For couples, families and individuals interested in EFT, the following is a short summary of studies and commentaries on Emotionally Focused Therapy research. EFT is recognized by the American Psychological Association as a best-practice, empirically-based model for working with couples in distress. ““We adhere to the philosophy that relationships are at the core of human experience. Research indicates that emotionally fulfilling relationships are integral components of mental and physical health, and that emotionally focused interventions have the power to establish and re-create supportive bonds among individuals. We are therefore dedicated to the understanding and enhancement of couple and family relationships through an emphasis on emotions and their interpersonal impact. We believe that all people can maximize their potential given a nurturing social environment, which we endeavor to foster in our work with clients.”
Short Summary of EFT Research
Does EFT conform to any “Gold” standard in terms of research validation and the standards set out for psychotherapy?
In terms of the gold standard set out by bodies such as APA for psychotherapy research, EFT epitomizes the very highest level set out by this standard. Over the last 25 years, the EFT research program has systematically covered all the factors set out in optimal models of psychotherapy research.
The meta-analysis (Johnson et al, 1999) of the four most rigorous outcome studies conducted before the year 2000, showed a larger effect size (1.3) than any other couple intervention has achieved to date. Studies consistently show excellent follow-up results, and some studies show that significant progress continues after therapy. EFT has a body of process research showing that change does indeed occur in the way that the theory suggests. This level of linkage between in-session process and rigorous outcome measurement is unusual in the field of psychotherapy.
EFT is the only model of couple intervention that uses a systematic empirically validated theory of adult bonding as the basis for understanding and alleviating relationship problems. The generalizability of EFT across different kinds of clients and couples facing co-morbidities such as depression and PTSD has been examined and results are consistently positive. Outcome and process research addressing key relationship factors, such as the forgiveness of injuries, has also been conducted with positive results. EFT studies are generally rigorous and published in the best peer reviewed journals.
In brief, EFT researchers can show that, as set out in the Johnson 2004 seminal text, Creating Connection: The Practice of Emotionally Focused Couple Therapy, EFT works very well, results last, we know HOW it works so we can train therapists to intervene efficiently and we know it works across different populations and problems. It also links congruently to other bodies of research such as those examining the nature or relationship distress and adult attachment processes.
Recent research involves outcome studies of couples facing trauma (the Dalton and MacIntosh studies, and a study on EFT effects on attachment security with an FMRI component.) The FMRI component shows that EFT changes the way contact with a partner mediates the effect of threat on the brain. There is an outcome study in progress of the new educational program based on EFT (Hold Me Tight® Program: Conversations for Connection). A pilot study has also just been completed at the VA in Baltimore on EFT with veteran couples dealing with PTSD.
Completed and ongoing EFT research consistently supports the efficacy of the Emotionally Focused Therapy model.
1. Denton, W.H., Wittenborn, A.K., & Golden, R.N. (in review) Augmenting antidepressant medication treatment of depressed women with emotionally focused therapy for couples: A randomized pilot study. Journal of Marital and Family Therapy.
2. Naaman, S., & Johnson, S. M., & Radwan, K. (in review) Evaluation of the clinical efficacy of emotionally focused therapy on psychological adjustment of couples facing early breast cancer. Psychiatry: Biological and Interpersonal Processes.
3. Halchuk, R., Makinen, J. & Johnson, S. M. (2010) Resolving Attachment Injuries in Couples using Emotionally Focused Therapy: A 3 year follow-up. Journal of Couple and Relationship Therapy, 9, 31-47.
4. Honarparvaran, N., Tabrizy, M., & Navabinejad, Sh. (2010) The efficacy of emotionally focused couple therapy (EFT-C) training with regard to reducing sexual dissatisfaction among couples. European Journal of Scientific Research, 43(4), 538-545.
5. Dalton, J., Johnson, S. M., Classen, C., & Greeman, P. (in review, 2009) Treating relationship distress and the effects of childhood abuse with emotion focused couple therapy: A randomized controlled trial. Journal of Marital and Family Therapy.
6. MacIntosh, H.B. & Johnson, S. (2008) Emotionally focused therapy for couples and childhood sexual abuse survivors. Journal for Marital and Family Therapy, 34, 298-315.
7. Couture-Lalande, M.-E., Greenman, P.S., Naaman, S. & Johnson, S.M. (2007) Emotionally focused therapy (EFT) for couples with a female partner who suffers from breast cancer: an exploratory study. Psycho-Oncology, 1, 257–264. (Journal of the Psychological, Social and Behavioral Dimensions of Caner).
8. Couture-Lalande, M.-E., Greenman, P.S., Naaman, S. & Johnson, S.M. (2007) La therapie de couple axe sur l’emotion (EFT) our traiter les couples donts la femme a le cancer du sein: une etude exploratoire. Psycho-Oncologie, 1, 1-8.
