EFT Treatment Plan for Couples

For couples experiencing relational distress and/or conflict, EFT therapists might use the following treatment plan to help them conceptualize and guide their treatment.

Initial Phase of Treatment: EFT for Couples

Initial Phase Therapeutic Tasks

1. Create a working alliance with both partners. Diversity note: Adjust expressions of empathy to respect cultured, gendered, and other styles of emotional expression.
   1. Relationship building approach/intervention:
      1. Use empathic attunement, RISSSC, and genuineness to develop a safe emotional context for the therapy process.
2. Assess individual, systemic, and broader cultural dynamics. Diversity note: Adjust assessment based on cultural, socioeconomic, sexual orientation, gender, and other relevant norms.
   1. Assessment strategies:
      1. Identify the negative interaction cycle, including pursuer/distance roles.
      2. Identify secondary and primary (attachment) emotions that characterize cycle.
      3. Assess attachment history, including attachment injuries, as well as history of trauma.
3. Define and obtain client agreement on treatment goals. Diversity note: Modify goals to correspond with values from the client’s cultural, religious, and other value systems.
   1. Reframe problem in terms of negative interaction cycle, with the cycle being the common enemy.
4. Identify needed referrals, crisis issues, collateral contacts, and other client needs.
   1. Assess for appropriateness of EFT for couple, ruling out substance abuse, trauma, violence, conflicting agendas, or other contraindications.

Initial Phase Client Goal

1. Increase couple’s awareness of negative interaction cycle and the primary emotions that fuel it to reduce conflict and hopelessness.
   1. Use validation, reflecting emotions, evocative responding, and empathic conjecture to identify secondary and primary emotions.
   2. Track the negative interaction cycle, first with secondary emotions and later identifying primary emotions.
   3. Reframe in the context of the negative interaction cycle and attachment needs.

Working Phase of Treatment: EFT for Couples

Working Phase Therapeutic Tasks

1. Monitor quality of the working alliance with both partners. Diversity note: Attend to family’s response to interventions that indicate therapist’s approach is not connecting with family’s culturally informed meaning systems.
   1. Assessment intervention: Attend to nonverbal communication as well as client’s sense of emotional safety in the session.
2. Monitor client progress. Diversity note: Attend to cultural, gender, social class, and other diversity elements when assessing progress.
   1. Assessment intervention: Track couple’s progress through the EFT stages in weekly progress notes.

Working Phase Client Goals

1. Increase engagement and emotional expression of withdrawn partner to reduce conflict/avoidance.
   1. Use empathy, validation, and conjecture to facilitate identification and expression of attachment needs.
   2. Use enactments to allow for direct communication of needs, the acceptance by partner, and new interaction sequences.
2. Decrease criticism from pursuing partner and increase pursuer’s expression of attachment emotions to reduce conflict.
   1. Heighten pursuer’s primary emotions to facilitate softening of blaming position.
   2. Use enactments to promote acceptance by partner and to facilitate new interaction sequences.
3. Increase the ability of both partners to respond to the other in ways that create a sense of relational safety and bonding even in moments of tension to reduce conflict, depressed mood, and/or anxiety.
   1. Track the interaction cycle and empathetic conjecture to help each partner see how his/her response affects his/her partner.
   2. Use enactments that help partners to more directly express primary emotional needs as well as respond in supportive ways when the other reaches out.

Closing Phase of Treatment: EFT for Couples

Closing Phase Therapeutic Task

1. Develop aftercare plan and maintain gains. Diversity note: Access resources in the communities of which they are a part to support them after ending therapy.
   1. Track positive as well as negative interaction cycles to help couple prepare for potential setbacks.

Closing Phase Client Goals

1. Increase couple’s ability to respond effectively to new stressors to reduce conflict and hopelessness.
   1. Track positive interaction cycles to reinforce positive changes.
   2. Reframe both positive and negative interaction cycles in terms of attachment needs.
2. Increase couple’s ability to consistently respond to one another in ways that solidify a secure bond to reduce conflict, depression, and anxiety.
   1.  Use enactments to facilitate direct expression of emotional needs.
   2. Facilitate turning the new emotional experience into a new response.