Emotion-focused therapy

Domain III · Humanistic, existential & experiential · Greenberg, Rice, Elliott · 1993

What it is

EFT is a humanistic-experiential therapy that integrates person-centred, gestalt and existential traditions with emotion theory. Its core idea of change is that people change by making sense of their emotion. Clients become aware of and symbolise emotion (they feel it rather than only think about…

Format

• Opening phase. Goals are relationship building and alliance formation ("contact before contract"), agreeing a focus from the client's most painful and poignant experience, and giving rationales.
• Closing phase. Goals are consolidating gains, building new narratives and preparing the client to continue without therapy. In the published Carol case this was an informal phase of 4 monthly sessions after 16 weekly ones.

Who practises it, and how they are trained or regulated

• Stage 1, early sessions. Listen to presenting problems. Find what is most poignant and painful, using the "pain compass". Observe the client's emotional processing style: over-regulated or under-regulated, conceptual or external, accessed through memory or through the body. Unfold the emotion-based life narrative, covering attachment and identity.
• Which task now. Match the task to the marker and to the client's current arousal. Over-aroused clients: use clearing a space, meaning creation or regulation work first. Do not start empty-chair work.
• EFT is a humanistic-experiential therapy that integrates person-centred, gestalt and existential traditions with emotion theory. Its core idea of change is that people change by making sense of their emotion. Clients become aware of and symbolise emotion (they feel it rather than only think about it). They express constricted primary emotion, regulate overwhelming emotion, reflect on aroused experience to build new…

Questions to explore with your client

• What drew you to it, and what are you hoping it will change?
• Is there physical contact? Was it explained beforehand, and do you feel free to say no or stop at any point?
• Does it involve intense or unusual breathing? Have you been told about the medical conditions for which that is not advised?
• Does it involve fasting, a special diet or 'detox'? Have you discussed this with your doctor?
• Is it a group, retreat or community? How do they respond if someone wants to leave or raises a concern?
• Who runs it, and what training or registration do they hold?
• What actually happens in a session or meeting, and how often?
• What does it cost, and is there pressure to commit to more?
• How do you feel afterwards, in the hours and days that follow?
• Does it fit with, or clash with, the work we do here?

What practitioners of it watch for

• Regulation becoming avoidance of all affect. Once the client is regulated, return to the task.
• Disclosures that shift the focus onto you. Bring the focus back to the client within one sentence.
• Homework framed as a test. If the client "forgets", explore that gently rather than pressing for compliance.
• Formulations that are too intellectual. Working is shown by the client recognising the formulation with feeling.
• Chasing intense emotion that is secondary, for example angry complaining that covers hurt. Ask what is underneath it.

When to involve someone else

• New or worsening physical symptoms, or advice to stop or change prescribed medication: involve the client's doctor or prescriber.
• Signs of coercion, isolation from family and friends, escalating costs or secrecy: discuss openly and consider safeguarding.
• A crisis or thoughts of suicide: follow your crisis protocol. In the US, call or text 988; in the UK and Ireland, Samaritans on 116 123.

Drawn automatically from the guide's own sections. Stay curious: neither endorse nor dismiss what the client values, and check anything that matters against the full guide and its sources. Not medical advice.