduce fear and worry and seek to stay as far away as possible from the people or things that provoke anxiety.  Therapists practicing this method take a compassionate, non-judgmental, and reflective approach to listening and questioning in order to best help the individual in therapy arrive at a better understanding of their emotions. 

By using EFT to address their concerns, individuals may be able to come to see their emotions as valuable sources of information instead of painful or difficult states that are better suppressed than experienced. Because EFT addresses the regulation and impact of emotions, something common to many mental health concerns, it may offer benefit in the treatment of a range of psychological issues. 

This method was first used to treat depression, but it has since expanded in practice to be used to address childhood abuse or neglect, anxiety, eating disorders, and borderline personality, as well as various general concerns such as interpersonal issues.

EFT has also been found to be one potentially effective treatment for couples in distress. 

Limitations of Emotion-Focused Therapy

Some psychological issues, such as panic or impulse control, can be described as disproportionate responses to parts of one’s internal experience, such as thoughts, feelings, or bodily sensations. Because EFT helps people be more responsive to their internal experience, it is generally not recommended in the treatment of issues such as these.

EFT requires individuals to be willingly open and honest and work toward development of a compassionate stance toward their own emotional experience. Although compassion and honesty can be increased through therapy, this treatment is generally not indicated for those who may make deliberate attempts to deceive or manipulate the therapist. Finally, because EFT is a type of therapy aimed at improving a person’s overall functioning, rather than addressing specific symptoms, it may not be the most effective approach for individuals seeking treatment to reduce a specific symptom of a psychological issue.  

Several research studies conducted by the developer and others have shown EFT to be an effective approach, and the method is empirically supported as an evidence-based treatment

References: 

  1. Greenberg, L. S. (2004, January 29). Emotion-focused therapy. Clinical Psychology and Psychotherapy, 11, 3-16. doi: 10.1002/cpp.388
  2. Goldman, R. N., Watson, J. C., and Greenberg, L. S. (2011, June 5). Contrasting two clients in emotion-focused therapy for depression 2: The case of 'Eloise,'  'It’s like opening the windows and letting the fresh air come in.' Pragmatic Case Studies in Psychotherapy, 7, 305-338. doi: 10.14713/pcsp.v7i2.1093
  3. Van Nuys, D. (n.d.). An interview with Leslie Greenberg, PhD, on emotion-focused therapy. Retrieved from http://gulfbend.org/poc/view_doc.php?type=doc&id=36618&cn=91
  4. What is emotion focused therapy? (n.d.). Retrieved from http://www.iseft.org/What-is-EFT
  5. What is emotion-focused therapy (EFT)? (n.d.). Retrieved from http://www.emotionfocusedclinic.org/whatis.htm