Thursday, 13 November 2014

Emotionally Focused Family Therapy (EFFT)



Image: loriunderwoodtherapy.com
 
Emotionally Focused Family Therapy (EFFT)

Emotionally Focused Family Therapy (EFFT) was developed by Leslie Greenberg and Sue Johnson from “Bowlby Attachment Theory” (Carr, 2012). It is one of the Experiential Therapies (Gestalt Therapy, Emotion-Focused Therapy-EFT ) (Prochaska & Norcross, 2014). It was first known as Process- Experiential Therapy, as an alternative to Gestalt Therapy (Prochaska & Norcross, 2014).The EFFT combines elements of client-centered and Gestalt Therapy (Prochaska & Norcross, 2014). It is a brief therapy, conducted in ten to fifteen sessions, and is applicable for couples, families and individuals (Gehart, 2013). The first and last sessions include the whole family, with the sessions in between, being with family subsystems (Johnson, Bradley, Furrow, Lee, Palmer,Tilley & Woolley, 2014).

This model concentrates on what is happening at the present moment, in the intercommunication, and in the emotions expressed (Johnson, Bradley, Furrow, Lee, Palmer,Tilley & Woolley, 2014). The goal of this approach is to help clients to learn how to better deal with their emotions and act in order to have their needs met by their closest relationships (Carr, 2012). It concentrates on reorienting the connection of emotional bonds among family members (Carr, 2012). 

This theory states that maladjustments occur when the couple's attachment style does not meet their needs (Carr, 2012). Consequently, feelings such as fear and frustration, connected with internalised childhood insecure attachment programs (Carr, 2012) will originate, but are not exposed to the partner. This will generate a self-protective secondary level of stronger emotions such as irritation, and avenging, affecting the entire family (Carr, 2012). Hence, the couple create a negative sequence of behaviour response where people offend, retreat or detach, but never meet each other needs (Carr, 2012).

The EFFT therapist guides clients to improve communication and create a sense of safety in their relationships, where they are be able to clearly speak about their feelings with each other, in order to fulfill their needs (Carr, 2012). This change develops new neural pathways (Grawe, 2007), and establish a new positive cycle of interaction (Carr, 2012). The EFFT process is to assess, disable, and reorganise the structure of the family members interactions and stabilize the changes (Johnson, Bradley, Furrow, Lee, Palmer,Tilley & Woolley, 2014).

The therapist's role is to create a safe environment, where the therapist reflects client's feelings, re-describes the issues to disable the problem, endorse clients emotional experience,and establish a solid therapeutic alliance (Johnson, Bradley, Furrow, Lee, Palmer,Tilley & Woolley, 2014). During the therapeutic process, the couple is asked to indicate their conflicting issues, how they resolve them, as well as to search for the hidden feelings (Johnson, Bradley, Furrow, Lee, Palmer,Tilley & Woolley, 2014). The expected outcome is that they will modify their habitual behaviour by creating new response pathways (Johnson, Bradley, Furrow, Lee, Palmer, Tilley & Woolley, 2014).

The therapeutic relationship in this approach has a specific intention, where the therapist is more active, complimenting and kindly guiding the clients (Prochaska & Norcross, 2014). Clients are considered specialists in creating their goals and solutions, while therapists are the professionals in the process and structure of therapy (Goldenberg & Goldenberg, 2014). The therapist must create a safe therapeutic environment, where clients can identify their main conflicts, and freely and directly express their feelings to each other (Johnson, Bradley, Furrow, Lee, Palmer,Tilley & Woolley, 2014).

By changing the couple's negative habits of interaction, the relationships among the family is fortified and the withholding of feelings decrease (Johnson, Bradley, Furrow, Lee, Palmer,Tilley & Woolley, 2014). This intervention consequently improve the client's ability to solve their problems and allow the children to have a more active expression and participation in the family, hence, preventing the repetition of this unhelpful cycle in their future family (Stavrianopoulos, Faller, & Furrow, 2014). 

Research indicate that Emotionally Focused Family Therapy is effective to be applied for couples experiencing stress, trauma, grief (Johnson & Keeler, 2007), childhood trauma due to sexual abuse (Macintosh & Johnson, 2008), families and individuals (Gehart, 2013), in a variety of settings, with long term positive outcomes (Furrow, Johnson & Bradley, 2011).

Some other strengths of the EFFT includes the fact that it is an enriched conceptualised approach, which incorporated the concepts of “Bowby's attachment theory”(Furrow, Johnson & Bradley, 2011). It has been chosen by clinicians for being a short term treatment with strong impact of change, as the approach addresses not only the interactions among the family members as a system, but also the individual intra-psychic conflicts (Johnson, Bradley, Furrow, Lee, Palmer,Tilley & Woolley, 2014).

Some criticisms to this approach include the requirement for a careful assessment, as it is not indicated for all types of clients, as well as the difficulties in control the unpredictability of the behaviours in a family therapy session, when expressing withholding feelings (Palmer, Gail, Efrom, 2007). The last criticism is regarding to the therapist active position, which may resemble too direct to some clients (Efron & Bradley, 2007).

Mrs Glaucia Barbosa,
PACFA Reg. Provisional 25212 
MCouns, MQCA(Clinical)  
ABN: 19 476 932 954


References
Carr, A. (2012). Family therapy : Concepts, process and practice (3rd ed.). Hoboken:Wiley.
Efron, D., & Bradley, B. (2007). Emotionally focused therapy (eft) and emotionally focused family
therapy (efft): A challenge/opportunity for systemic and post-systemic therapists. Journal of Systemic Therapies, 26(4), 1-4. doi:101521/jsyt.2007.26.4.1
Furrow, J. L., Johnson, S. M., Bradley, B. A. (2011). The emotionally focused casebook: New directions in treating couples. New York, NY: Brunner-Routledge.
Gehart, D. R. (2014). Mastering competencies in family therapy: A practical approach to theories and clinical case documentation. Belmont, Calif.: Brooks/Cole, Cengage Learning.
Goldenberg, I.,Goldenberg, H. (2013). Family therapy: An overview. Belmont, CA: Brooks/Cole.
Grawe, K. (2007). Neuropsychotherapy: How the neuroscience inform effective psychotherapy. Marrawah, N.J: Lawrence Erlbaum.
Johnson, S. M. (2005). Becoming an emotionally focused couple therapist: The workbook. London: Routledge.
Johnson, S. M., & Williams-Keeler, L. (1998). Creating healing relationships for couples dealing with trauma: The use of emotionally focused marital therapy. Journal of Marital and Family Therapy, 24(1), 25-40. doi:10.1111/j.1752-0606.1998.tb01061.x
MacIntosh, H. B., & Johnson, S. (2008). Emotionally focused therapy for couples and childhood sexual abuse survivors. Journal of Marital and Family Therapy, 34(3), 298-315.
Palmer, Gail, MSW, RMFT, & Efron, Don, MSW, RSW. (2007). Emotionally focused family therapy: Developing the model. Journal of Systemic Therapies, 26(4), 17-24. doi: 10.1521/jsyt.2007.26.4.17
Prochaska, J. O, Norcross, J. C. (2014). Systems of psychotherapy: A transtheoretical analysis. Belmont, CA: Brooks/Cole Cengage Learning.
Stavrianopoulos, K., Faller,G., & Furrow, J. L. (2014). Emotionally Focused Therapy : Facilitating Change within a family system. Journal of Couple & Relationship Therapy, ISSN 1533-2691, 01/2014, Volume 13, Issue 1, p. 25


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