The Contribution of Emotionally Focused Couples Therapy

This article describes emotionally focused couple therapy and the contribution of this model to the field of couple therapy. A focus on emotional processing in the present moment, on process factors and on a genuine empathic connection with both clients is at the heart of this model. The creation of new patterns of emotional responses results in the creation of key new interactional responses. EFT is empirically validated on several levels: on the level of treatment outcome, and on the levels of the relational theory in which it is based and key moments and factors in the change process.     

The Effectiveness of Emotionally Focused Couples Therapy With Veterans With PTSD: A Pilot Study

The current study is a pilot project conducted at Baltimore VA Medical Center investigating the use of emotionally focused couples therapy (EFT) for couples in which one partner is a veteran who has been diagnosed with posttraumatic stress disorder (PTSD). Fifteen couples enrolled in the study and seven of these couples completed treatment (26 to 36 weekly sessions of EFT). Both partners were assessed on measures of relationship satisfaction, psychological distress, depression, and quality of life, and veterans were assessed on measures of PTSD symptoms at baseline and 2 weeks after the intervention. Paired t-tests were used to compare scores before and after EFT. In terms of results, the veterans' partners reported significant improvements in relationship and life satisfaction and in decreased depression and a decrease in psychological distress. Veterans demonstrated a significant decrease in self-reported symptoms of PTSD. These results provide preliminary evidence for the usefulness of EFT to help foster improved relationship satisfaction, and psychological well-being for veterans with PTSD and their partners who completed treatment.     

Healing the Attachment Injury of Marital Infidelity Using Emotionally Focused Couples Therapy: A Case Illustration

This case illustration is a demonstration of a therapist handling the betrayal of infidelity through the application of Emotionally Focused Couples Therapy (EFT), specifically utilizing the attachment injury resolution model. An actual dialogue from a key couples session is included as it applies to the model, providing clinicians with an example for how EFT can be applied to the common clinical occurrence of infidelity.     

The Efficacy of Behavioral Couples Therapy and Emotionally Focused Therapy for Couple Distress

Twenty treatment outcome studies, 13 of which evaluated behavioral couples therapy (BCT) and seven of which evaluated emotionally focused therapy (EFT) were reviewed, leading to the following conclusions. BCT leads to short and long-term gains for moderate to severe couple distress. In the long term BCT probably leads to no better outcomes than its constituent components—behavioral exchange training and communication and problem solving skills training. Addition of a cognitive therapy component to BCT or the use of a variety of treatment formats does not improve the efficacy of BCT. Integrative couples therapy and insight-oriented marital therapy may be more effective than BCT, but studies supporting this conclusion require replication. EFT leads to short and long-term gains for mild to moderate couple distress. Addition of a cognitive therapy component to EFT does not enhance its efficacy. EFT may be more effective than problem solving therapy and less effective than integrated systemic therapy, but the two studies supporting this conclusion require replication.Michael Byrne, PhD, is a Clinical Psychologist, Midland Health Board, Ireland; Alan Carr, PhD, is Director of the Clinical Psychology Training Programme, Department of Psychology, Arts Building, University College Dublin, Belfield, Dublin 4, Ireland (alan.carr@ucd.ie). Marie Clark, PhD, is Lecturer, Department of Psychology, University of Surrey, United Kingdom.     

Emotionally Focused Couple Therapy with Couples Facing Terminal Illness

Research on effective therapeutic interventions for couples dealing with terminal illness is scant. Changes in daily routine, added responsibilities, role changes, and the grief process are all contributors to the enormous stress and emotional strain felt by these couples. Couples where one partner is terminally ill may experience anger, depression, guilt, and anxiety. The authors propose that emotionally focused couple therapy (EFT), originally developed by Greenberg and Johnson (Emotionally focused therapy for couples, Guilford Press, New York, NY, 1988) may be effective in addressing this distress and in facilitating the grieving and support process in couples dealing with terminal illness. EFT is a systemic, experiential form of therapy that builds upon Bowlby’s (Attachment and loss: Volume I: Attachment, Basic Books, New York, NY, 1969) attachment theory. By exploring the emotional experience of both partners it may be possible to re-structure the couple’s emotional partnership and support the grief process for both partners.     

Conceptual and Application Issues: Emotionally Focused Therapy With Gay Male Couples

Therapists working with couples are likely to see gay male couples in their practice yet there is a lack of training to prepare therapists to work with gay couples. Emotionally Focused Therapy (EFT) is an empirically supported approach to couples therapy and offers a clear structure and map for working with gay male couples. This article reviews some of the issues that are specific to EFT work with gay men. Given the range of minority stressors that gay men contend with EFT is particularly appropriate for work with gay male couples because of the focus on the attachment bond. Building a secure relationship is an important source of resilience that can buffer against prejudice and discrimination and provide a secure base for individual and couple exploration.     

