How to Do Emotion-Focused Couples Therapy: 6 Interventions

Emotion Focused Couples TherapyWhile emotions are often strong and all consuming when a couple first meets, they continue to influence the ongoing health of the mature relationship.

Along with encouraging partners to connect, they also form, maintain, and strengthen bonds (Greenberg, 2015).

While emotions positively impact how we act and react to our partners, they can also have negative consequences.

Emotionally Focused Therapy (EFT) “taps into the innate power of emotions and potent motivations, like the longing for connection” to help relationships positively grow and develop (Johnson, 2020, p. 1).

This article explores the potential of EFT to help couples regain their closeness and strengthen their bonds and introduces techniques and interventions to help.

Before you continue, we thought you might like to download our three Positive Relationships Exercises for free. These detailed, science-based exercises will help you or your clients build healthy, life-enriching relationships.

What Is Emotion-Focused Couples Therapy?

“When two people connect, it is like the meeting of two chemicals: All kinds of reactions occur” (Greenberg, 2015, p. 284). Partners in a relationship typically seek out feelings that make them feel good and avoid ones that make them feel bad. Such emotions can affect our goals, including approaching, withdrawing, connecting, or running away.

Emotionally Focused Couples Therapy helps reduce relationship distress while “supporting the attachment concept that love relationships provide fertile ground for the development of a more secure and integrated sense of self and a sense of connection and trust in others” (Johnson, 2020, p. 1).

EFT focuses on emotions and emotional communication in relationships and their influence on patterns of interaction. It also recognizes emotion as a powerful agent of change, rather than simply part of the relationship problem (Greenberg, 2015; Johnson, 2020).

So, what is the EFT approach?

EFT looks at how individuals process their experiences, particularly their emotional responses, along with how partners interact together in patterns. The therapist aims to guide the distressed couple away from rigid, harmful, and destructive ways of reacting and toward sensitive, flexible ones that support intimate and secure bonds (Greenberg, 2015; Johnson, 2020).

Johnson (2020) describes the process of EFT as a journey, moving from:

  • Feelings of alienation to emotional engagement
  • Defensiveness and self-protection to taking risks and being open with one another
  • Feelings of hopelessness within the relationship dance, to being able to “actively create the dance” (Johnson, 2020, p. 14)
  • Attributing blame to the other person to understanding how they may be making it difficult to be caring and responsive
  • Focusing on the other’s faults to exploring one’s own concerns, fears, needs, and longing

Above all else, EFT encourages the often-tricky move from isolation to connectedness. Helping both partners expand and change their inner experience requires considerable skills, impacting their self-awareness and relationship with their partner and ultimately leading to new responses and ways of interacting (Greenberg, 2015; Johnson, 2008).

How to Do EFT With Couples: 9 Simple Steps

EFT with couplesSusan Johnson (2008), one of the leading developers of EFT, describes the typical therapy treatment as consisting of between 8 and 20 sessions per couple.

The following points are important to note (Johnson, 2008):

  • Building a positive therapeutic alliance with both partners is a prerequisite.
  • EFT is most successful when partners, despite having become alienated from one another, wish to restructure their relationship to ensure a close bond.
  • EFT is not appropriate for violent or separating couples.
  • EFT has been shown to be effective in clinical settings, such as where one or more partner is experiencing depression or post-traumatic stress disorder.
  • EFT is also effective in other situations, including lack of intimacy, or if one partner is experiencing a serious illness.
  • EFT is equally effective with same-gender couples.

Throughout the sessions, the therapist continues to track and reflect on “emotional moments and interactional moves” (Johnson, 2020, p. 20).

Johnson suggests the change process experienced by the couple as part of EFT consists of three stages (with three major relationship shifts occurring in the first two stages) broken into nine steps.

De-escalation of negative cycles

While the way interactions between partners are structured may remain the same throughout this first-order stage, the severity is reduced. Withdrawn partners are less withdrawn and hostile partners, less angry. The couple may move toward more intimacy and find therapy less daunting and more engaging. They may even begin to feel hopeful regarding the future of their relationship.

