SUPPORTIVE RESEARCH OF Emotionally Focused Therapy:
Rev. 17 – October 2014 – EFT Research Overview and Citations
Following the short summary is a list of studies and commentaries on Emotionally Focused Therapy research.
Question: 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 of relationship distress and adult attachment processes.
Recent research involves outcome studies of couples facing trauma and stressful events (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 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. Elliott, C., Wiebe, S. A., Johnson, S. M. & Tasca, G. A. (2014). Attachment & sexual satisfaction in emotionally focused therapy for couples.( Manuscript in preparation.)
2. Dalgleish, T.L., Johnson, S.M., Burgess Moser, M., Lafontaine, M. F., Wiebe, S.A. & Tasca, G.A. (2014) Predicting change in marital satisfaction throughout Emotionally Focused Couple Therapy. Journal of Marital and Family Therapy, doi: 10.1111/jmft.12077.
3. Mehr, S.E., Bahrami, F., Karami, B., Mehr, Y.E., Hedayati, A.M., Ahmadi, S. & Rozeyan, A. (2014) Studying the effect of emotion focused therapy on couples’ attachment styles. MAGNT Research Report, Vol.2(5), 595-602.
4. Ahmadi, F.S., Zarei, E. & Fallahchai, S.R. (2014) “The Effectiveness of Emotionally-Focused Couple Therapy in Resolution of Marital Conflicts between the Couples Who Visited the Consultation Centers.” Journal of Education and Management Studies, 4(1), 118-123.
5. Soltani, M., Shairi, M.R., Roshan, R., & Rahimi, C. (2014) The Impact of Emotionally Focused Therapy on Emotional Distress in Infertile Couples. International Journal of Fertility and Sterility, 7(4): 337-344.
6. 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.
7. 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,Vol.2(3), 209-221.
8. 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.
9. 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.
10. Naaman, S., Johnson, S.M., & Radwan, K. (2011) 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.
11. 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.
12. 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.
13. MacIntosh, H.B. & Johnson, S. (2008) Emotionally focused therapy for couples and childhood sexual abuse survivors. Journal of Marital and Family Therapy, 34, 298-315.
14. 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 Cancer). 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. Psycho-Oncologie, 1, 1-8.
15. 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.
16. 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.
17. 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.
18. 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.
19. 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
20. Johnson, S., Maddeaux, C. & Blouin, J. (1998) Emotionally Focused Family Therapy for Bulimia: Changing Attachment Patterns. Psychotherapy: Theory, Research & Practice, 35, 238-247.
21. 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.
22. 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.
23. Dandeneau, M. & Johnson, S. (1994) Facilitating Intimacy: Interventions and Effects. Journal of Marital & Family Therapy, 20, 17-33.
24. 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. 25. James, P. (1991) Effects of a Communication Training Component Added to an Emotionally Focused Couples Therapy. Journal of Marital & Family Therapy, 17(3), 263-275.
26. Johnson, S. & Greenberg, L. (1985) Emotionally Focused Couples Therapy: An Outcome Study. Journal of Marital & Family Therapy, 11, 313-317.
27. 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
1. Schade, L.C., Sandberg, J.G., Bradford, A., Harper, J.M., Holt-Lunstad, J. & Miller, R.B. (2014) A Longitudinal View of the Association Between Therapist Warmth and Couples’ In-Session Process: An Observational Pilot Study of Emotionally Focused Couples Therapy. Journal of Marital and Family Therapy, DOI: 10.1111/jmft.12076.
2. McRae, T.R., Dalgleish, T.L., Johnson, S.M., Burgess-Moser, M., & Killian, K.D. (2014) Emotion Regulation and Key Change Events in Emotionally Focused Couple Therapy. Journal of Couple & Relationship Therapy, 13(1), 1-24.
3. Dalgleish, T.L., Johnson, S. M., Burgess Moser, M., Wiebe, S.A. & Tasca, G.A. (2014). Predicting Key Change Events in Emotionally Focused Couple Therapy. Journal of Marital and Family Therapy, doi: 10.1111/jmft.12101.