Non-suicidal Self-Injury (NSSI): A Case for Using Emotionally Focused Family Therapy

Non-suicidal self-injury (NSSI) is defined by engaging in self destructive behaviors specifically targeted toward the body without suicidal intent. It is a mental health phenomenon increasing in occurrence. Marriage and family therapists will need to know how to treat this clinical presentation, as it is gaining recognition as a diagnostic category in the 2013 Diagnostic and Statistical Manual used to identify mental illness. This paper provides background information about NSSI, and includes an argument for testing the treatment of this disorder with Emotionally Focused Family Therapy. A clinical example is included.     

EMDR and Emotionally Oriented Couples Therapy

When reviewing past and current research on the role of emotion in couples therapy, there appeared to be a lack of articulation concerning how emotional expressions and relational dynamics are affected by emotional trauma that has not been accessed. The authors demonstrate how emotionally and experientially oriented therapy with couples can be enhanced by accessing stored trauma through the use of Eye Movement Desensitization and Reprocessing (EMDR). This approach is called Eye Movement Relationship Enhancement (EMRE) therapy and includes key clinical areas such as accessing and tolerating previously disowned emotion, reprocessing emotional experiences, and amplifying couple intimacy. These key areas are discussed and illustrated with case examples.     

Emotionally Focused Family Therapy and Play Therapy Techniques

Emotionally Focused Family Therapy provides a framework for understanding children's behaviors in terms of attachment needs of comfort and support. However, when working with young children, play therapy is often developmentally preferred over “talk therapy.” By integrating play therapy techniques within an Emotionally Focused Family Therapy theoretical framework, therapists can help parents understand and meet their child's needs for affection and comfort. This article will discuss how play therapy techniques can be integrated with an Emotionally Focused Family Therapy theoretical framework for work with young children and their families.     

Learning Emotionally Focused Couple Therapy: Four Clinicians' Perspectives

This study examined the experiences of four clinicians learning emotionally focused couple therapy (EFT). Two group interviews, separated by 6 years, explored topics that included emotion, gender, model differences, personal practitioner impact, and the long-term influence of EFT training on clinical work. Emotion emerged as a major theme, with three subthemes at each phase. Phase 1 results indicated an increase in personal awareness of emotions, a positive impact on close personal relationships, and challenges for males in learning to elicit and use emotion. Phase 2 results, 6 years later, revealed that focusing on emotions remained salient and that EFT continues to influence the work of each clinician to varying degrees. Limitations, future research suggestions, and clinical implications are discussed.     

Treating Depression in Men: The Role of Emotionally Focused Couple Therapy

While initial treatment recommendations for depression in the context of relationship problems have been outlined, attention typically has been focused on females experiencing depression. Less is known about the assessment and treatment of men with depression and relationship distress. This article presents the current literature on depression and relationship problems, including what is currently known about the occurrence, expression, assessment, and treatment of depression in men. Theoretical and empirically based assessment and treatment recommendations are then provided for Emotionally Focused Couple Therapy with depressed men in distressed relationships.     

Emotionally Focused Couple Therapy With Neurodegenerative Diseases: A Pilot Study

ABSTRACT

This research wants to verify the effectiveness of couple's treatment, when a neurodegenerative disease affects one of the two partners. The disease affects not only the ailing individual, but also the dynamics within the couple. Fourteen patients affected by neurodegenerative diseases participated in an emotionally focused couple therapy (EFT) with their spouses. We collected a measure of the quality of life (SF-36) and relationship satisfaction (DAS) at the beginning and at the end of the treatment for both partners. The results show an improvement in quality of life and couple contentment, underlining the usefulness of such a psychotherapeutic intervention on the couple.     

Using Acceptance and Commitment Therapy to Treat Distressed Couples: A Case Study With Two Couples

Although the field of couple therapy has made significant strides in recent years, there continues to be a need for theoretically sound and empirically supported treatments. The current case study examines whether Acceptance and Commitment Therapy (ACT), an experiential acceptance-based behavior therapy, can be effective in treating distressed couples. Although ACT has demonstrated effectiveness in treating a variety of disorders in individuals, it has not been systemically applied to the treatment of couple distress, and the current study is the first empirical examination of ACT for the treatment of couples. Two married couples participated in the study. A number of core ACT interventions were modified to treat couples in a conjoint format. Cognitive defusion exercises were used to help couples reduce their fusion with and the believability of negative thoughts and feelings related to the relationship. Mindfulness and acceptance techniques were used to help couples increase awareness of their reactions to negative relationship cycles. Finally, value-directed action was used to help partners act in ways consistent with relationship values even in the presence of unwanted thoughts and feelings. The results of this preliminary case study suggest that ACT may be effective in increasing marital adjustment and satisfaction, and in reducing interpersonal and psychological distress in couples. Future studies with larger samples and more controlled designs are needed to build on the results from this single-case study.     

Relationship Education for Military Couples: Recommendations for Best Practice

Military couples have a number of distinctive strengths and challenges that are likely to influence their relationship adjustment. Military couples' strengths include stable employment, financial security, and subsidized health and counseling services. At the same time, military couples often experience long periods of separation and associated difficulties with emotional disconnect, trauma symptoms, and reintegrating the family. This paper describes best practice recommendations for working with military couples, including: addressing the distinctive challenges of the military lifestyle, ensuring program delivery is seen as relevant by military couples, and providing relationship education in formats that enhance the accessibility of programs.     