The four steps in this stage are (Johnson, 2008):

  • Step one – alliance and assessment
  • Step two – identify the negative cycle and attachment issues
  • Step three – access the underlying attachment emotions
  • Step four – reframe the problem, including the cycle and the attachment needs and fears

Overall, the first major shift can be summarized as a de-escalation of negative cycles.

The next two stages are second-order changes affecting the relationship structure.

Restructuring the bond

Here, we aim for two possible shifts in the interactional position. A withdrawn partner becomes noticeably more engaged and active in the relationship while asserting their needs and wants. As trust grows, hostile and angry partners begin to risk expressing their own needs and vulnerabilities.

The three steps in this stage are (Johnson, 2008):

  • Step five – access to implicit needs, fears, and models of the self
  • Step six – promote acceptance by the other person
  • Step seven– structure the reach and responses, express attachment needs, and create bonding interactions

Overall, these second-order changes involve the withdrawer re-engaging and blamer softening, and a restructuring of the attachments.

Consolidation and integration

New solutions begin to emerge to old relationship problems, and new cycles of attachment behaviors are consolidated.

The two steps in this stage are (Johnson, 2008):

  • Step eight – new solutions are facilitated
  • Step nine – positions, cycles, and stories of secure attachment are consolidated

6 EFT Interventions for Supporting Couples

Johnson (2020) describes six powerful interventions that are essential to the change process during EFT.

Reflection

It is vital that the therapist understands the client’s experience and that intense emotions are attended to, focused on, and reflected back to them.

Reflection involves more than simply paraphrasing; it requires absorbing the client’s experience and recognizing shifts in their emotional engagement or when they become lost for words.

“A good reflection is the first step in making a client’s experience vivid, tangible, concrete, specific/granular, and active (something you create versus something that happens to you)” (Johnson, 2020, p. 86).

Validation

EFT therapists strive to make clear to both partners that they are entitled to their experiences and how they feel. For example, the couple must understand that feeling hate doesn’t mean the other person is hateful, only that a person can feel a certain way even if not truly justified.

Each partner’s experience of the relationship is therefore valid and should be validated. Such acceptance can lift self-criticism and enable increased engagement in the therapeutic process.

Evocative responding

As each partner’s experiences and emotions emerge, they should be encouraged and engaged with – or evoked. Skilled therapists tentatively offer reflections and questions that ‘try’ or ‘take on’ the client’s responses and gently nudge them further in “formulating and symbolizing the experience” (Johnson, 2020, p. 87).

Questions such as, “How do you feel as you say X?” or “What is X like for you?” invite exploration and reprocessing of their experiences.

Heightening

The therapist may highlight specific responses from each partner or between the couple. This can help move clients deeper into their awareness of emotional realities, intensifying responses and emotional realities that maintain destructive interactions to create a new dialogue.

This may include the therapist:

  • Repeating a phrase
  • Intensifying by saying something in a deeper, lower, or louder voice
  • Using metaphors
  • Maintaining a specific and unrelenting focus

Empathic conjecture/interpretation

The EFT therapist typically “infers the client’s current state and experience from nonverbal, interactional, and contextual cues to help the client give color, shape, and form to his or her experience and take this experience one stage further” (Johnson, 2020, p. 90).

EFT therapists aim to clarify and extend the couple’s experience, encouraging new and intense experiences and pushing new meanings to the surface.

Examples of what the therapist might say could include, “So, couldn’t you say to him, ‘Come and be with me, I need you’?” or “So you could never say to her, ‘I can’t cope with this endless testing of how I feel.’”

Self-disclosure

While usually limited to specific situations, disclosing (limited) personal details can sometimes encourage stronger therapeutic alliances and validate what the client is talking about.

Normalizing the clients’ experiences by sharing our own through self-disclosure can be helpful but at the risk of over-sharing and damaging the therapeutic alliance.