9. Makinen, J. A. & Johnson, S. (2006) Resolving Attachment Injuries in Couples using EFT: Steps Toward Forgiveness and Reconciliation. Journal of Consulting and Clinical Psychology. 74(6), 1055-1064.
10. Dessaulles, A., Johnson, S. M. & Denton, W. (2003) Emotion Focused Therapy for Couples in the Treatment of Depression: A Pilot Study. American Journal of Family Therapy, 31, 345-353.
11. Clothier, P., Manion, I., Gordon-Walker, J. & Johnson, S. M. (2002) Emotionally Focused Interventions for Couples with Chronically Ill Children: A two year follow-up. Journal of Marital and Family Therapy, 28, 391-399.
12. Denton, W., Burleson, B., Clark, T., Rodriguez, C. & Hobbs, B. (2000) A Randomized Trial of Emotionally Focused Therapy for Couples in a Training Clinic. Journal of Marital and Family Therapy, 26, pp. 65-78.
13. Johnson, S., Hunsley, J., Greenberg, L. & Schindler, D. (1999) Emotionally Focused Couples Therapy: Status & challenges (A meta-analysis). Journal of Clinical Psychology: Science and Practice, 6, 67-79.
NOTE: Also listed under Meta-Analyses.
14. Johnson, S., Maddeaux, C. & Blouin, J. (1998) Emotionally Focused Family Therapy for Bulimia: Changing Attachment Patterns. Psychotherapy: Theory, Research & Practice, 35, 238-247.
15. Gordon-Walker, J., Johnson, S., Manion, I. & Cloutier, P. (1996) Emotionally Focused Marital Intervention for Couples with Chronically Ill Children. Journal of Consulting & Clinical Psychology, 64, 1029-1036.
16. McPhee, D. & Johnson, S.M. (1995) Marital Therapy for Women with Low Sexual Desire. Journal of Sex and Marital Therapy, 21, 159-182.
17. Dandeneau, M. & Johnson, S. (1994) Facilitating Intimacy: Interventions and Effects. Journal of Marital & Family Therapy, 20, 17-33.
18. Goldman, A. & Greenberg, L. (1992) Comparison of Integrated Systemic and Emotionally Focused Approaches to Couples Therapy. Journal of Consulting and Clinical Psychology, 60(6), 962-969.
19. James, P. (1991) Effects of a Communication Training Component Added to an Emotionally Focused Couples Therapy. Journal of Marital & Family Therapy, 17, 263-276.
20. Johnson, S. & Greenberg, L. (1985) Emotionally Focused Couples Therapy: An Outcome Study. Journal of Marital & Family Therapy, 11, 313-317.
21. Johnson, S. & Greenberg, L. (1985) The Differential Effectiveness of Experiential and Problem Solving Interventions in Resolving Marital Conflict. Journal of Consulting & Clinical Psychology, 53, 175-184. (EFT, CBT and controls tested.)
Process & Predictors Research: Research regarding the processes that effect change within EFT therapy, research on key change events, and research regarding client factors and impact on effectiveness of this approach:
1. Zuccarini, D.J., Johnson, S.M., Dalgleish, T. & Makinen, J. (submitted for review) Forgiveness and reconciliation in EFT for couples: The client change process and therapist interventions. Submitted to the Journal of Marriage and Family Therapy.
2. Denton, W., Johnson, S. & Burleson, B. (2009) Emotion-Focused Therapy-Therapist Fidelity Scale (EFT-TFS): Conceptual Development and Content Validity. Journal of Couple and Relationship Therapy, 8, 226-246.
3. Bradley, B. & Furrow, J. L. (2004) Toward a Mini-theory of the Blamer Softening Event: Tracking the Moment-by-Moment Process. Journal of Marital and Family Therapy, 30(2), 233- 246.
4. Talitman, E. & Johnson, S. (1997) Predictors of Success in Emotionally Focused Marital Therapy. Journal of Marital & Family Therapy, 23, 135-152. It is interesting to note that in this study, couples continued to significantly improve from the end of therapy to follow-up.
5. Greenberg, L.S., Ford, C., Alden, L. & Johnson, S.M. (1993) In-session change in emotionally focused therapy for couples. Journal of Consulting and Clinical Psychology, 61, 78-84.
6. Johnson, S.M. & Greenberg, L. S. (1988) Relating Process to Outcome in Marital Therapy. Journal of Marital and Family Therapy, 14, 175-183.
Reviews of EFT Research / Commentaries
1. Lebow, J.L., Chambers, A., Christensen, A., & Johnson, S.M. (in press) Marital distress. In D. Sprenkle & R. Chenail (Eds.), Effectiveness research in marriage and family therapy. Washington: AAMFT.
