Emotionally Focused Therapy (EFT) is a short-term, goal-oriented therapy that helps couples improve their emotional connection and resolve conflict. EFT is based on attachment theory, which posits that our early relationships with our caregivers shape how we relate to others in adulthood. When our attachment needs are not met in our adult relationships, we may experience emotional distress and engage in negative patterns of interaction.

EFT therapists help couples identify and understand the negative cycles that contribute to their distress. They then help couples learn new ways of communicating and relating to each other that promote emotional safety and connection. EFT has been shown to be effective in helping couples improve their relationships, and it is a widely accepted and respected form of therapy.

Here are some of the key concepts of EFT:

• Attachment theory: EFT is based on the idea that our early relationships with our caregivers shape how we relate to others in adulthood. When our attachment needs are not met in our adult relationships, we may experience emotional distress and engage in negative patterns of interaction.
• Negative cycles: EFT therapists help couples identify and understand the negative cycles that contribute to their distress. These cycles are often characterized by criticism, defensiveness, and withdrawal.
• Emotional safety: EFT helps couples create a safe space where they can express their emotions without fear of judgment or rejection. This is essential for couples to be able to heal from their past hurts and build a secure emotional bond.
• New ways of relating: EFT helps couples learn new ways of communicating and relating to each other that promote emotional safety and connection. This includes learning how to express their needs in a clear and direct way, and how to listen to and validate each other's feelings.

If you are considering couples therapy, EFT is a good option to consider. It is a short-term, goal-oriented therapy that has been shown to be effective in helping couples improve their relationships.

Outcome Research

1.        Ganz, M. B., Rasmussen, H. F., McDougall, T. V., Corner, G. W., Black, T. T., & De Los Santos, H. F. (2022). “Emotionally focused couple therapy within VA healthcare: Reductions in relationship distress, PTSD, and depressive symptoms as a function of attachment-based couple treatment.” Couple and Family Psychology: Research and Practice, 11(1), 15-32.

2.        Chun-Sing Cheung, J., Suk-Man Leung, G., Lam, Y-M., & Wing-Tung Chan, J. (2022). “Emotionally focused therapy group intervention for parents of primary school students with parenting stress: an evaluation study in Hong Kong.” Asia Pacific Journal of Social Work and Development, DOI: 10.1080/02185385.2022.2092770

3.         Tapia-Fuselier, J. L., Ray, D. C., Allan, R., & Reyes, A. G. (2022). “Emotionally focused therapists’ experiences serving interabled couples in couple therapy: An interpretative phenomenological analysis.” Journal of Marital and Family Therapy, advance online publication.

4.         Koren, R., Woolley, S.R., Danis, I., & Török, S. (2022). “Training Therapists in Emotionally Focused Therapy: A longitudinal and cross-sectional analysis.” Journal of Marital and Family Therapy, 48(3), 709-725.

5.        Kailanko, S., Wiebe, S.A., Tasca, G.A., & Laitila, A.A. (2022). “Somatic Interventions and Depth of Experiencing in Emotionally Focused Couple Therapy.” International Journal of Systemic Therapy, 33(2), 109-128.

6.        Schafer, L., Edwards, C. P., Allan, R., Johnson, S. M., Wiebe, S. A., Chyurlia, L., & Tasca, G. A. (2021). “Development of the Emotionally Focused Individual Therapy Adherence Measure (EFIT-AM): Conceptualization and preliminary reliability.” Counselling and Psychotherapy Research, Advance online publication.

7.        Kailanko, S., Wiebe, S. A., Tasca, G. A., & Laitila, A. A. (2021). “Impact of repeating somatic cues on the depth of experiencing for withdrawers and pursuers in emotionally focused couple therapy.” Journal of Marital and Family Therapy, 48(3), 693-708.

8.         Ceniza, M., & Allan, R. (2021). “Conceptual and Application Considerations of Emotionally Focused Therapy with White Heterosexual Working-Class Rural Males.” The Family Journal, 29(2), 200-207.

9.         Koren, R., Woolley, S. R., Danis, I., & Török, S. (2021). “Measuring the Effectiveness of the Emotionally Focused Therapy Externship Training in Hungary done through Translation.” Journal of Marital and Family Therapy, 47(1), 166-182.

10.        Rodríguez-González, M., Schweer-Collins, M., Greenman, P.G., Lafontaine, M.-F., Fatás, M., & Sandberg, J.G. (2019). “Short-Term and Long-Term Effects of Training in EFT: A Multi-National Study in Spanish-speaking Countries.” Journal of Marital and Family Therapy, 46(2), 304-320.

