At the Center and in our EFT Communities, we field questions from couples regularly about “How do I know a therapist is trained in E.F.T.?” or “That they will actually use E.F.T. with us?”
Director Jim Thomas wrote this article offer some ideas and questions you can ask when looking for a couples therapist regardless of what approach they use and specifically if they do say they use Emotionally Focused Therapy. He thanks Patti Swope, EFT Therapist and Supervisor, LMFT, for inspiring this article in a recent conversation.
Finding a Couples Therapists – Considerations and Questions
The Mixed Blessing of Couples Counseling and Marital Therapy: Let the Buyer Beware:
Finding a competent, well trained and qualified couples therapist even with the internet can be a daunting task. One needs only randomly select ten psychotherapists websites found in a google or bing search. Most all of those therapists state that “I work with individuals, couples and families,” or list couples therapy or marriage counseling as one of the services they offer. Yet, most will not report additional training in this most difficult of therapy specialities or indicate membership in an organization like the American Association for Marriage and Family Therapists, AAMFT, or the International Center for Excellence in Emotionally Focused Therapy, ICEEFT. Thus, how does a couple know if the therapist trained in couples therapy, has advanced training or engages in ongoing continuing education and improvement in the field of couples therapy.
A colleague and researcher in the impacts of individual therapy on marriage as well as on “bad couples counseling,” Bill Doherty, Ph.D., University of Minnesota, recently discussed this issue of training with Center Director, Jim Thomas. ”Surveys indicate that about eighty percent of therapists in private practice do couples therapy. Where they got their training is a mystery because most therapists practicing today never took a course in couples therapy and never did their internships under supervision from someone who’d mastered the art. From a consumer’s point of view going in for couples therapy is like having your broken leg set by a doctor who skipped orthopedics in medical school,” said Doherty.
Making it more difficult, the research outcome studies for couples therapy do not generally achieve strong results. Success rates in the 35 to 50% range do not inspire confidence? Several factors may contribute to these low success rates including couples. For example, often partners wait years to come for help after they knew they needed. Imagine being a dentist whose patients only come in for help maybe five years after knowing they have a cavity. And then saying, “Doc, can you save my tooth, oh and make sure it does not hurt.” That would be delicate work!
Also, couples face an uphill climb against societal and friends well-meaning advice at times. Some of it is counter-productive to a good relationship. Advice like, ”You have to fix your personal issues before you can deal with your marriage,” “You need to learn to have a life outside of your marriage,” and “Depending on your partner or wanting their approval is needy and weak.” These ideas are not supported by research and may hinder closeness.
Plus, delving in to the distance between you and conflicts is not always going to provide instant relief. It can take work and some investment in your relationship to uncover the pattern or dance of distress you are in as a couple. and to learn to slow that negative cycle down, get to underlying vulnerabilities, emotions and needs, and then learn to reach for each other to reconnect and deepen your bond. The search for an instant fix or set of easily implemented tools or techniques can set up false hopes for an easy fix.
So if we put these factors together, a lack of training, couples come in long after they knew they needed help and advice from friends, the internet and friends that might be counter-productive, we can see why having success in marital therapy seems daunting. Yet, there is another factor that may contribute to lackluster to bad results for couples who seek therapy. Even trained therapists may be trained in something that does not work that well, has no evidence to support it, or goes against what couples need to reconnect and create a deep, fulfilling emotional bond that will make their relationship more solid and will give long-term benefits. As an E.F.T. Therapist, the author hears these complaints twenty plus times a year. They come from couples who have tried one, two, maybe three therapies and therapists, only to leave each time with either moderate improvements that did not last or more discouraged than when they walked in for their first session.
The Importance of Knowing To Whom You Are Entrusting Your Relationship Too:
A s we noted above, some of the training for therapists may not be helpful. Some of it is in models that do not have outcome research showing they work. Combining all the factors above, we hear from couples that they encounter situations and interventions like the following:
1) An over-reliance on teaching, psycho-education to the exclusion of helpful experiences in session.
2) Working with assumptions or a theory that goes against what science is showing us about the nature of adult romantic love (see, Love Sense, The Revolutionary Science of Romantic Love, by Dr. Sue Johnson, for an engaging review of this emerging science).
3) Taking sides, shaming and blaming and then using scolding and rule-based interventions that couples have a hard time hearing and applying. Couples report they then feel worse over time.
4) No solid theory about adult love, couples distress and root causes, and/or
5) Without a theory grounded in science and research, not having a map and methods to guide a couple to a better place.
6) Doing lots of individual sessions at the expense of the couples work or recommending breaking up or divorce.
As you are talking to them, do they seem open, are they attuning to your concerns and being responsive and engaged in the conversation. How the therapist is during a five minute phone call often reflects how you will experience them over an hour or so in session or over several months of couples therapy.
Where the Rubber Meets the Road: What do they base their couples therapy work on? Under Colorado Statutes regarding the practice of psychotherapy, consumers have a right to ask questions. Some useful questions might include:
1) Can you describe how you generally think of couples problems and distress? (they ought to know, watch for vagueness and comments like, “It depends on each couple.” This may be an indication they lack a grounded theory about what ails you).