2. Furrow, J.L, & Bradley, B. (2011) Emotionally Focused Couple Therapy: Making the Case for Effective Couple Therapy. In J. Furrow, B. Bradley & S. Johnson (Eds.), The Emotionally Focused Casebook, pp. 3-30. New York: Brunner Routledge.
3. Weissman, N., Batten, S.V., Dixon, L., Pasillas, R.M., Potts, W., Decker, M. & Brown, C.H. (2011) The Effectiveness of Emotionally Focused Couples Therapy (EFT) with Veterans with PTSD. In preparation.
4. Johnson, S. M. (2008) Couple and family therapy: An attachment perspective. In J. Cassidy & P. Shaver (Eds.), Handbook of attachment: Theory, research and clinical applications, 2nd Edition, pp. 811-832. New York: Guilford Press.
5. Johnson, S.M. (2007) The Contribution of Emotionally Focused Couples Therapy. Special Edition of Journal of Contemporary Psychology: Humanistic Psychology, 37, 47-52.
6. Johnson, S.M. (2007) A new era for couple therapy: Theory, research and practice in concert. Journal of Systemic Therapies, 26, 5-16.
7. Caldwell, B. E., Woolley, S. R., & Caldwell, C. J. (2007) Preliminary estimates of cost-effectiveness for marital therapy. Journal of Marital and Family Therapy, 33(3), 392-405.
8. Johnson, S.M. (2004) Emotionally focused couples therapy: Empiricism and art. In T. Sexton, G. Weeks, & M. Robbins (Eds.), American Journal of Family Therapy, pp. 345-353. New York: Brunner/Routledge.
9. Johnson, S. M. (2003) The revolution in couples therapy: A practitioner-scientist perspective. Journal of Marital and Family Therapy, 29, 365-385.
10. Johnson, S.M. (2003) Couples therapy research: Status and directions. In G.P. Sholevar (Ed.), Textbook of Family and Marital Therapy, pp. 797-820. Washington, D.C.: APPI Press.
11. Johnson, S.M. (2002) Marital problems. In D. Sprenkle (Ed.), Effectiveness Research in Marriage and Family Therapy, pp. 163-190. Alexandria, VA.: American Association for Marriage and Family Therapy.
12. Johnson, S.M. & Lebow, J. (2000) The coming of age of couple therapy: A decade review. Journal of Marital and Family Therapy, 26, 9-24.
13. Baucom, D., Shoham, V., Mueser, K., Daiuto, A. & Stickle, T. (1998) Empirically Supported Couple and Family Interventions for Marital Distress and Adult Mental Health Problems. Journal of Consulting & Clinical Psychology, 58, 53-88.
1. Wood, N. D., Crane, D. R., Schaalje, G. B., & Law, D. D. (2005) What works for whom: A metaanalytic review of marital and couples therapy in reference to marital distress. The American Journal of Family Therapy, 33, 273-287.
2. Johnson, S., Hunsley, J., Greenberg, L. & Schindler, D. (1999) Emotionally Focused Couples Therapy: Status & challenges (A meta-analysis). Journal of Clinical Psychology: Science and Practice, 6, 67-79.
NOTE: Also listed under Outcome
3. Dunn, R.T. & Schwebel, A.I. (1995) Meta-analytic review of marital therapy outcome research. Journal of Family Psychology, 9, 58-68.
Research on EFT Training and Learning EFT
1. Sandberg, J.G. (in press) Introduction to the Special Section on Learning Emotionally Focused Couples Therapy. Journal of Marital & Family Therapy.
2. Sandberg, J.G. & Knestel, A. (in press) The Experience of Learning Emotionally Focused Couples Therapy. Journal of Marital & Family Therapy.
3. Montagno, M., Svatovic, M. & Levenson, H. (in press) Short-Term and Long-Term Effects of Training in Emotionally Focused Couple Therapy: Professional and Personal Aspects. Journal of Marital & Family Therapy.
4. Palmer-Olsen, L., Gold, L.L. & Woolley, S.R. (in press) Supervising Emotionally Focused Therapists: A Systematic Research-Based Model. Journal of Marital & Family Therapy. Programs Based on EFT Research
1. Johnson, S.M., & Rheem, K. (2006) Becoming a couple again: A post-deployment retreat for military couples. Washington, DC. Strong Bonds-Strong Couples, Rheem Media.
2. Johnson, S.M. (2009) The Hold Me Tight® Program: Conversations for Connection – Facilitators Guide. Ottawa, Canada. International Centre for Excellence in EFT.
From the International Centre for Excellence in Emotionally Focused Therapy, Used by Permission, Copyright, ICEEFT, 2012