11.         Beasley, C.C., & Ager, R. (2019). “Emotionally Focused Couples Therapy: A Systematic Review of its Effectiveness Over the past 19 Years.” Journal of Evidence-Based Social Work, 16(2), 144-159.

12.         Wiebe, S.A., Elliott, C., Johnson, S.M., Burgess Moser, M., Dalgleish, T.L., Lafontaine, M-F., & Tasca, G.A. (2019). “Attachment Change in Emotionally Focused Couple Therapy and Sexual Satisfaction Outcomes in a Two-year Follow-up Study.” Journal of Couple and Relationship Therapy, 18(1), 1-21.

13.         Alder, M.C., Dyer, W.J., Sandberg, J.G., Davis, S.Y., & Holt-Lunstad, J. (2018). “Emotionally-focused therapy and treatment as usual comparison groups in decreasing depression: A clinical pilot study.” The American Journal of Family Therapy, 46(5), 541-555.

14.         Wittenborn, A.K., Liu, T., Ridenour, T.A., Lachmar, E.M., Rouleau, E., & Seedall, R.B. (2018). “Randomized controlled trial of emotionally focused couple therapy compared to treatment as usual for depression: Outcomes and mechanisms of change.” Journal of Marital and Family Therapy, 45, 395-409.

15.         Weissman, N., Batten, S.V., Rheem, K.D., Wiebe, S.A., Pasillas, R.M., Potts, W., Barone, M., Brown, C.H., & Dixon, L.B. (2018). “The Effectiveness of Emotionally Focused Couples Therapy With Veterans With PTSD: A Pilot Study.” Journal of Couple & Relationship Therapy, 17(1), 25-41.

16.          Lee, N.A., Furrow, J.L., & Bradley, B.A. (2017). “Emotionally Focused Couple Therapy for Parents Raising a Child with an Autism Spectrum Disorder: A pilot study.” Journal of Marital and Family Therapy, 43(4), 662-673.

17.          Wiebe, S., Johnson, S. M., Burgess-Moser, M., Dalgleish, T., Lafontaine, M., & Tasca, G. (2017). “Predicting follow-up outcomes in Emotionally Focused Couple Therapy: The role of change in trust, relationship-specific attachment, and emotional engagement.” Journal of Marital and Family Therapy, 43(2), 213-226.

18.          Wiebe, S., Johnson, S. M., Burgess-Moser, M., Dalgleish, T., Lafontaine, M., & Tasca, G. (2016). “Two-year follow-up outcomes in Emotionally Focused Couple Therapy: An investigation of relationship satisfaction and attachment trajectories.” Journal of Marital and Family Therapy, 43(2), 227-244.

19.          Burgess-Moser, M., Johnson, S. M., Dalgleish, T., Lafontaine, M., Wiebe, S., & Tasca, G. (2015). “Changes in relationship-specific attachment in Emotionally Focused Couple Therapy.” Journal of Marital and Family Therapy, 42(2), 231-245.

20.          Dalgleish, T.L., Johnson, S.M., Burgess Moser, M., Lafontaine, M. F., Wiebe, S.A. & Tasca, G.A. (2015). “Predicting change in marital satisfaction throughout Emotionally Focused Couple Therapy.” Journal of Marital and Family Therapy, 41(3), 276-291.

21.         Johnson, S.M., Burgess Moser, M., Beckes, L., Smith, A., Dalgleish, T., Halchuk, R., Hasselmo, K., Greenman, P.S., Merali, Z. & Coan, J.A. (2013). “Soothing the threatened brain: Leveraging contact comfort with Emotionally Focused Therapy.” PLOS ONE, 8(11): e79314.

22.          Dalton, J., Greeman, P., Classen, C., & Johnson, S. M. (2013). “Nurturing Connections in the Aftermath of Childhood Trauma: A randomized controlled trial of Emotionally Focused Couple Therapy (EFT) for Female Survivors of Childhood Abuse.” Couple and Family Psychology: Research and Practice, 2(3), 209-221.

23.          McLean, L.M., Walton, T., Rodin, G., Esplen, M.J., & Jones, J.M. (2013). “A couple-based intervention for patients and caregivers facing end-stage cancer: outcomes of a randomized controlled trial.” Psycho-Oncology, 22(1), 28-38.

