What is Emotion
Focused Therapy?
Emotions are understood as innate and adaptive, connected to our most essential needs and guiding us towards action. Emotions evolved with us to help us survive and thrive. Emotion Focused Therapy is an empirically-supported, evidence based psychotherapeutic approach which views emotions as centrally important in human functioning and core to therapeutic change.
Emotion Focused Therapy was initially developed by Professor Leslie Greenberg, in collaboration with Professor Robert Elliott and Dr. Laura Rice (for individual therapy) and Dr. Sue Johnson (for couples’ therapy). In a program of research spread over more than 30 years, EFT has developed a distinctive perspective on emotion underpinning meaning, direction, and growth. The approach utilises well researched methods to facilitate emotion processing in therapy. It helps people to accept, express, regulate, make sense of and transform stuck emotions as a path to change. Further, it recognises the importance of meaning making, and seeks to open up ‘meaning bridges’ between emotion and cognition, thereby supporting and consolidating client change and connecting ‘the head and the heart’.
Emotion Focused Therapy developed as a series of individual tasks with specific goals. Utilising decades of detailed research, the tasks and the therapeutic steps to change within each one have been refined to maximise outcomes. Tasks can be selected and applied on a single session or multiple session basis, enabling them to be easily integrated into existing psychological practice. This makes them useful even where therapists are working predominantly with other models. Evidence shows that incorporating individual EFT tasks such as chairwork tasks can bolster treatment outcomes. They can lead to a strong pre- to post-session symptom change, and when used repeatedly over the course of a wider therapy can lead to greater change than other approaches that do not use chairwork (Pascual-Leone & Bahar, 2023).
Tasks can also be delivered in a full Emotion Focused Therapy, with many disorder-specific models available.
Emotion processing (i.e. how emotion productively changes) is a common therapeutic process across therapies, including Emotion Focused Therapy (EFT), Schema Therapy (ST), Cognitive Behavioural Therapy (CBT), Dialectical Behavioural Therapy (DBT) and psychodynamic psychotherapy (Pascual-Leone, 2018). Models differ in the way they may target emotional change, but these methods are all thought to represent subtypes of emotion processing which include aspects of: awareness, affective arousal, down regulation, cognitive reflection on emotion and emotion transformation. Mapping out emotional change (understanding key emotional states and productive transitions between them) enables building of causal models of how people can get better, and which methods might best facilitate such changes. Emotion Focused Therapy utilises decades of change process research to more efficiently facilitate emotion processing. Furthermore, Emotion Focused Therapy goes a step further than other therapy models in emotional processing by focusing on emotion transformation to shift stuck emotional patterns (feelings that have become ‘the story of my life’).
Crucial to Emotion Focused Therapy and to facilitating change is the therapeutic relationship. The style is built on genuine empathy and warmth and is both responsive and proactive. It combines an approach of ‘following and guiding’ the client in their experiential process. Using detailed change process analysis, such as conversation analysis, the field of Emotion Focused Therapy has developed a range of empirically supported techniques (Advanced Empathy) that help build strong and safe relationships with clients, and assist in supporting the deepening of emotion processes and in guiding clients toward change.
For those wanting to offer a full Emotion Focused Therapy therapeutic approach, Emotion Focused Therapy also has an evidence-base for disorder-specific interventions. Most of the Emotion Focused Therapy models and evidence base exists in the areas of anxiety disorders (including in primary care settings), depression, complex trauma, and eating disorders (including Binge Eating Disorder and anorexia nervosa).
I am a co-developer of SPEAKS which is well suited to eating disorders.
Emotion Speaks is the professional website of Dr Anna Oldershaw, clinical psychologist, Director of Emotion Focused Therapy Institute of England and co-developer of SPEAKS.
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