2) What training have you received in couples therapy in graduate school and after? (A warning sign might be answers that indicate very little training, lack specifics or brush the question aside implying all therapists can do couples therapy without specialized training).
3) Does your approach have any supporting evidence, particularly outcome research showing that it works for couples? (Even some “research-based” couples models, developed by looking at what couples, healthy and unhealthy do or don’t do, do not have outcome studies showing they actually work. Plus, a therapist without a model that has been studied, will need to tell you how they have faith in what they are doing, what is their confidence based on?).
4) What type of success rate do you have with couples? Would you say you are an optimistic couples therapist? How do the couples you have worked with describe you and their experience with you?
5) How often do you recommend a couple divorce or break up? This is a bit of a trick question, because a couples therapist ethics prohibit them from making such a recommendation except in the most dire and life threatening circumstances. A strong couples therapist often will say something like, “Ultimately it is up to a couple if they want to be together. I assume if you are coming to work with me, you want me to do everything I can to enhance the chances you can work through your difficulties. I will work hard to help you both get to a good space with each other and create a truly fulfilling relationship for the long-term.”
The Relevance of an Evidenced-Based Approach, like E.F.T. to you the Couple:
Emotionally Focused Therapy is recognized by the American Psychological Association as a therapy that has solid outcome studies showing it’s effectiveness. E.F.T. also has grounding in studies that look at what parts of the model and it’s interventions work and at what time in the process. We also have research looking at how the therapist can best show up to help you as a couple (photo: Misti Klarenbeck-McKenna, LMFT, LCSW, a Certified E.F.T. Therapist with her family on vacation).
Certification as an E.F.T. Therapist from ICEEFT is a useful indicator of training and commitment to this evidence-supported, grounded approach to helping couples. Feel free to ask a prospective therapist questions like, “If you are not yet certified in E.F.T., where are you in that process?”, “Do you get consultation or supervision about your couples therapy cases?”, “How often do you engage in continuing education in couples therapy and E.F.T.?” and “Do you tape sessions with couples so you can routinely review your own work for continuous quality assurance?”
In Summary: Our Hope For Your Relationship:
We hope this article both got your attention. This is information is provided for your consideration. We hope you feel empowered to ask questions in a brief conversation by phone for example. That conversation will give you good information. It can give an early sense of whether the potential therapist will be a good match for you. Your relationship is one of the most important factors in your overall health and well-being. You have a right to ask questions and access the best therapy models based on available research data.
E.F.T. has the additional advantage of being grounded in attachment theory, one of the most researched and substantiated ways of understanding human relationships, personality and development in social and neuro science. Thus, many couples report that this approach “gets to the heart of the matter early on,” and things like, “We met with several couples therapist. One just listened while we argued which felt awful. Another kept teaching us something called active listening, which we could never do at home. It frustrated us. And the last one took one partner’s side over the other, then suggested we were not a good match for each other.” E.F.T. fits well with a hopeful, optimistic view of couplehood, partnership and the ability to heal, grow stronger together and have a fulfilling relationship for a lifetime of love and shared adventures in life.
E.F.T. also has the advantage of outcome studies indicating that it is effective. Plus, there is research about the stages, steps and interventions, a road map for this approach that fits how we are wired for connection and how we deal with marital distress when we don’t feel safely connected emotionally. So your distress will make sense to the E.F.T. Therapist rather than overwhelm them or have them distracted by symptoms and your initial distress. For the therapist, this research provides as a general guide for the therapy process. Elegantly, it also allows individualizing to your situation like affair recovery, addictions, cultural factors, step-family issues and more.
Finally, E.F.T. Therapists learn the central importance of listening, of being open and emotionally engaged themselves in therapy, and of asking for feedback about how the therapy is going throughout the process. No therapist and no therapy approach can guarantee results. Much of the effectiveness or success depends on your contributions, openness and willingness to work in sessions and across sessions. Much like physical training, the best physical trainer cannot make you do the exercises needed to get your strength back. Yet, you would want to go to one with proven techniques and a solid knowledge of the body, health and recovery. Why not give yourself this same gift when looking for a couples therapist?
You deserve a chance at a healthy secure emotional bond with your partner. Ask the questions, find out if this couples therapist will be a fighter for your relationship or someone who will be passive or ineffectual. They will seek to co-create with you and your partner a safe haven and secure base in the therapy room for your relationship. A place to slow things down, find the pattern or patterns you get stuck in, access your underlying vulnerabilities and emotions driving your distance or distress, and help you learn to reach to each other to create safety and bonding.
We welcome your feedback about your experience with couples therapists, particularly Certified E.F.T. Therapists and those on the journey to Certification. Feedback, both positives and concerns, help us to learn and improve our training and resources offered to therapists in Colorado who want to practice Emotionally Focused Therapy.
For more on the research about EFT, see the research link on this website.
Copyright 2014, Institute for Change, P.C., Jim Thomas, LMFT, Certified EFT Therapist
Inspired by a conversation with Patti Swope, LMFT, EFT Therapist and Supervisor and a Founder of the Boulder EFT Community