Emotion-focused Family Therapy Research Articles

Outpatient treatment of children and adolescents using emotion-focused family therapy (EFFT) caregiver workshops: A pre- to postintervention evaluation.

Outpatient treatment of children and adolescents using emotion-focused family therapy (EFFT) caregiver workshops: A pre- to postintervention evaluation.

The potentiality of nature to tug at our heartstrings: an exploratory inquiry into supportive affordances for emotion-focused family therapy in the outdoors

AbstractA wealth of studies demonstrate the associations between nature contact and well-being, and gradually, nature-based solutions are becoming more widespread in mental health care and recovery. While emotion-focused therapies generally show promising results, evidence of nature-based family therapy is still scarce. In a forthcoming clinical trial at Sørlandet hospital in Southern Norway, we will compare indoor and outdoor provision of emotion-focused multi-family therapy. The foundation of emotion-focused therapeutic work with families is a deep belief in the healing powers of families, where resources within the “ecosystem” of a given family can be reactivated and nudged towards establishing a greater sense of harmony and connectedness over time. According to a Gibsonian understanding of affordances, humans respond to possibilities and limitations within an environment, where affordances in the context of this article arise from a systemic interplay between nature, participating families and facilitators. In this exploratory inquiry, we are particularly interested in the myriad ways nature may influence four core principles in emotion-focused therapy, including (a) emotion awareness, (b) emotion regulation, (c) reflection on emotion, and (d) emotion transformation. In this perspective article, we propose hypotheses and working metaphors in relation to everything from emotions’ multiple purposes to the delineation of facilitators’ accepting, empathic and curious stance. First and foremost, we attempt to generate a preliminary account of nature’s potentiality to tug at our heartstrings and offer a supportive environment for the novel provision of emotion-focused family therapy in the outdoors.

A case study of virtually delivered emotion-focused family therapy.

Clinical psychologists and therapists are increasingly taking advantage of internet and mobile-based technologies to deliver mental health services for individuals and groups since the COVID-19 pandemic. However, there is a dearth of research evaluating the appropriateness of virtual platforms for family interventions. Further, no research has examined the effectiveness of weekly emotion-focused family therapy (EFFT). This case study presents a virtually delivered 8-week EFFT intervention, which supportedcaregivers tomanagechild symptoms of depression, anxiety, and anger, facilitate emotion processing, and strengthen relationships. Two parents from one family during a marital separation participated and completed brief measures of therapeutic alliance, family functioning, parental self-efficacy, and parental and child psychological distress at 12 time points as well as a posttreatment semistructured interview. A strong therapeutic alliance was formed, and general family functioning, parental self-efficacy, parent psychopathology, and child depression, anger, and anxiety symptoms improved over the course of therapy.

Caregiver openness in emotionally focused family therapy: A critical shift.

Through the application of a discovery-oriented task analysis, this research delineated specific therapist behaviors that resulted in a successful caregiver openness event in emotionally focused family therapy (EFFT). EFFT experts were recruited via email and asked to submit family therapy recordings where they believed a caregiver openness event occurred. Ten family therapy recordings were submitted by three experts. Within these recordings, 12 caregiver openness events were discovered and critically analyzed. Nine themes were identified and interventions therapists applied to accomplish these themes were delineated using the emotionally focused therapy-coding scheme (EFT-CS). These themes included:(1) validating and reframing the child's protected stance, (2) processing the impact of the child's unmet attachment longings, (3) validating the caregiver's blocked relational stance, (4) expanding caregiving intentions, (5) enacting the caregiver's intentions to meet the child's attachment longings, (6) processing the enactment, (7) processing and promoting caregiver accessibility to the child's response, (8) heightening the caregiver's accessible stance, and (9) enhancing shifting family dynamics. Additional findings, implications for clinical practice, training, and future research are discussed.

Brief emotion-focused family therapy: A 12-month follow-up study.