Phase-based Emotionally Focused Couple Therapy for Adults With Complex Posttraumatic Stress Disorder

Complex posttraumatic stress disorder (complex PTSD) presents unique challenges to treatment beyond that of posttraumatic stress disorder (PTSD). The expert consensus best practice for treatment of complex PTSD is a phase-based or sequenced approach that has typically been offered in individual or group therapy modalities. Emotionally focused couple therapy (EFCT) shows promise as a couple-based treatment for PTSD, but the standard protocol may inadequately incorporate best practice guidelines of phase-based treatment for complex PTSD. Integration of phase-based treatment of complex PTSD within an EFCT format is proposed, giving direction to EFCT providers on incorporating best practice guidelines into their work with survivors.     

Using Explicit Case Formulation to Improve Cognitive Processing Therapy for PTSD

We investigated the utility of explicit case formulation (CF) within Cognitive Processing Therapy (CPT) for individuals with posttraumatic stress disorder (PTSD). An uncontrolled pre-posttreatment design was used. Participants attended 12–16 weekly sessions of CPT with explicit CF, where CF guided treatment length and treatment components. Treatment was completed by 19 of the 23 participants who started therapy. Results revealed significant reductions in PTSD and depression severity as well as unhelpful PTSD-related beliefs from pre- to posttreatment (ds between 1.10 – 1.92) and treatment gains were maintained at 3-month follow-up. Of the participants available at posttreatment for assessment, 69% (n = 11/16) met good end-state functioning for PTSD and 62% (n = 8/13) did so at follow-up. Finally, 72% (n = 13/18) of those interviewed at posttreatment no longer met criteria for PTSD and this was found for 93% of those assessed at follow-up (n = 14/15). Treatment, and CF in particular, was found to be acceptable by participants. Explicit case formulation did not interfere with positive outcomes of Cognitive Processing Therapy for PTSD. Further clinical implications and future directions for research are discussed.     

A Case Study of Cognitive-Behavioral Conjoint Therapy for Combat-Related PTSD in a Same-Sex Military Couple

Military deployments to Iraq and Afghanistan are associated with increased risk for posttraumatic stress disorder (PTSD), depression, and relationship impairment. Unfortunately, the perceived stigma associated with seeking deployment-related behavioral health care in military settings has been a significant barrier to care. Historically, active-duty military service members involved in same-sex intimate relationships have experienced further stressors and barriers to care related to additional stigma and lack of social support. Prior federal regulations excluded sexual minorities from openly serving in the military, thereby limiting the available behavioral health services for same-sex couples. Since this ban was lifted after the repeal of the U.S. policy known as "Don’t Ask, Don’t Tell" in 2010, gay and lesbian service members have increased opportunities to obtain behavioral health care. One therapy that is newly available to sexual minority military couples is Cognitive-Behavioral Conjoint Therapy (CBCT), which effectively addresses co-occurring PTSD and relationship dysfunction. This case study illustrates the use of CBCT for the treatment of deployment-related PTSD in a same-sex active-duty military couple. After completing all 15 CBCT sessions, the couple reported clinically meaningful changes in the service member’s PTSD symptoms, which was maintained at the 2-month follow-up. The results of this case study indicate that CBCT for PTSD can have positive treatment outcomes with military same-sex couples. Further clinical implications are discussed.     

The Relationship Balance Model and Its Implications for Individual and Couples Therapy

No abstract available for this article.     

Change in Attachment Dimensions and Reflective Functioning Following Emotionally Focused Group Therapy for Binge Eating Disorder

The current study examines change in attachment variables from pre- to six months post-emotionally focused group therapy (EFGT) for binge eating disorder (BED). A clinical sample of 118 women and men with BED attended 20 sessions of EFGT and completed the Adult Attachment Interview pre- and six months post-treatment. There was a significant increase in secure attachment style classification, significant increases in Coherence of Mind and Reflective Functioning scores, and significant decreases in both unresolved/disorganized attachment style classification and scale scores from pre- to six months post-treatment. Interventions specific to EFGT, common therapeutic factors and group process interventions may have contributed to changes in these attachment variables. The current study demonstrated that EFGT is a promising treatment for facilitating change in attachment in women and men with BED.     

Integrating Sex and Couples Therapy: A Multifaceted Case History

Traditionally, sexuality has not been a focus in couples therapy training, research, or practice, although it is an important, often complex issue for many couples. This article tells the story of a couple presenting for sex therapy due to their unconsummated marriage, and is told to exemplify how sex therapy and couples therapy can be integrated in order to best meet the needs of couples. As the story unfolds, the multilayered facets of the presenting issue are revealed. The therapy incorporates and weaves together family of origin history, intrapsychic and cognitive issues, relational dynamics, patterns of interaction, and physiological/medical concerns into a postmodern couples therapy with behavioral interventions. This combined approach recognizes the value of each method on its own and their greater usefulness when blended together.