Emotionally Focused Couples Therapy

Emotionally focused couples therapy, emotionally focused therapy, Emotionally focused therapy for couples, EFCT,

Emotionally Focused Couples Therapy (Emotionally Focused Couples Therapy) was created by Sue Johnson and Les Greenberg in the mid-1980s as a treatment for couples in distress. It was one of the first therapies to focus on the power of emotion as an agent of change. The Emotionally Focused Couples Therapy therapist assesses unhealthy interactions and uses emotions as a pathway to heal relationships and alter maladaptive communication patterns. Ultimately, Emotionally Focused Couples Therapy is a journey towards interpersonal emotional connectedness.

What is Emotionally Focused Couples Therapy?

Emotionally Focused Couples Therapy is a short-term treatment of 8–20 sessions. Much of the emphasis of Emotionally Focused Couples Therapy is on helping the clients become aware of their feelings and working with them to regulate their emotions and their subsequent behavior. 

It has a basis in attachment theory and posits that creating more secure attachments can lead to personal healing. Emotionally Focused Couples Therapy attempts to move clients from feelings of isolation, fear, and insecurity to connectedness and love. Les Greenberg borrowed some of the original Emotionally Focused Couples Therapy concepts and has adapted them for work with individuals and families.

What are the three stages of Emotionally Focused Couples Therapy?
Emotionally Focused Couples Therapy has three stages of treatment:

When couples first come to therapy, they are frequently in a state of distress. They exhibit maladaptive patterns of interaction and significant emotional reactivity. This first stage of treatment helps couples recognize how their insecure attachment to each other is contributing to their damaging interactions. The therapist first must establish a therapeutic alliance with their client(s) while they are assessing the situation. Then they will reframe the clients’ behavior as attempts to gain connection from their partner and show them more adaptive ways to attain feelings of love and security.


Phase two of Emotionally Focused Couples Therapy is devoted to restructuring the bond between partners. It focuses on the recognition of each other’s emotional needs and constructively sharing those feelings. The therapist acts as a facilitator of the couple’s emotional expression and guides them toward more appropriate reactions. This stage requires a higher level of vulnerability and may cause anxiety for those uncomfortable with sharing. Forming adaptive patterns of behavior that increase intimacy and support is the overall goal of restructuring.


The last phase of treatment involves the therapist attempting to consolidate the gains the couple has made in the restructuring stage. During the final sessions, couples will practice their new way of relating. Previous conflicts will be reviewed to see how they could have been handled differently. The therapist will point out how new interaction patterns lead to more successful and engaging outcomes. The objective is for partners to be able to better weather their difficulties due to increased feelings of security and connection.

Emotionally Focused Couples Therapy techniques
The following techniques are frequently used in Emotionally Focused Couples Therapy:

Reflection is a technique first popularized by Carl Rogers’ person-centered therapy. It is the non-judgmental empathetic reflection back of what the client says during the session.

In Emotionally Focused Couples Therapy, reflection serves two main purposes: 
  • It helps to clarify what the couple is saying so that the therapist can accurately assess the situation. 

  • It makes more obvious the issues and communication patterns that the couple may not realize are taking place. 

This is especially important because maladaptive patterns cannot be changed until they are accurately identified. For example, a therapist may comment to a husband, “I hear you saying that when Mary confronts you about spending more time together, you won’t address it and leave the room.”


Reframing is when you help someone view a situation from another perspective. It is a crucial technique in Emotionally Focused Couples Therapy because it is theorized that most negative interactions between a couple are simply misguided attempts for connection. Of course, in the heat of a conflict, it is rarely viewed that way. It is the job of the therapist to reframe any negative behavior so that both members of the couple look at their interactions as bids for intimacy rather than just one (or both) of them behaving badly. For instance, a therapist might say, “So, Mary, am I correct in saying that when you were calling John an ‘absent husband’, you were really just trying to get him to spend more time with you?”


Re-enactment provides clients the opportunity to review patterns of conflictual emotional involvement and replace them with healthier interactions. Various types of re-enactment could be used. For example, the therapist may simply ask the clients to talk about past experiences and look at them with a fresh perspective. Or, they could perform a role-play or empty-chair exercise. Whatever the case, the point of re-enactment is to show how previous patterns led to isolation and insecurity, and how new rules of engagement will foster more positive connections. 


Emotionally Focused Couples Therapy exhibits impressive results.

It is one of the most empirically supported couples therapies, with over 30 years of research.
  • An earlier study noted that 90 percent of couples felt better about their marriage after Emotionally Focused Couples Therapy and an astounding 70-75 percent of couples felt that they were no longer in distress. In essence, Emotionally Focused Couples Therapy had eliminated their need for further treatment.

  • In a meta-analysis of studies over 20 years, Emotionally Focused Couples Therapy significantly improved marital satisfaction in couples and those gains were sustained at follow-up.

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Training Resources in Emotionally Focused Couples Therapy

There is no shortage of training in Emotionally Focused Couples Therapy.

Whether you want hours of extensive training through an institute or to spend a few hours reading a book, here are some training resources available to therapists:
  • The Emotion-focused Therapy Institute offers three levels of intensive training through videoconferencing and online. They are affiliated with the International Society of Emotion-Focused Therapy (ISEFT), which has institutes around the world. This is the training you need if you want to obtain certification in Emotionally Focused Couples Therapy.

  • "Hold Me Tight” is the seminal book from Sue Johnson on Emotionally Focused Couples Therapy for couples. There is also an accompanying workbook.

Emotionally Focused Couples Therapy uses the awareness and regulation of emotions to heal relationships. Its focus on emotions, rather than thoughts, sets it apart from most current popular therapies. 


If you would like more information about Emotionally Focused Couples Therapy and other relevant psychotherapies turn to Theraplatform. TheraPlatform is an all-in-one EHR, practice management and teletherapy software for clinicians. Try a 30-day free trial of Theraplatform today.

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