This study provides a 12-month follow-up evaluation of caregivers after participating in a 2-day Emotion-focused family therapy (EFFT) intensive, a brief intervention for caregivers of youth struggling with mental health difficulties. Caregivers (N = 498) of children (N = 337) completed measures of caregiver self-efficacy and child mental health difficulties 1 week before the intervention, immediately after the intervention, and at 4, 8, and 12-month follow-ups. Piecewise latent trajectory models revealed that parental self-efficacy showed a large immediate increase following the intervention, β = 1.61 (1.32, 2.14), and although this effect was attenuated by 4months, β = -0.77 (-1.31, -0.52), it did not change further by 12 months. Reductions in child mental health difficultieswere observed by 4 months, β = -0.54 (-0.77, -0.37), and remained stable through the 12-month follow-up. Caregivers reporting more increases in self-efficacy also reported greater reductions in their children's symptoms at 4 and 12 months.

Caregiver maltreatment history and treatment response following an intensive Emotion Focused Family Therapy workshop.

This single-arm, repeated measures study investigated the impact caregiver trauma history may have on treatment response following an intensive, 2-day Emotion Focused Family Therapy (EFFT) caregiver workshop. Caregivers (n = 243) completed questionnaires regarding their child's emotion regulation and clinical symptoms, as well as their own childhood trauma history (i.e., exposure to various forms of child maltreatment), caregiver self-efficacy and caregiver blocks (e.g., fears) to support their child's treatment and recovery. Questionnaires were administered prior to and immediately following the workshop and again 4, 8 and 12 months later. At baseline, caregivers who reported experiences of childhood maltreatment demonstrated more blocks compared with caregivers who did not (B = 6.35, SE = 2.62, p < 0.05). Results indicated that caregivers with and without maltreatment histories reported similar, significant gains in their child's total difficulties (B = 0.64, SE =0.41, p = 0.12) and emotional negativity and lability (B = 0.51, SE =0.48, p = 0.29) at 12-month post-workshop. Caregivers with maltreatment histories reported greater improvements in caregiver blocks (B = 5.15, SE =1.34, p < 0.001) and child emotion regulation (B = 0.90, SE =0.18, p < 0.001) than caregivers without maltreatment histories. They also report less, but still significant, improvement in parental self-efficacy (B = -0.68, SE =0.26, p < 0.01) when compared with caregivers without maltreatment histories. Findings suggest that EFFT workshops may be an acceptable and effective trans-diagnostic intervention for families presenting with complex histories, including caregiver exposure to childhood maltreatment.

Processes and outcomes of an emotion-focused family therapy two-chair intervention for transforming problematic parenting patterns.

Emotion-focused family therapy (EFFT) is a therapy model which includes a two-chair intervention aimed at facilitating awareness and an interruption of problematic patterns of parenting as well as a reconnection to healthy caregiving instincts. The present study employed a task analysis to examine the process of this intervention with parents in a therapeutic setting and report on preliminary outcomes. Four trained EFFT therapists conducted chair work interventions with four parents (total of 16) and parents completed questionnaires directly following the intervention. Results indicated that most parents experienced significant emotional resolution of their love-based fears and an increase in confidence in supporting their children struggling with mental health issues. Use of the intervention in clinical settings is an effective and efficient way to support parents in responding to their children's mental health challenges.

Therapist adaptations for online caregiver emotion-focused family therapy during the COVID-19 pandemic

ABSTRACT The urgency to implement distance-based methods to provide ongoing mental health care during the novel coronavirus (COVID‐19) pandemic represents a critical shift in treatment delivery for children, youth, and families. The COVID-19 pandemic has placed additional strain on the mental health of families and children. As a result, there is an increased need for brief, family-based interventions. Emotion-Focused Family Therapy (EFFT) is an empirically-supported intervention targeting caregivers of children with mental health challenges. The EFFT group therapy modality typically involves thirty caregivers who participate in a two-day intensive workshop, serving as a brief yet efficient intervention with enduring impact. Based on experiences within our clinic, this article provides practical intervention strategies to address common challenges therapists may contend with while providing EFFT intervention to caregivers and families through a secure videoconferencing platform. Additional research in distance-based mental health care for children and their caregivers can assess effectiveness, efficiency and improved access to mental health care throughout the pandemic.

