EFT is an evidence-based systemic approach to couple therapy that centers on re-establishing intimacy between partners. Practitioners incorporate emotional expression and externalizing of the couple dynamic in order to foster teamwork and healthy attachment.

The April issue of The Journal of Marital and Family Therapy (JMFT) included several articles on outcomes related to the use of EFT. Today, I am summarizing one of these articles, Vulnerable Emotional Expression in Emotion Focused Couples Therapy: Relating Interactional Process to Outcome, by McKinnon and Greenberg, and highlighting the main results. If you are an EFT practitioner, or interested in EFT, I encourage you to take a look at additional articles found in this JMFT issue.

"Helping couples to reveal their underlying vulnerable emotions and to respond to one another's vulnerable emotional expressions in an empathic, supportive manner is crucial to relationship repair and healing." - McKinnon and Greenberg (2017)

Participants

The study included couples that had "unresolved hurt or anger" related to a relationship injury from their partner at least two years in the past. Participating couples were also required to have been living together for at least two years.

Procedures

Each partner completed several assessments related to "forgiveness, trust, unfinished business, and relationship satisfaction" one week prior to treatment and one week following treatment. Raters watched videotaped sessions of each couple for emotionally vulnerable and supportive communication. They assigned an overall vulnerability and supportiveness score to each partner. The researchers' hypothesis was that high levels of vulnerability matched by high levels of supportive response would result in higher post scores on assessments by each partner.

Results

The researchers hypothesis was accurate. A meaningful result of this study is that “the resolution of an emotional injury is most likely to occur when a) the offending partner shows a high level of supportiveness at those times when the injured partner expresses vulnerable emotion, and b) the offending partner expresses a high level of vulnerable emotion himself or herlself. Whether or not the injured partner responded to the offending partner’s vulnerable emotional expression with a high level of supportiveness was found to be of little consequence to outcome in this sample" (McKinnon & Greenberg, 2017, p. 209).

The researchers also noted an unexpected outcome: The "offending" partner's high level of vulnerability during therapeutic dialogue was not associated with increased relationship satisfaction, but did impact scores for forgiveness and unfinished business.

Takeaway

What all therapists can take away from this research study, regardless of their theoretical approach with couples, is that helping "offending" partners stay in the moment of their partner’s vulnerability and communicate support is a significant factor in resolving long-term relational injury.

The authors also note that the offending partner must feel comfortable expressing vulnerability in therapy sessions. While no one person's vulnerability is most important, the offending partner's support is crucial in moving the couple past the injury.

Resources for further reading:

Dr. Sue Johnson's website: http://www.drsuejohnson.com/

Johnson, S. (2004). The practice of emotionally focused couple therapy: Creating connection (2nd ed.). New York, NY: Brunner-Routledge.

Johnson, S. (2013). Love sense: The revolutionary new science of romantic relationships. New York, NY: Little, Brown and Company.

Let's Chat

What approach do you use with couples?
What is your experience with EFT?

Follow on Facebook for relevant reading and inspiration for the therapist life. >>

How To Address Therapy Clients' "Undercurrents" and Stress In Therapy

Feeling confident when offering therapy to families is a goal for many therapists and counselors. When we face the limitations of an individual perspective on treatment, we are left to wonder, “What theory, or techniques, can help this client comprehensively?”

Dr. Scott Sells explains two techniques from the Family Systems Trauma Model (FST) that will reframe family problems and help lead to second-order change. FST is applicable to your work whether you see individuals, couples, or families.

The Importance of Using Metaphors and Metaphoric Tales as a Therapeutic Intervention

Metaphor is a figure of speech that consists of naming, describing, or qualifying something through its similarity or analogy to something else. It’s not just about songwriting or poetry-- we use metaphors all the time. After all, we all “fall in love” or “get stuck” at some point in our lives.

In the psychoanalytic approach, metaphors have always been very important, since the unconscious mind is

Family Therapy Basics Research RoundUp: Winter 2020

This post includes brief summaries of four articles, and two books I read recently. Three articles are from 2017, and one article is from 2019. I found the articles from 2017 as I researched topics for a few classes I was teaching last fall.

All articles are from the Journal of Marital and Family Therapy. As a MFT, I always start my research in this journal.