24.          Denton, W.H., Wittenborn, A.K., & Golden, R.N. (2012). “Augmenting antidepressant medication treatment of depressed women with emotionally focused therapy for couples: A randomized pilot study.” Journal of Marital and Family Therapy, Vol.38, Supplement s1, 23-38.

25.          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.

26.          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.

27.          MacIntosh, H.B. & Johnson, S. (2008). “Emotionally focused therapy for couples and childhood sexual abuse survivors.” Journal of Marital and Family Therapy, 34(3), 298-315.

28.          Naaman, S., Johnson, S.M., & Radwan, K. (2008). “Evaluation of the clinical efficacy of emotionally focused therapy on psychological adjustment of couples facing early breast cancer,” (Doctoral Dissertation). School of Clinical Psychology, University of Ottawa, Canada.

29.          Couture-Lalande, M.-E., Greenman, P.S., Naaman, S. & Johnson, S.M. (2007). “La thérapie de couple axée sur l’émotion (EFT) pour traiter les couples dont la femme a le cancer du sein: Une étude exploratoire / Emotionally focused therapy (EFT) for couples with a female partner who suffers from breast cancer: an exploratory study.” Psycho-Oncology, 1(4), 257–264. (Journal of the Psychological, Social and Behavioral Dimensions of Cancer).

30.          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.

31.          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(5), 345-353.

32.         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(4), 391-398.

33.         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(1), 65-78.

34.         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(1), 67- 79.   NOTE:  Also listed here under “Meta-Analyses”

35.          Johnson, S., Maddeaux, C. & Blouin, J. (1998). “Emotionally Focused Family Therapy for Bulimia: Changing Attachment Patterns.” Psychotherapy: Theory, Research & Practice, 35(2), 238-247.

36.          Gordon-Walker, J., Johnson, S., Manion, I. & Cloutier, P. (1996). “Emotionally Focused Marital Intervention for Couples with Chronically Ill Children.” Journal of Consulting and Clinical Psychology, 64(5), 1029-1036.

37.          McPhee, D., Johnson, S.M. & van der Veer, M.C. (1995). “Low sexual desire in women: The effects of marital therapy.” Journal of Sex and Marital Therapy, 21(3), 159-182.

38.          Dandeneau, M. & Johnson, S. (1994). “Facilitating Intimacy: Interventions and Effects.” Journal of Marital and Family Therapy, 20(1), 17-33.

39.          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.

40.         James, P. (1991). “Effects of a Communication Training Component Added to an Emotionally Focused Couples Therapy.” Journal of Marital and Family Therapy, 17(3), 263-275.

41.         Johnson, S. & Greenberg, L. (1985). “Emotionally Focused Couples Therapy: An Outcome Study.” Journal of Marital and Family Therapy, 11(3), 313-317.

42.          Johnson, S. & Greenberg, L. (1985). “The Differential Effects of Experiential and Problem Solving Interventions in Resolving Marital Conflict.” Journal of Consulting & Clinical Psychology, 53, 175-184. (EFT, CBT and controls tested.)

EFT Relationship Education Program Research

22.          Kennedy, N.W., Johnson, S.M., Wiebe, S.A., & Tasca, G.A. (2019). “Conversations for Connection: An Outcome Assessment of the Hold-Me-Tight Relationship-Education Program for Couples, and Recommendations for Improving Future Research Methodology in Relationship Education.” Journal of Marital and Family Therapy, 45(3), 431-446.

23.          Morgis, B., Ewing, E., Liu, T., Slaughter-Acey, J., Fisher, K., & Jampol, R. (2019). “A Hold Me Tight Workshop for Couple Attachment and Sexual Intimacy.” Contemporary Family Therapy, 41(4), 1409-1411.

24.          Lesch, E., de Bruin, K., & Anderson, C. (2018). “A Pilot Implementation of the Emotionally Focused Couple Therapy Group Psychoeducation Program in a South African Setting.” Journal of Couple & Relationship Therapy, 17(4), 313-337.

25.          Conradi, H.J., Dingemanse, P., Noordhof, A., Finkenauer, C., & Kamphuis, J.H. (2017). “Effectiveness of the ‘Hold me Tight’ Relationship Enhancement Program in a Self-referred and a Clinician-referred Sample: An Emotionally Focused Couples Therapy-Based Approach.” Family Process, 57(3), 613-628.