BRINGING FAMILIES TOGETHER IN CRISIS: FAMILY-BASED INTERVENTIONS ACROSS DIFFERENT SETTINGS OF CARE

There is considerable evidence for the clinical utility of family-based interventions (FI) in several domains of childhood psychopathology. Despite the known efficacy of FI, many child and adolescent psychiatry fellowship programs in the United States provide minimal FI training. The goals of this presentation are to highlight the feasibility and relevance of FI across acute care settings and crisis situations, and to provide practical tips on incorporating FI within the scope of daily practice of child and adolescent psychiatry. Presenters from different institutions across the country will discuss the role of FI in treating youth in crisis from inpatient, consultation-liaison, outpatient, and emergency department (ED) perspectives. Using a case-based approach, presenters will give real-life context for the following treatment approaches: brief family therapy for adolescents in the inpatient psychiatric unit, family CBT to treat psychological distress in children on a transplant unit, attachment-based family therapy (ABFT) for high-risk adolescents in the outpatient setting, and emotionally focused family therapy (EFFT) for suicidal adolescents in the ED. The presenters will engage the audience by incorporating a think/pair/share activity to practice problem solving in each treatment setting, and by providing clinical pearls for clinicians to apply FI skills in their practice. Family factors frequently play a significant role in childhood mental health crises. The presenters demonstrate how FI can be effective practical treatment tools for psychiatrists to apply across treatment settings. Family dynamics represent a critical underpinning in understanding both childhood mental distress and well-being. Therefore, it is critical for child and adolescent psychiatrists to understand how family dynamics affect patient distress and to be equipped with skills to intervene with families across treatment settings.

Emotion-focused parenting interventions for prevention and treatment of child and adolescent mental health problems: a review of recent literature.

To review recent studies on emotion-focused parenting interventions to provide clinicians with knowledge about how these approaches might be used in prevention and treatment of mental health difficulties for children, adolescents and their families. A number of emotion-focused parent interventions are reported in the literature, including emotion coaching/communication parenting programs, emotion-focused family therapy, attachment-focused parenting interventions (including those that address parental reflective functioning/mentalization), mindfulness parenting programs and behavioral programs with added emotion components. All target emotions or emotional communication to assist parents and children understand and work through emotional experiences so they are less likely to impede healthy functioning. These interventions target four main domains: exploring family of origin or early attachment/relational experiences with emotion, targeting parents' own emotion awareness and regulation, shifting parents responses to or communication with their children when emotions occur, and promoting parents' skills for assisting children to regulate emotions and behavior. This review from the last 18 months found 50 studies that evaluated programs addressing these domains. Whilst the dominant approach in evidence-based parenting programs has been teaching behavioral strategies, it has been recognized that a focus on emotion-related processes is important. This is especially when working to improve the attachment relationship or when parents and children experience emotion dysregulation. This review demonstrates extensive evidence to support emotion-focused parenting interventions.

An Emotion Focused Family Therapy workshop for parents with children 6-12 years increased parental self-efficacy

ABSTRACTIn this pilot study, we examined whether a 2-day Emotion-Focused Family Therapy workshop strengthened parental self-efficacy, satisfaction and beliefs regarding their ability to help their children regulate emotions and reduce the children’s symptoms of behavioural- or psychological difficulties. Twenty-three caretakers with 17 children (9 boys) aged 6 to 12 years old completed the workshop. Pre, post and 3-month follow-up data on the Parents` Beliefs About Children`s Emotions – Guidance scale and Parenting Sense of Competence scale, as well as pre and 3-month follow-up data on the Child Behaviour Checklist parent form, were used to assess the effects of the intervention. Parental self-efficacy significantly increased, the caretakers` satisfaction in the parenting role significantly increased but faded after 3 months and the caretakers` beliefs that children can guide their emotions on their own were significantly reduced. Finally, oppositional defiant problems in the children significantly declined.