4. Greenman, P., & Johnson, S. (2013). Process Research on EFT for Couples: Linking Theory to Practice. Family Process, Special Issue on Couple Therapy, 52(1), 46-61.
5. Zuccarini, D.J., Johnson, S.M., Dalgleish, T. & Makinen, J. (2013) Forgiveness and reconciliation in Emotionally Focused Therapy for Couples: The Client Change Process and Therapist Interventions. Journal of Marriage and Family Therapy, 39(2), 148-162.
6. Furrow, J.L., Edwards, S.A., Choi, Y., & Bradley, B. (2012) Therapist presence in emotionally focused couple therapy blamer softening events: promoting change through emotional experience. Journal of Marital and Family Therapy, Vol.38, Supplement s1, 39-49.
7. Wittenborn, A.K. (2012) Exploring the Influence of the Attachment Organizations of Novice Therapists on their Delivery of Emotionally Focused Therapy for Couples. Journal of Marital and Family Therapy, Vol.38, Supplement s1, 50-62.
8. 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.
9. 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.
10. 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.
11. 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.
12. 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. Johnson, S. and Greenman, P. (2013), Commentary: Of Course It Is All About Attachment!. Journal of Marital and Family Therapy. doi: 10.1111/jmft.12035.
2. 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.
3. Johnson, S.M., & Wittenborn, A.K. (2012) New research findings on emotionally focused therapy: Introduction to special section. Journal of Marital and Family Therapy, Vol.38, Supplement s1, 18-22.
4. 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.
5. 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.
6. 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.
7. 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.
8. Johnson, S.M. (2007) The Contribution of Emotionally Focused Couples Therapy. Special Edition of Journal of Contemporary Psychology: Humanistic Psychology, 37, 47-52.
9. Johnson, S.M. (2007) A new era for couple therapy: Theory, research and practice in concert. Journal of Systemic Therapies, 26, 5-16.
10. 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.
11. 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.
12. Johnson, S. M. (2003) The revolution in couples therapy: A practitioner-scientist perspective. Journal of Marital and Family Therapy, 29, 365-385.
13. 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.
14. 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.
15. 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.
16. 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 / Learning EFT
1. Sandberg, J.G., Knestel, A., & Cluff Schade, L. (2013) From Head to Heart : A Report on Clinicians’ Perceptions of the Impact of Learning Emotionally Focused Couple Therapy on Their Personal and Professional Lives. Journal of Couple & Relationship Therapy, 12, 38-57.
2. Sandberg, J.G. (2011) Introduction to the Special Section on Learning Emotionally Focused Couples Therapy. Journal of Marital & Family Therapy, 37(4), 377-379.
3. Montagno, M., Svatovic, M. & Levenson, H. (2011) Short-Term and Long-Term Effects of Training in Emotionally Focused Couple Therapy: Professional and Personal Aspects. Journal of Marital & Family Therapy, 37(4), 380-392.
4. Sandberg, J.G. & Knestel, A. (2011) The Experience of Learning Emotionally Focused Couples Therapy. Journal of Marital & Family Therapy, 37(4), 393-410.
5. Palmer-Olsen, L., Gold, L.L. & Woolley, S.R. (2011) Supervising Emotionally Focused Therapists: A Systematic Research-Based Model. Journal of Marital & Family Therapy, 37(4), 411-426. Miscellaneous
1. Sandberg, Jonathan G., Busby, Dean M., Johnson, Susan M., & Yoshida, Keitaro (2012). The Brief Accessibility, Responsiveness, and Engagement (BARE) Scale: A Tool for Measuring Attachment Behavior in Couple Relationships. Family Process, 51(4), 512-526.
2. Caron, A., Lafontaine, M.-F., Bureau, J.-F., Levesque, C., & Johnson, S.M. (2012). Comparisons of attachment in close relationships: An evaluation of relationship quality and attachment to parents, friends, and romantic partners in young adults. Canadian Journal of Behavioural Science, 44, 245-256.
Programs Based on EFT Research
1. Johnson, S.M. (2009) The Hold Me Tight® Program: Conversations for Connection – Facilitators Guide. Ottawa, Canada. International Centre for Excellence in EFT.
2. 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.