6 Best EFT Counseling Techniques

EFT Counseling Techniques“EFT is a process-oriented approach,” encouraging partners to “gradually taste and savor their relational experience, and the power of attachment longings and strivings” (Johnson, 2020, p. 111).

The aim is to shift the couple’s connections and relationship from:

  • Vague to vivid
  • Obscure to tangible
  • General to specific
  • Then to now
  • Global to personal
  • Passive to active
  • Abstract to concrete

The following six communication techniques promote client safety and encourage emotional risk in EFT:

  1. Repeating key messages (phrases and words) multiple times.
  2. Communicating using images, capturing ideas, emotions, and thoughts through visualization.
  3. Ensuring words and phrases remain simple, clear, and concise.
  4. Talking slowly, allowing and enabling emotional experiences to unfold in each session (Johnson, 2020).
  5. Using a soft and calming voice that fosters deepened experiences and risk taking.
  6. Adopting client wording and phrasing to promote collaboration and validation.

Worksheets & Workbooks for Your Sessions

Sharing relational experiences and understanding emotional responses are crucial aspects of successful EFT. Use the following worksheets to dig deeper into relationships to uncover unhelpful responses and patterns of interaction while highlighting positive emotions within each partner.

When You First Met

A host of positive emotions can arise from reflecting on when a couple first met and the meaningful bond they created.

Use the When You First Met worksheet to reflect on those initial meetings and the positive feelings experienced.

Recognizing Defensive Patterns

Over time, unhelpful patterns of behavior and unhelpful responding can develop in couples, forming a negative emotional cycle.

The Recognizing Defensive Patterns worksheet can identify and reflect on the couple’s automatic responses and consider their emotional impact.

For example, my partner…

  • Makes excuses
  • Ignores me
  • Turns away from me or looks down
  • Avoids me
  • Is angry with me
  • Acts defensively in another way

Acknowledging Defensive Patterns

It can be helpful to recognize the emotions and feelings experienced when couples act defensively in relationships and fall into negative emotional cycles of behavior.

Use the Acknowledging Defensive Patterns worksheet to reflect on why the couple act defensively.

Ask the client to capture how they are feeling; examples may include:

I just want to be out of here.
I’m failing.
I’m falling.
I’m overwhelmed.
I’m exhausted.
I have disappointed you.

Examining Your Relationship Beliefs

Past relationships can shape beliefs about relationships and how we respond to our present partner.

Use the Examining Your Relationship Beliefs worksheet to consider the beliefs the clients hold and the emotions associated with each one.

For example:

People always cheat.
You can’t trust anyone.
If I am too open, I will be walked over.

Breaking Negative Relationship Patterns

Couples can easily fall into habitual negative patterns of thinking and behaving, but it doesn’t have to be that way.

Use the Breaking Negative Relationship Patterns worksheet to reflect on negative behavior and plan what might be said in the future to stop it.

Facing Up to Your Fears

Closeness and intimacy can be scary. Being open can make us feel vulnerable and at risk.

Use the Facing Up to Your Fears worksheet with clients to reflect on their fears and share vulnerabilities with their partner.

For example:

I am scared of failing.
I am scared of being rejected.
I am sad that I am not providing financially.

Top 3 Books on EFT & Couples Therapy

While there are many books on EFT, some including a focus on couples therapy, we have chosen several of our favorites below.

1. The Practice of Emotionally Focused Couple Therapy: Creating Connection – Susan Johnson

The Practice of Emotionally Focused Couple Therapy

The definitive guide to EFT from one of its leading developers, Susan Johnson, this book is aimed at both students and seasoned professionals.

This third edition includes the latest research and a focus on applications, micro and macro interventions, and how to bring the process of change alive for distressed couples.

Find the book on Amazon.

2. Hold Me Tight: Seven Conversations for a Lifetime of Love – Sue Johnson

Hold Me Tight Seven Conversations for a Lifetime of Love

In this remarkable book, Susan Johnson encourages the reader to dig deep into the emotional underpinnings of their relationship and seek out emotional attachments and dependencies.