Brief Emotion Focused Family Therapy: An Intervention for Parents of Children and Adolescents with Mental Health Issues.

This study evaluated the 2-day intensive modality of Emotion Focused Family Therapy (EFFT). The intervention attempts to prepare parents to take a primary role in their child's recovery from a range of mental health issues. One hundred and twenty-four parents completed the intervention and provided data a week prior to intervention, post-intervention and at 4-month follow-up. Results include significantly reduced parent blocks and increased parental self-efficacy in relation to involvement in their child's recovery, as well as significant improvement in child symptomatology. The findings confirm positive results from an earlier pilot study involving eating disorders and demonstrate the potential for EFFT as an intervention for a range of clinical problems in children and youth.

«Jeg forstår henne bedre nå» – En kvalitativ studie av foreldres opplevelse av relasjonen til egne barn etter emosjonsfokusert foreldreveiledning [“I understand her better now” – A qualitative study of parents’ experiences of their relationship to their children after Emotion-Focused Family Therapy (EFFT)

In this article, we report from a qualitative study investigating whether and how parents experience Emotion-Focused Family Therapy’s (EFFT’s) impact on the relationship to their children. Six parents who had attended a two-day course of EFFT were interviewed, with qualitative in-depth interviews taking place two to four months after completion of the course. We used a hermeneutic-phenomenological approach in analyzing these interviews. Analysis resulted in four main themes: Increased understanding of the child; Stronger confidence in their role as parents; Increased focus on emotions improving relationships; and Improved communication with the child. The study shows how the parents experienced becoming more secure in their role as parents and obtaining increased confidence in their own abilities. In addition, they experienced improved contact with, and better understanding of, their children. The parents underscored how these processes were ongoing and demanding and how they entailed considerable effort. Further research will contribute to expanding and nuancing our knowledge on how parents experience receiving EFFT and how such therapy affects parents’ experiences of their relationships with their children.

Increasing parental self-efficacy with emotion-focused family therapy for eating disorders: a process model

ABSTRACTA process model was tested whereby parental fear and self-blame were targeted in order to enhance parental self-efficacy and supportive efforts in the context of emotion-focused family therapy (EFFT) for eating disorders (ED). A 2-day EFFT group intervention was delivered to parents of adolescent and adult children with ED. Data were collected from eight treatment sites (N = 124). Data were analyzed using t-tests, regression analyses and structural equation modeling. The findings supported the proposed process model. Through the processing of parents’ maladaptive fear and self-blame, parents felt more empowered to support their child’s recovery. This increase in self-efficacy led to an increase in parents’ intentions to engage in recovery-focused behaviors. This study is the first to test a method for clinicians to increase supportive efforts by targeting and enhancing caregiver self-efficacy via the processing of emotion.

Emotionally Focused Family Therapy and Play Therapy for Young Children Whose Parents Are Divorced

ABSTRACTDivorce is common and can pose risks to those involved. Although divorce affects all parts of the family system, young children face extraneous challenges due to their unique developmental stage and limited cognitive ability. Emotionally focused family therapy (EFFT) works to enhance attachment bonds by restructuring a family’s negative interaction cycle and can be useful for repairing relationships between parents and their children who are suffering negative effects of parental divorce. Whereas adults have the skills to express themselves verbally, young children often use imaginary play to convey their emotional experiences and unmet attachment needs. By using play therapy techniques within an EFFT framework, adults and children can better communicate their perspectives concerning difficult life events such as parental divorce.

La thérapie dyadique parent-adolescent centrée sur les émotions

A variety of psychotherapeutic settings have been explored in the treatment of the adolescent and his family. To our knowledge, no single psychotherapeutic setting encompasses within its own theoretical framework the dyadic parent-adolescent psychotherapy. In this article, we first review as sources of references and inspiration the Attachment-Based Family Therapy and the Emotion-Focused Family Therapy. Then, we present the Dyadic Emotion-Focused Parent-Adolescent Therapy. In the third part, we seek to illustrate through clinical extracts the dyadic intervention.