My regular disclaimer for these posts is: While MFTs are referenced throughout the summaries, the information is relevant to all psychotherapists, regardless of discipline.

Trauma and Ambivalence In Therapy, with Dr. Robert T. Muller

In the following video, my guest is Dr. Robert T. Muller, author of Trauma and The Struggle to Open Up. Dr. Muller and I discuss the topic of clients’ ambivalence toward their trauma histories, how this ambivalence is challenged, naturally, through clients’ life experiences, as well as how the ambivalence may show up in the therapeutic encounter.

To view the video, or read the transcript,

Are Gottman Method and Emotionally Focused Therapy (EFT) Compatible?

Couples counseling today is so much more effective than in decades past. There is almost too much information out there to guide therapists. It can be overwhelming.

I have seen many discussions about two of the main therapeutic models for couple therapy: Sue Johnson’s Emotionally Focused Couple Therapy, and John and Julie Gottman’s Gottman Method. The discussion can be, like so many discussions, very polarized at times. But there is such a richness and joy to learning from both (not to exclude all of the other contributors to the field right now) that the idea of folding together some of what these models offer seems inevitable.

How to Use The Systemic Therapy MicroSkills: The Joining Skills, Part 2

Series Intro

Dr. Schooley and her co-author, fellow professor and family therapist, Jim Hibel, are currently writing a book on the small systemic skills that therapists can intentionally practice in order to increase their effectiveness. In this video series, we review the systemic therapy skills that will be included in their book.

If you haven’t already read, or viewed, part one from this series, do that now!

How to Use The Systemic Therapy MicroSkills: The Joining Skills, with Dr. AnnaLynn Schooley

This post is the first of several articles in which I discuss the systemic therapy microskills, with Dr. AnnaLynn Schooley.

Dr. Schooley and her co-author, fellow professor and family therapist, Jim Hibel, are writing a book on the small systemic skills that therapists can intentionally practice in order to increase their effectiveness.

Six Steps For "Socioculturally Attuned" Family Therapy: A Summary

Socio-cultural factors influence almost all significant relational interactions between clients and themselves, clients and their significant others, as well as clients and therapists. Language, economic status (and sense of mobility), ethnicity, gender, privilege, among other identities through which clients (and therapists) navigate their realities intersect in therapeutic interactions.

Failure to name and discuss these factors leaves clients to continue entrenched stories of self and relationships, and limits clients’ options for negotiating their needs and pursuing their sought-after changes.

How To Structure Therapy, So Parents Will Participate

For today’s post, I chatted with Kristin O’Rourke, a licensed clinical social worker in the state of New York. Kristin heads a group practice in Rockland County, where she and her team specialize in working with children and families.

Included in this post is a section of our conversation, during which Kristin details how she engages parents in therapy, when a child is the identified patient.

Mindfulness Tips for Therapists, for Work and Life

Mindfulness is popular.

You likely have worksheets, lessons, techniques, and theories that help your clients understand mindfulness and its benefits.

You understand mindfulness and its benefits.

But, as we therapists know, sometimes understanding doesn’t foster motivation, or change. The fact is, therapists struggle to implement mindfulness, along with a “self-caring” lifestyle (Kissil and Niño, 2017).

Linear vs. Circular Causality: Systemic Therapy Series

Lately, I’ve been reviewing the history of the marriage and family therapy (MFT) field. Including the stories of MFT pioneers, the shift represented in the field from treating the individual to treating the system, and the core concepts that mark systemic thinking and systemic therapy.

It’s been fun!

I’ve decided to begin a systemic therapy series to review the major concepts of systems theory, as well as how to begin and maintain the systemic perspective.

How To Write A Therapy Case Summary

Conceptualizing a case systemically can be challenging, because of the many family members and influences that are relevant to our work with clients. In the practicum courses I teach, students are required to write a case summary and present the case to the class. In this post, I outline and explain the sections of the case summary assignment.

* This post contains amazon affiliate links. If you choose to purchase via the link, I earn a small percentage that supports this blog.