Johnson encourages being open and responsive to one another’s needs by focusing on key moments in a relationship and seven healing conversations.

Find the book on Amazon.

3. Emotion-Focused Therapy: Coaching Clients to Work Through Their Feelings – Leslie Greenberg

Emotion-Focused Therapy

This classic work offers a comprehensive overview of EFT, including both theory and practice. Through helping clients increase their emotional intelligence, therapists learn how to help them achieve greater wellbeing.

The book covers EFT’s application in multiple settings and contains a valuable chapter on its psychoeducational value with couples.

Find the book on Amazon.

Training in EFT: 3 Certification Options

There are many sources of training available for becoming certified as an EFT trainer; we have listed three essential resources below.

Best Resources From PositivePsychology.com

We have many resources available for therapists providing support to couples wanting to address relationship issues or strengthen emotional bonds.

Why not download our free positive relationships pack and try out the powerful tools contained within? Here are some examples:

  • Connecting With Others by Self-Disclosure
    Feeling understood, accepted, and cared about is crucial in any relationship. In this exercise, we learn how to practice self-disclosure to strengthen existing and create new connections.
  • The Sound Relationship House Inspection
    Relationships require nurturing and regular actions to promote friendship, growth, and trust. This tool examines how well a relationship is performing through the lens of the relationship house metaphor.

Other free resources include:

  • Relationship Audit
    This helpful tool offers a set of questions to understand the degree of authenticity within relationships.
  • Capitalizing Positive Emotions With Active Constructive Responding
    Couples can use this activity to promote positive emotions and learn how to respond more constructively.

More extensive versions of the following tools are available with a subscription to the Positive Psychology Toolkit©, but they are described briefly below:

  • Building the 5 Rituals of Connection
    Creating rituals can encourage communicative behavior in a relationship and create specific emotional significance. Try out the following four steps:

    • Step one – Introduce multiple ritual types, including parting, affection, and date night rituals.
    • Step two – Offer specific actions to translate a ritual into a reality.
    • Step three – Track and record weekly rituals.
    • Step four – Reflect on positive emotions and the impact of putting in place meaningful rituals.

  • Creating a Hugging Habit
    Physical contact is an essential part of relationships, forming closeness and connection over time.

This exercise encourages putting in place a daily hugging ritual to transition partners out of a busy workday and into their home life.

The couple commits to hugging for at least 20 minutes before and after work, then reflects on the experience at the end of each week.

If you’re looking for more science-based ways to help others communicate better, this collection contains 17 validated positive communication tools for practitioners. Use them to help others improve their communication skills and form deeper and more positive relationships.

A Take-Home Message

Emotional bonds are crucial to the ongoing health of a relationship and its eventual outcome. While emotions are positive forces for strengthening connections, they can also lead to motivations at odds with maintaining positive bonds with our partner.

Emotions are more than something we experience; they are powerful tools for change and influence how we process experiences. The aim of EFT is to help a couple that experiences alienation, defensiveness, and hopelessness to create a relationship that is flexible and sensitive to the needs of each partner, moving them from isolation to connection.

Emotion-Focused Couple Therapy limits or removes relationship discord by encouraging a stronger sense of self in each partner while communicating a sense of connection and fostering trust.

Research into the use of EFT as relationship therapy for couples has consistently found it to have the potential to “reduce marital distress and shape relationship satisfaction” (Johnson, 2020, p. 6).

We trust that this article, introducing the theory and practical application of EFT, will provide you with several tools and activities to make a positive difference in your couples therapy practice.

We hope you enjoyed reading this article. Don’t forget to download our three Positive Relationships Exercises for free.

References

  • Greenberg, L. S. (2015). Emotion-focused therapy: Coaching clients to work through their feelings (2nd ed.). American Psychological Association.
  • Johnson, S. M. (2008). Hold me tight: Seven conversations for a lifetime of love. Little Brown Spark.
  • Johnson, S. M. (2020). The practice of emotionally focused couple therapy: Creating connection (3rd ed.). Routledge.

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