Emotionally Focused Couples Therapy (EFCT)
What is emotionally focused couples therapy?
Emotionally focused couples therapy is a structured, shorter-term type of couples counseling, in which the therapist helps the couple to examine unhelpful habits of interacting with one another and replace them with more helpful habits. The role of emotions is at the front and center of this therapeutic approach.
Emotionally focused couples therapy was developed in the 1980s and has been the subject of much research.
The therapy is grounded in attachment theory, a long-standing psychological theory with considerable support. According to this theory, emotional engagement and responsiveness are essential to a secure bond in a relationship. Having this secure and safe emotional connection is a fundamental human need.
The aim of emotionally focused couples therapy, therefore, is to help couples to develop a trusting and secure bond.
What emotionally focused couples therapy can help with
Emotionally focused couples therapy can help couples who simply want to strengthen their relationship, as well as those who are experiencing problems in their relationships.
For example, emotionally focused couples therapy can be helpful for couples where one or both partners are experiencing:
- A loss of trust in the other (for example, in instances of infidelity)
- Fear or anger towards the other
- Depression, chronic illness, post-traumatic stress disorder, or another mental or physical health condition
You do not need to be experiencing a mental health problem for your relationship to benefit from emotionally focused couples therapy.
However, if you are, it is generally recommended that you also engage in individual therapy to address mental health problems directly.
Effectiveness of emotionally focused couples therapy
Many studies have examined the impact of emotionally focused couples therapy and found it to be an effective therapy for couples. 
For example, research has shown that 70-75% of couples move from distress to recovery after participating in emotionally focused couples therapy. 
The main barrier to improvement through emotionally focused couples therapy occurs if one or both of the partners continues to engage in abuse in the relationship.
How emotionally focused couples therapy works
Emotionally focused couples therapy works by helping you and your partner to understand and then change the unhelpful ways you might interact with one another. This reduces conflict and distress while also strengthening your attachment to one another.
The emotionally focused couples therapy therapist pays particular attention to the emotions you and your partner are experiencing during your interactions, as emotions are considered critical to facilitating change.
Therapists who practice EFCT are deliberately open and egalitarian in their approach, so that they can provide a safe place where exploration is possible for both people in the relationship – they do not take sides in disagreements.
Your emotionally focused couples therapy therapist will usually make observations or teach skills to help you both to:
- Identify unhelpful cycles in the way you and your partner interact with each other as it occurs during the session and understand the impact that this is having on the relationship.
- Examine and become more aware of your emotions and become better able to identify them in the moment.
- Become more aware of how your emotions are triggered and how you behave when that happens.
- Express your emotions and needs to each other more effectively, especially those which may be difficult to discuss.
- Listen, understand and react more empathically to your partner’s expression of emotions.
- Better cope with difficult or intense emotions.
- Communicate with each other in more helpful ways.
The aim is to help you and your partner to be more emotionally engaged with one another, strengthen your bond and increase trust. A variety of techniques may be used by the therapist to help achieve this, including modeling or role-playing to practice new skills or ways of interacting.
Frequency of emotionally focused couples therapy sessions
Although you, your partner and your therapist will work together to meet your specific needs, sessions are often scheduled on a weekly basis initially.
Frequent sessions are beneficial at the beginning, as you work together to identify and understand the problems and learn skills to communicate and cope more effectively.
As therapy progresses, session frequency tends to reduce to biweekly or monthly. This allows for more time between sessions to practice and consolidate skills at home.
Length of emotionally focused couples therapy treatment
The duration of emotionally focused couples therapy treatment varies, but is typically shorter-term and tends to last up to around 20 sessions.
You, your partner, and your therapist will work together to determine the right time to finish therapy.
Structure of emotionally focused couples therapy sessions
Emotionally focused couples therapy often begins with an initial assessment session, with both you and your partner present.
Sometimes this is followed by an individual session each before you both come back together to continue therapy in conjoint sessions.
Together, you will work through the three stages of emotionally focused couples therapy:
Stage one of EFCT:
Your therapist observes and assesses the difficulties in your relationship. They work collaboratively with you both to understand what the underlying problems are and set goals.
You’ll work together to identify unhelpful cycles of interacting with each other as well as learn to identify and communicate underlying emotions.
Your therapist helps you both to change the way you view your relationship problems so that you can see them in terms of the unhelpful cycles of interactions and underlying emotions.
Stage two of EFCT:
Therapy becomes more skills-based to enable you and your partner to build new and helpful ways of interacting with one another. This often involves learning skills for:
- Coping with and expressing emotions and needs
- Accepting your partner’s expression of their emotions and needs
- Communicating with one another more effectively
Stage three of EFCT:
Sessions focus on consolidating the new ways of interacting with each other. Usually, a plan will be made collaboratively to ensure the continued progression of your strengthened relationship.
What happens in a typical emotionally focused couples therapy session
What actually happens in an emotionally focused couples therapy session depends on the particular difficulties you are experiencing and which stage of therapy you are at. However, a typical session often includes the following components:
- Review: A review of homework tasks and discussion of any difficulties encountered since the last session.
- Therapist observations: The therapist pays close attention to the dynamics between you and your partner during the session. They may ask questions to help you to identify underlying emotions.
- Modeling or role-playing: The therapist might show you how to communicate your emotions to one another and listen and respond effectively. They may model the behavior themselves or coach you both in role-playing the interaction.
- Skills-training: For example, the therapist might teach you and your partner skills and strategies to help you both to regulate your emotions. This often involves practicing in the session and at home.
- Summary: The session might conclude with a summary of the observations made and skills learned.
- Homework: Usually, the therapist will set homework exercises to complete at home between sessions to supplement treatment.
What to look for in an emotionally focused couples therapy therapist
- Credentials: Look for a licensed mental health professional who has specifically undertaken additional training in emotionally focused couples therapy.
- Comfort and trust: You and your partner should both feel comfortable working with the therapist. The trusting working relationship between the couple and the therapist is a crucial factor known as the “therapeutic alliance."
The best way to gauge how you might feel about your prospective therapist is to ask for a preliminary phone call in which you can ask about their qualifications, experience, any ongoing training in emotionally focused couples therapy they are undertaking and what therapy with them will be like.
New to therapy? Learn about how to find a therapist here.
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