26.          Wong, T.Y., Greenman, P.S., & Beaudoin, V. (2017). “‘Hold Me Tight’: The generalizability of an attachment-based group intervention to Chinese Canadian couples.” Journal of Couple & Relationship Therapy — Innovations in Clinical and Educational Interventions, 17(1), 42-60.

Reviews of EFT Research / Commentaries

1.          Doss, B.D., Roddy, M.K., Wiebe, S.A., & Johnson, S.M. (2022). “A review of the research during 2010–2019 on evidence-based treatments for couple relationship distress.” Journal of Marital and Family Therapy, 48(1), 283– 306.

2.          Wiebe, S.A., & Johnson, S.M. (2016). “A Review of the Research in Emotionally Focused Therapy for Couples.” Family Process, 55(3), 390-407.

3.          Johnson, S. and Greenman, P. (2013). “Commentary: Of Course It Is All About Attachment!” Journal of Marital and Family Therapy, 39(4), 421-423.

4.          Priest, Jacob B. (2013). “Emotionally Focused Therapy as Treatment for Couples with Generalized Anxiety Disorder and Relationship Distress.” Journal of Couple & Relationship Therapy: Innovations in Clinical and Educational Interventions, 12(1), 22-37.

5.          Fitzgerald, J., & Thomas, J. (2012). “A report: Couples with medical conditions, attachment theoretical perspectives and evidence for Emotionally-focused Couples Therapy.” Journal of Contemporary Family Therapy, Vol. 34(2), 277-281.

6.          Johnson, S.M., & Wittenborn, A.K. (2012). “New research findings on emotionally focused therapy: Introduction to special section.” Journal of Marital and Family Therapy, 38, Supplement s1, 18-22.

7.          Lebow, J.L., Chambers, A.L., Christensen, A., & Johnson, S.M. (2012). “Research on the Treatment of Couple Distress.” Journal of Marital and Family Therapy, 38(1), 145-168.

8.          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.

9.          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.

10.          Johnson, S.M. (2007). “The Contribution of Emotionally Focused Couples Therapy.” Special Edition of the Journal of Contemporary Psychology: Humanistic Psychology, 37(1), 47-52.

11.          Johnson, S.M. (2007). “A new era for couple therapy: Theory, research and practice in concert.” Journal of Systemic Therapies, 26(4), 5-16.

12.          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.

13.          Johnson, S.M. (2003). “Emotionally focused couples therapy: Empiricism and art.” In T. Sexton, G. Weeks, & M. Robbins (Eds.), Handbook of Family Therapy: The science and practice of working with families and couples, pp. 303-322. New York, NY: Brunner/Routledge.

14.          Johnson, S.M. (2003). “The revolution in couples therapy: A practitioner-scientist perspective.” Journal of Marital and Family Therapy, 29(3), 365-385.

15.          Johnson, S.M. (2003). “Couples therapy research: Status and directions.” In G.P. Sholevar (Ed.), Textbook of Family and Couples Therapy: Clinical Applications, pp. 797-820. Arlington, VA: American Psychiatric Publishing Inc. (APPI).

16.          Johnson, S.M. (2002). “Marital problems.” In D. Sprenkle (Ed.), Effectiveness Research in Marriage and Family Therapy, pp. 163-192. Alexandria, VA.: American Association for Marriage and Family Therapy (AAMFT).

17.          Johnson, S.M. & Lebow, J. (2000). “The coming of age of couple therapy: A decade review.” Journal of Marital and Family Therapy, 26(1), 23-38.

18.          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, 66(1), 53-88.

19.          Johnson, S.M. (1997). “A Critical Review of Marital Therapy Outcome.” The Canadian Journal of Psychiatry, 42(3), 323.

Meta-Analyses

1.          Spengler, P. M., Lee, N. A., Wiebe, S. A., & Wittenborn, A. K. (2022). “A comprehensive meta-analysis on the efficacy of emotionally focused couple therapy.” Couple and Family Psychology: Research and Practice, advance online publication.

2.          Wood, N.D., Crane, D.R., Schaalje, G.B., & Law, D.D. (2005). “What works for whom: A meta- analytic review of marital and couples therapy in reference to marital distress.” The American Journal of Family Therapy, 33(4), 273-287.     NOTE:  Refers to EFT

3.          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 Research

4.          Dunn, R.T. & Schwebel, A.I. (1995). “Meta-analytic review of marital therapy outcome research.” Journal of Family Psychology, 9(1), 58-68.