Emotion-Focused Family Therapy for Eating Disorders Across the Lifespan: A Pilot Study of a 2-Day Transdiagnostic Intervention for Parents.

Emotion-focused family therapy is a transdiagnostic approach that affords parents and caregivers a significant role in their loved one's recovery from an eating disorder. A 2-day intervention was developed on the basis of emotion-focused family therapy principles and delivered to 33 parents of adolescent and adult children. Data were collected pre- and post-intervention. Through education and skills practice, parents were taught strategies with respect to meal support and symptom interruption as well as emotion coaching. Parents were also supported to identify and work through their own emotional blocks that could interfere with their supportive efforts. Analyses revealed a significant increase in parental self-efficacy, a positive shift in parents' attitudes regarding their role as emotion coach and a reduction in the fears associated with their involvement in treatment, including a decrease in self-blame. Overall, this broad-based, low-cost intervention shows promise, and future research is warranted. Copyright © 2014 John Wiley & Sons, Ltd. A low-cost, intensive emotion-focused family therapy intervention shows promise for parents of individuals with an eating disorder, regardless of their loved one's age, symptom profile or involvement in treatment. Working with parents' emotions and emotional reactions to their child's struggles has the potential to improve supportive efforts. An emotion-focused family therapy intervention for parents yields high satisfaction rates, improves parental self-efficacy and reduces fears regarding their involvement, including self-blame.

Emotionally Focused Family Therapy: Facilitating Change Within a Family System

Adolescent transition to adulthood is often challenged in families with high levels of anxiety, distress, and emotional conflict. Attachment theory offers a robust developmental model for conceptualizing emotional distress and symptomatic behavior as an adaptive response to emotional insecurity in parent–child relationships. Recent developments in emotionally focused family therapy (EFFT) and attachment-based family therapy demonstrate promising empirical support for the application of attachment theory to the treatment of childhood disorders and family distress. However, few resources exist that demonstrate the practice of EFFT and its conceptual approach to facilitate family change. The authors demonstrate the successful application of EFFT to a parent–adolescent problem and examine key moments in the process of change from an attachment perspective.

Emotion‐Focused Family Therapy for Eating Disorders in Children and Adolescents

Family-based therapy (FBT) is regarded as best practice for the treatment of eating disorders in children and adolescents. In FBT, parents play a vital role in bringing their child or adolescent to health; however, a significant minority of families do not respond to this treatment. This paper introduces a new model whereby FBT is enhanced by integrating emotion-focused therapy (EFT) principles and techniques with the aims of helping parents to support their child's refeeding and interruption of symptoms. Parents are also supported to become their child's 'emotion coach'; and to process any emotional 'blocks' that may interfere with their ability to take charge of recovery. A parent testimonial is presented to illustrate the integration of the theory and techniques of EFT in the FBT model. EFFT (Emotion-Focused Family Therapy) is a promising model of therapy for those families who require a more intense treatment to bring about recovery of an eating disorder. More intense therapeutic models exist for treatment-resistant eating disorders in children and adolescents. Emotion is a powerful healing tool in families struggling with an eating disorder. Working with parent's emotions and emotional reactions to their child's struggles has the potential to improve child outcomes.

The Attachment Frame is the Thing: Emotion-Focused Family Therapy in Adolescence

The current article discusses emotion-focused family therapy (EFFT) with families where adolescents are struggling with symptomatic behaviors. EFFT conceptualizes symptomatic behaviors in a nonpathologizing, developmental framework that focuses on the parent-child bond. The article describes the process of change in EFFT and presents a case study to demonstrate the efficacy of EFFT as a therapeutic intervention. The article also discusses the challenges that the beginning EFFT therapist may encounter, as well as the strengths of EFFT that enable its effective implementation, nonetheless.