Following the short summary is a list of studies and commentaries on Emotionally Focused Therapy research.
Short Summary of EFT 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 30 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 study shows that EFT changes the way contact with a partner mediates the effect of threat on the brain. A short video, Soothing the Threatened Brain, summarizing this study can be viewed on drsuejohnson.com/videos. 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.
Kennedy, N.W., Johnson, S.M., Wiebe, S.A., & Tasca, G.A. (2017). “Conversations for Connection: An Outcome Assessment of the Hold Me Tight Relationship Education Program for Couples.” (Manuscript in review.)
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. Published online 03 Apr 2017.
Elliott, C., Wiebe, S. A., Johnson, S. M. & Tasca, G. A. (2015). “Attachment & sexual satisfaction in emotionally focused therapy for couples.” (Manuscript in review.)
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. Rev. 25 – June 2017 Page 3 of 9
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.
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.\
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. Rev. 25 – June 2017 Page 4 of 9
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).
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.
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.
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. Rev. 25 – June 2017 Page 5 of 9
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.)
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.
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.
Talitman, E. & Johnson, S. (1997). “Predictors of Success in Emotionally Focused Marital Therapy.” Journal of Marital & Family Therapy, 23(2), 135-152. It is interesting to note that in this study, couples continued to significantly improve from the end of therapy to follow-up.
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.
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.
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. Rev. 25 – June 2017 Page 7 of 9
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.
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. Poster presented at the Veterans Affairs National Annual Conference: Improving Veterans Mental Health Care for the 21st Century, Baltimore, MD.
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.
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.
Johnson, S.M. (2007). “A new era for couple therapy: Theory, research and practice in concert.” Journal of Systemic Therapies, 26(4), 5-16.
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.
Johnson, S. M. (2003). “The revolution in couples therapy: A practitioner-scientist perspective.” Journal of Marital and Family Therapy, 29(3), 365-385.
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).
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).
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. Rev. 25 – June 2017 Page 8 of 9
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(1), 38-57.
Sandberg, J.G. (2011). “Introduction to the Special Section on Learning Emotionally Focused Couples Therapy.” Journal of Marital & Family Therapy, 37(4), 377-379.