10 Therapist (and Child)-Approved Activities to Support Kids with Anxiety

If you’re a mental health professional working with children, you will probably agree that many of the calls you receive from parents have something to do with anxiety or stress. Child therapists have the amazingly important yet challenging task of educating and supporting kids in a therapeutic setting that is both productive and fun. When working with children as young as preschool age, it can be a very daunting task to keep things fresh and exciting week after week! So, how do we help children develop the coping skills they need while keeping them engaged (and not glancing at their watch)? Here are ten therapist (and child!)-approved, fun activities that address anxiety-based disorders and promote relaxation and stress reduction in children:

The Art and Science of Therapy as Craft, Part 2: Crafting Questions

For this week's video chat, Dr. AnnaLynn Schooley returns to discuss therapy questions as an intentional craft, and she covers four basic question types: single answer, open, closed, relational, and circular.

Therapist Self-Disclosure Simplified

Self-disclosure is a touchy subject among therapists. Some therapists never self-disclose, while others feel stifled by having a rigid boundary around self-disclosure. As I consider self-disclosure in therapy, I ask myself, “When is self-disclosure appropriate?” “How does self-disclosure deepen the therapist-client connection?"

Solution Focused Brief Couples Therapy Tips, with Elliott Connie

Elliott Connie is a Solution Focused Brief Therapy (SFBT) practitioner, author, and speaker. He developed an approach to couples work that distills the essence of SFBT into guiding principles for working with couples.

As a therapist who loves working with couples, I am always interested in ways to enhance my couples therapy skills. For this reason, I invited Elliott to explain the reasons why SFBT is his choice for working with clients, as well as how it creates a contrasting experience for couples that have a history in therapy.

Family of Origin Exploration for the Therapist: How to Create Your Genogram

In article three of the Family of Origin for the Therapist series, you learned 3 simple steps for how to begin family of origin (FOO) exploration: 1) read Bowen’s chapter, 2) observe your FOO experience, and 3) reflect on what you learned. Hopefully, your curiosity has led to significant understanding.

Understanding is the foundation of Bowen Family Systems Theory (BFST). Bowen (1985) believed that if clients could understand themselves as members of their FOOs and as created by their histories, they could begin and continue significant change.

In today’s post, I offer the next step in developing understanding: Creating your genogram. I explain how to create a basic genogram that you can expand as you continue your exploration.

5 Tips for Keeping Up with Therapy Paperwork

In my interaction with therapists as a mentor and supervisor, I’ve learned that one of the main struggles therapists face is having too much work and not enough time. Many therapists find themselves overwhelmed by documentation responsibilities, in particular; this includes completing client notes, referrals, billing, treatment plans, etc.

In today’s post, I offer several strategies for keeping up with paperwork, so that you can stay on track and avoid the stress of falling behind.

Solution-Focused Brief Therapy Client Types, and Their Relevance To Every Session

In her 1989 article, Of Visitors, Complainants, and Customers, Insoo Kim Berg details three types of “client-therapist relationships” (p. 21). Her wording is significant, because she is not labeling clients; she is describing them in terms of their relationship to the therapist, the process of therapy, and the problem. These three relationships have undergirded Solution-Focused Brief Therapy theory and interventions over the years, although they are not consistently discussed in newer works. The client relationship types are widely applicable to therapy, regardless of theoretical orientation, making them one of the most useful concepts in marriage and family therapy.

In this post, I present a review of these client types, and I explain their relevance to and usefulness for all therapeutic sessions.

How to Ethically Offer Coaching as a Licensed Therapist: A Step-By-Step Guide

One of the most common professional goals for my clients is expanding their private practice to include life coaching services. As professionals with a depth of knowledge in personal development and goal achievement strategies, therapists are ideal candidates for the coaching profession. Despite this near perfect fit, there are some important ethical consideration for therapists when offering coaching services alongside therapy, or when choosing to become professional coaches. In this post, I focus on offering solutions for these complications, in an effort to help you ethically practice coaching.

5 Step Plan for De-escalating an In-Session couple Argument

Most of us, therapists, have been there: A simple disagreement turns into an all-out screaming match in the middle of a therapy session. This is, thankfully, not a common scenario for most therapists, but it’s also not rare--especially for therapists who specialize in couple therapy.

In this post, I cover steps for disrupting an argument occurring in a couple therapy session. Intervention on the part of the therapist is necessary during some conflicts, because the arguments can cause further damage in the couple relationship. And, if therapists allow arguments to continue for too long, they can affect the couple’s sense of safety when in therapy.

The main goals of intervention in this case are to: