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Introduction
In the realm of psychotherapy, the efficacy and credibility of therapeutic approaches are often measured against rigorous research standards set by organisations such as the American Psychological Association (APA). Emotionally Focused Therapy (EFT) stands out as a shining example of a therapeutic model that not only meets but exceeds these gold standards for psychotherapy research. Over the past three decades, EFT has amassed a wealth of empirical evidence showcasing its effectiveness in improving relationships and emotional well-being.
The Meta-Analysis: A Resounding Success
One of the cornerstones of EFT’s research support is the groundbreaking meta-analysis conducted by Johnson and colleagues in 1999. This analysis examined the outcomes of the four most rigorous EFT outcome studies conducted prior to the year 2000. The results were nothing short of remarkable, with EFT achieving an effect size of 1.3, surpassing any other couple intervention at that time. This effect size is a clear indicator of the substantial positive impact EFT can have on relationships.
Sustained Benefits and Process Research
EFT doesn’t stop at immediate results; it excels in providing long-lasting benefits. Numerous studies consistently demonstrate excellent follow-up results, with some indicating that the positive changes continue well beyond the conclusion of therapy. This sustained impact underscores the effectiveness of EFT in creating lasting relationship transformations.
What sets EFT apart from many other psychotherapy models is its extensive body of process research. This research illustrates that the changes observed in clients align closely with the underlying theoretical framework of EFT. The tight linkage between in-session therapeutic processes and rigorous outcome measurements is an uncommon and powerful characteristic in the field of psychotherapy.
The Bonding Theory Foundation
EFT distinguishes itself further by being the only couple intervention model grounded in a systematic, empirically validated theory of adult bonding. This solid theoretical foundation allows EFT therapists to deeply understand and address the core issues underlying relationship distress. It’s not just about addressing the surface-level symptoms; it’s about targeting the root causes of relational problems.
Generalisability and Diversity of Applications
EFT’s effectiveness isn’t limited to specific demographics or relationship types. Numerous studies have explored its applicability across diverse populations and couples facing various challenges, such as depression and post-traumatic stress disorder (PTSD). Consistently positive results indicate that EFT has broad generalisability, making it a versatile and inclusive approach.
Rigorous Publication and Peer Review
EFT studies adhere to rigorous standards of research and are published in some of the most esteemed peer-reviewed journals in the field of psychology. This commitment to academic excellence ensures that the research supporting EFT undergoes thorough scrutiny and validation.
Building on Success: Recent Research
EFT’s commitment to ongoing research is evident in recent studies exploring its impact on couples facing trauma and stressful life events. Research initiatives, such as the Dalton and MacIntosh studies, have further expanded the scope of EFT’s applications. Additionally, a study involving functional magnetic resonance imaging (fMRI) demonstrated how EFT can change the way the brain responds to threat, providing neuro-scientific evidence of its effectiveness.
Conclusion
In summary, Emotionally Focused Therapy (EFT) stands as a gold standard in psychotherapy research. Its remarkable effect sizes, sustained benefits, process research, and theoretical foundation make it a standout approach. EFT’s adaptability across diverse populations and rigorous research publication practices cement its place as a highly effective and evidence-based therapeutic model. As EFT continues to evolve and explore new frontiers in research, it remains a beacon of hope for couples seeking to improve their relationships and emotional well-being.
Abstract
Social relationships are tightly linked to health and well-being. Recent work suggests that social relationships can even serve vital emotion regulation functions by minimizing threat-related neural activity. But relationship distress remains a significant public health problem in North America and elsewhere. A promising approach to helping couples both resolve relationship distress and nurture effective interpersonal functioning is Emotionally Focused Therapy for couples (EFT), a manualized, empirically supported therapy that is strongly focused on repairing adult attachment bonds. We sought to examine a neural index of social emotion regulation as a potential mediator of the effects of EFT. Specifically, we examined the effectiveness of EFT for modifying the social regulation of neural threat responding using an fMRI-based handholding procedure. Results suggest that EFT altered the brain’s representation of threat cues in the presence of a romantic partner. EFT-related changes during stranger handholding were also observed, but stranger effects were dependent upon self-reported relationship quality. EFT also appeared to increase threat-related brain activity in regions associated with self-regulation during the no-handholding condition. These findings provide a critical window into the regulatory mechanisms of close relationships in general and EFT in particular.
W. Steven Rholes, Texas A&M University
Abstract
In this article, we discuss theory and research on how individuals who have insecure adult romantic attachment orientations typically think, feel, and behave when they or their romantic partners encounter certain types of chronic or acute stress. We first review basic principles of attachment theory and then discuss how two forms of attachment insecurity—anxiety and avoidance—are associated with unique patterns of emotion regulation in response to certain types of threatening/distressing situations. We then discuss a diathesis-stress process model that has guided our research, highlighting studies that provide support for certain pathways of the model.
Testimonials
"Thanks, Aaron, we could feel the benefits of each couple counselling session, even in our first session. We had done lots of work with different psychologists individually and as a couple prior to our first session, but the work with you feels deeper and different, in a good way. Just by helping us to slow down during the session makes us more aware of our primary emotions."
“I was initially hesitant to commence as I have never undergone counseling and decided to take the leap of faith as I gathered that it could only help. WOW! I am so glad I did. Aaron was so much more than I could have ever imagined and assisted me in ways I never previously considered. Thank you so very much Aaron for helping me through a difficult time. 10/10”
“Aaron is a truly talented psychotherapist and relationship counsellor who cares deeply for his clients. I recommend his services without hesitation. Thanks for taking our marriage from ‘good’ to ‘amazing’ Aaron, we are forever grateful!”
“I have seen immense personal transformation in terms of no longer watching my life be ruled by my past complex trauma, but instead being able to live in the present and feel much more fully alive, empowered and fulfilled on a daily basis”
“I did not know what to expect when I started counselling but I'm glad to say that although the experience was very much out of my comfort zone, it has slowly transformed my internal emotional turmoil to one of much more peace and acceptance of myself and others.”
“My husband and I were very fortunate to see you … You (without a doubt in my mind) saved our marriage. Everything is wonderful currently … Eternally grateful. I truly mean every word. Very grateful to you”
“[The counselling process with Alive Counseling] showed me a way to unlock my inner self to be more relaxed in any situation. Give me a new lease on life. Looking at issues in a different way and handling them in a relaxed state. What got me was the emotions and feelings. This is what I needed. What I was looking for. Someone who could help me with these things.”
"Aaron was very straight forward and honest. Clear about the approach and consistent in helping us change our patterns. The greatest accomplishment through this counselling process is connecting with my partner on an emotional level."
"Through being heard and participating in different exercises I have a deeper awareness of myself, the issues I discussed and the relationships I am in. This is also having a flow on effect to others around me. I've noticed tangible changes in relational dynamics over these weeks as I've worked on things and set goals for action."
“[What I like about the way my counsellor works] Was able to bring out a lot of things about myself that I hadn’t realised. I did find counselling helpful and I thank Aaron for his time and advice.”
"You help me so much through the counselling sessions that have changed my negative view of counselling."
“[The benefits or changes I noticed in myself] Being able to label emotions and address them in the moment and being more mindful of my partners emotions.”
"I originally started seeing Aaron to help me through the grief of loosing someone very close to me but through our sessions Aaron tapped in to help reveal so much more about myself and I became more aware of why I was feeling such strong emotions and what I could do to acknowledge them and continue to function in a positive way."
“Thank you for the difference you’ve made to the life of our family. We are so blessed to have found you.”
“I am now able to be present in my everyday life whereas beforehand I was living in my head most of the time as a coping mechanism to my complex trauma. I am also able to deal with issues by myself now by using the tools Aaron has taught me, even after our individual sessions have ended. I am able to be there for myself and find acceptance, belonging and comfort within myself and also from the safe relationships I am now able to identify, pursue and cultivate. In my daily life I now feel like I am much more connected to myself and open to fulfilling connections with others than before.”
“[The benefits or changes I have noticed in myself is a] better acceptance of who I am, less fearful of expressing my thoughts to others and less fearful of initiating, maintaining and deepening connection with others.”
"I couldn't find the words ... Thank you so much for helping us throughout my family problem and obstacles ... not just our marital problems but more particularly to my son ... you're such a truly blessing to him."
"Aaron was one of the most insightful persons I have come across for a long time & has helped me understand myself a lot more."
"Aaron helped my partner and I reconnect. Not only with each other but within ourselves. Really listening to each other and not just 'doing the angry, dysfunctional dance'. We received lots of practical tips to manage in times of stress."
"Since we started sessions with you, I am so glad to see the positive changes it has had in our family interactions. ... Saying Thanks is not all enough Aaron but God will bless you."
"What we gain through the couple counselling process with Alive Counselling was greater insights into family of origins and the sources of [our] emotional pain. Stronger connection to partner."
“[What I gain from the counselling process with Alive Counseling] A greater awareness of my patterns of behaviour and how [these] may connect to my younger years. [The benefits or changes I noticed in myself] Greater grounded-ness for engaging with these aspects of myself I don't explore or talk about.”
“[The most helpful part of the counselling process] Insight to where a lot of my characteristics come from and why. Being reminded of what the basic needs of every human is.”
“Aaron provided me an avenue to process multiple issues I was experiencing at the time and enabled me to better manage my situation. I am still using the approach and mindset as it works so well.”
"Aaron is very patient and level headed ... What we gain through the couple counselling process with Alive Counselling was better awareness of the emotional cycle and triggers with my partner. What was most helpful about the counselling process was slowing the emotional reaction down to get to a calmer position ."
"Aaron has a gift for untying the knots of situations that seem complex and pinpointing the core issues when someone is overwhelmed by details and anxiety. He's good at helping people to identify clear steps forward and put them into practice in a logical order . . . "
“We used to think the ’honeymoon phase’ is just the early experience of a relationship that will end, and did not realise it is possible to feel the same ‘honeymoon’ experience again. Through the counselling process, we are so excited that we can connect deeply like we did early in our relationship.”
“Unlike most other counselors I've seen before, Aaron gets right to the root of the issue straight away in a session and heals it at its core. With previous counselors I had found that I would simply be talking the hour away, week after week, using my well thought-out analyses of stressful situations in my life, but I would not ever really experience true deep healing or change. Aaron, however, stops me in my tracks while I use my old coping mechanisms to try and avoid my pain (i.e. over-thinking, which keeps me in my head and not in my heart) and he brings me back to the root issue which he has a way of identifying very skillfully. He then provides a safe environment and helps me to deal with it effectively right there and then. This has been very powerful for me and I have found that I leave sessions feeling like a huge burden has been lifted off my shoulders, and in the weeks to follow I find that I still experience the healing effects of each session.”
“[The most helpful part of the counselling process, is] the experience of expressing certain thoughts and feelings to someone without being judged and thus being able to make peace with them. Chair exercises seem to have quite a deep and lasting impact on me although I felt very awkward in the beginning.”
“[My partner] and I are doing well. We continue to use your strategies to slow things down ... We have also recommended you to friends of ours.”
"Thanks Aaron . . . of all the help I've sought I learned more from you in an hour than in years."
"The greatest accomplishment through this couple counselling process, was developing emotional vulnerability and being celebrated for that. What I like about Aaron is his excellent construction of a safe environment. Very educational process."
"Aaron has a very gentle nature and an innate gift of helping you understand why you feel the way you do in certain situations and understanding the reasons why. This has given me a greater self awareness and skills to help me when challenged with these strong emotions."
“[What I gain from the counselling process with Alive Counselling] It reminded me that there is a reason for everyone’s behaviour and to be more conscious and empathetic of that.”
"Aaron has helped me with my past trauma and underlying issues. He has shown me how to deal with grief and anger in a healthy way. He has counselled me for 13 months and I am so grateful that he is a part of my journey to recovery."
"Every week I learn something new about myself that I can use in my everyday life. Emotions have such an effect on our lives physically and mentally."
“[The benefits or changes I have noticed about myself are that] I'm more easy going, I'm relaxed, I'm looking at my whole life in a better way. Breaking the old habits wasn't easy but with the guidance and knowledge it's helped me immensely. It was much more than what I expected. I really took to his style of counselling and recommend it to anyone.”
“I did have high expectations of Emotionally Focussed Therapy (EFT) as I had read great things about it, but I had no idea that it would have such a transformational effect on my life as a whole. One very important thing that I reminded myself of during the sometimes-painful journey of inner healing with Aaron is to Trust The Process! Aaron knows exactly what he is doing and it is more than worth it.”
“[What I gain through the counselling process with Alive Counselling is] having a safe environment to make sense of my emotions, to understand where they are coming from, and to be self-compassionate in acknowledging and dealing with them to improve my relationship with myself and with others in a more balanced, consistent and genuine way.”
“The whole [counselling] process was seamless and very easy to start and a pleasure looking forward to the followup sessions. I did not know what to expect as this was my first counseling session and given the COVID epidemic, Aaron more than exceeded my expectations.”
"Through the counselling process, I felt better after months of depression ... thank you for your counselling service ... You were a big part of my healing journey. I thank God for you."
" . . . He's also good at helping people become more aware of their emotions, so that they stop tolerating recurring negative patterns and face the root causes that are driving them. He is a sensitive, patient and caring listener, but he's also focused on reaching practical, effective solutions."
“[The most helpful part of the counselling process] Good listening on Aaron's part. Aaron knowing when to slow down and explore more deeply. Gentle, but probing questions. being challenged to connect with feelings.”
“... Aaron is very understanding, accommodating and flexible with the timing and duration of the sessions, especially during the early stages of my counselling process when I was quite distressed ... All these things combined has helped build my trust in him and gave me the courage and confidence to continue my journey of personal growth through counselling sessions with him.”
“Aaron is very open and understanding making sessions very easy by encouraging open conversation. Aaron strategically identifies, discusses and resolves points encountered in an easy-to-do meaningful way while aligning to the morals and standards. Christian values work for me, so Aaron then used terms and explanations aligned to me making everything so easily understandable.”
"Aaron has helped me deal with issues in a mature manner to see other people's point of view. He gave great examples which I understand and can put into real scenarios."
"What I gained through the counselling process was a clearer understanding of the emotions I was feeling and why. The greatest accomplishment was my understanding of how I feel in certain situations. I am more aware and adjust my thinking."
“[What I like about the way my counsellor works] Very attentive. Great listener. Gentle, respectful, insightful. Prepared to challenge. Some good variation including role-play, information-giving and occasional 'homework'. Open to doing things differently, and really responding to my needs or concerns.”
“I like the fact that Aaron is very consistent in the way he behaves during each session, both face-to-face and online. His facial expression, the speed and tone of his voice and his body language are all aligned to give out a sense of genuine care and concern, openness and non-judgment.”
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