What is EFFT?
EFFT is an initialism for emotion-focused family therapy, a system of psychotherapy emphasizing the role of emotion and social support, traditionally in the context of the family, in mental health.
EFFT originates in the context of the following two premises:
Mental health challenges and emotional dysregulation are linked; there is an emotional component to any mental health challenge, which is often exacerbated by a lack of ability to understand and process the emotion involved.
As humans are social beings, the social environment, particularly as involves the presence or absence of social support structures, has an impact on the prognosis of a mental health challenge; the more the actors in the social environment are supportive of the individual and invested in their recovery, the better the prognosis.
The application of EFFT involves the recognition of the primacy of the family in forming the social environment, and by extension the primacy of the involvement of the system of interaction between parent and child in comprising the social support structures a child can draw on in times of crisis.
While in a traditional therapeutic setting, a client with a mental health challenge uses the help of a therapist to improve their condition with any involvement from their family being incidental, EFFT actively involves the family in the recovery process. In particular, EFFT aims to outsource some of the powers traditionally ascribed to a therapist to the parent or caregiver, who models healthy emotional engagement for their child, who in turn emulates the parent or caregiver and thereby learns to engage more adaptively with their own emotion. This improves the prognosis of the mental health challenge by treating the emotional dysregulation with which it will be bound.
EFFT trains the parent or caregiver in the following 4 domains of action:
To become the child’s behaviour coach. The parent or caregiver learns strategies to help their child interrupt maladaptive behaviours; these behaviours are often emotionally motivated, and so, as part of a broader work to more adaptively engage with emotion, the behavioural response thereto is adaptively modified. For example, a child with anger-management problems may have the assistance of their parent or caregiver in interrupting the exteriorization of their anger in such forms as hitting or screaming, and finding more adaptive ways to contain and express the anger.
To become the child’s emotion coach. This involves helping the child to identify and process their emotion. The emotion, in the framework used in EFFT, is recognized as conveying useful information; the emotion is adaptive and mental wellness requires understanding the emotion’s adaptive function. In the process of becoming the child’s emotion coach, first the elements of the emotion are understood. The emotion is regarded as (i) having a bodily felt sense, which (ii) expresses a need, the presence of which produces (iii) an action tendency which seeks to meet it; this complex of bodily felt sense, need, and action tendency comprise the emotion, which can then (iv) be labeled as such. As an example, consider the emotion which we may label sadness: the felt sense is of a depletion of energy, a “depressiveness,” which conveys a need for contact and comforting; the action tendency will be, if the child is securely attached, to seek contact and comfort, perhaps in the form of touch and conversation, from the parent or caregiver. It is knowledge of these four elements of the emotion and the ability to identify them in real time in immediate response to the expression of an emotion which is among the first goals of emotion coaching, and it is this understanding which will in time, if the therapy is successful, also be adopted by the child.
Having understood the basic adaptive aim of the emotion and its composite elements, the parent or caregiver then learns to apply this knowledge to the emotional outbursts of their child. This takes the form of learning to (i) attend to the emotion, (ii) label or suggest a label for the feeling state observed, (iii) validate the emotion, (iv) attempt to meet its need, and (v) assist in further problem-solving if need be, as when the child remains upset.
Of note here is the process of articulating emotional experiences with the child. Articulation is a narrative process which semanticizes and thereby depletes the emotional experience of its emotional intensity.
To heal relational and attachment trauma, and repair relationships. It sometimes occurs that in the family there is dysfunction caused, for example, by relational or attachment trauma, as a result of which the child may be reluctant if not actively resistant to accepting help or guidance from the parent or caregiver, especially as they may have been involved in the experience of the child’s trauma. In addition, not only may the child have suffered certain traumas which are obstacles to the therapy, but so too may the parent or caregiver. Insecure attachment styles may be present, which may further prevent adaptive engagement with emotion and thereby further impair the therapy. For these reasons, EFFT works to heal relational and attachment trauma, and ultimately repair the relationship between the parent or caregiver and child where need be. In this regard, not only are the particular relationships between persons involved in the therapy made more adaptive, but so too are the underlying attachment styles, so that, having gone through this aspect of therapy, the client’s capacity enjoy all of their relationships is improved.
To work through and overcome any other obstacles to the administration of the therapy, present to the parent or caregiver. The parent or caregiver who seeks therapy for their child is often frightened, anxious, or unsure about elements in the therapeutic program, and how their child will react to them. As a result, the parent or caregiver may, motivated by what are fundamentally good intentions to do what’s best for their child, actually sabotage the therapy. This occurs frequently when, for example, a parent may seek to avoid emotionally charged discussions with their child for fear that they will intensify their child’s symptoms or further alienate them. Alternatively, a parent or caregiver may fear that the therapy is too intense, and that as a result their child may refuse to engage with it, so that the parent or caregiver, in administering the therapy to their child, only administers it partially, or becomes hyperleniant in allowing the child to manifest maladaptive behaviours. EFFT works to identify barriers such as these to the parent or caregiver’s application of the therapy and dissolve them.
The net effect of having gone through EFFT successfully is twofold. (1) Regarding the particular mental health challenge for which therapy was sought, there is an amelioration in the symptoms, effected by the introjection of the parent or caregiver in the role of the emotion and behaviour coach who the child emulates in overcoming the challenge. (2) Regarding the particular relationship between the parent or caregiver and child, this can be “enjoyed” again; whereas tension and displeasure may have dominated in the experience of the relationship before EFFT, where EFFT is successful, these are transformed and experiences of receptivity, openness, harmony, and pleasure increase. Skills learned in EFFT often lead to improvements in other relationships as well. EFFT may therefore be said to work both to improve the agency of the individual with a mental health challenge by improving their emotional intelligence and increasing the social support structures they can draw on to include the family, and to improve existing relationships as well as the capacity to relate adaptively more generally.
For more information on what EFFT is and how it works, the following sources, which were used to assist in the generation of this summary, may prove helpful: