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Posttraumatic Stress Disorder (PTSD)
Published in Judy Z. Koenigsberg, Anxiety Disorders, 2020
Emotionally Focused Therapy (EFT), an evidence-based treatment with low rates of dropout, which integrates experiential therapy and family systems, can be used to work with couples who struggle with PTSD (Blow et al., 2015; Johnson, Hunsley, Greenberg, & Schindler, 1999). EFT is well suited for veterans with PTSD and relies on attachment theory while targeting the expression of emotions in an adaptive manner (Blow et al., 2015). Individuals with PTSD have difficulty regulating their emotions because of what they suffered in combat, and frequently experience hyperarousal and affect numbing, resulting in distressed relationships (Greenman & Johnson, 2012; Johnson, 2002). The purpose of this integrated psychotherapy is to create a safe environment where couples can discuss their vulnerabilities in order to build a deeper relationship (Blow et al., 2015). Methods that EFT therapists utilize to address trauma that is complex include chair tasks (Paivio & Pascual-Leone, 2010). Chapter 5 discussed the use of chair conversations within the context of EFT for individuals with generalized anxiety disorder.
The Eating Disordered Couple
Published in Len Sperry, Katherine Helm, Jon Carlson, The Disordered Couple, 2019
While CBCT models such as UCAN address the couple’s communication skills, they do not specifically address how to create emotional safety around challenging topics such as sexuality and body image that have been seen to trigger emotional escalation and have the potential to exacerbate ED symptoms (Linville & Oleksak, 2013). Researchers note that using the UCAN model is particularly difficult with clients who struggle with emotional regulation, which can result in dropout and may increase the risk of engaging in ED behavior. These studies have found that ED symptoms such as restricting, binging, and purging are used as ways to regulate painful emotions (Linville & Oleksak, 2013). Therefore, difficulties with regulating emotion and fears around abandonment should be expected and may be better explained by the high rates of attachment injuries and trauma experiences (Zachrisson & Skarderud, 2010). Creating emotional safety within the couple system may be the most pivotal aspect of treatment if it is the case that emotional dysregulation leads to disconnect within the couple and increased use of ED behaviors for the ED partner. An integrated approach informed by attachment theory, such as emotionally focused therapy (EFT) (Johnson, 2015) and interventions of solution-focused therapy (SFT) that build on the couple’s strengths and resources for change may help to address the needs of couples dealing with EDs (Linville & Oleksak, 2013).
Introduction
Published in Fred P. Piercy, Katherine M. Hertlein, Joseph L. Wetchler, Handbook of the Clinical Treatment of Infidelity, 2013
Fred P. Piercy, Katherine M. Hertlein, Joseph L. Wetchler
Susan Johnson, the co-developer of Emotionally Focused Therapy (EFT), discusses affairs through the lens of attachment theory. She sees infidelity as a violation of trust that ruptures the attachment bond between partners. EFT, Johnson contends, provides a way to acknowledge and express pain, remorse, and regret, and to repair this attachment bond.
Veterans’ Treatment Engagement and Dropout from Couple and Family Therapy in a Veterans Affairs Health Care System
Published in Military Behavioral Health, 2021
Jerika C. Norona, Brian Borsari, Keith Armstrong, Sarah Shonkwiler
The present study from a VAHCS Couple and Family Therapy Program seeks to understand the dropout rates from initial referral for couple or family therapy to the active phase of treatment. The setting for the study, the Couple and Family Therapy Program (CFTP), consists of licensed clinical social work staff and 2nd and 4th year psychiatry residents, predoctoral psychology interns, and predoctoral psychology practicum students and postdoctoral psychology fellows. Emotionally Focused Therapy (EFT; Johnson, 2004), which is used with both couples and families to strengthen attachment bonds between couple members and between parents and children (Johnson, 2019), was the primary modality of treatment. Following the clinic protocol, assessment is conducted with the family within the first four sessions. During the fifth session, the therapist provides feedback to the family about their assessment of the presenting problem and relationship dynamics, and the active phase of therapy typically begins in this fifth session as the therapist and family begin working on the family’s relational dynamics. The length of the assessment process in EFT is similar to the assessment process in IBCT (Christensen et al., 2004) utilized by Fischer et al. (2018). In the CFTP, the active phase of treatment typically includes 10-15 sessions.
The aftershocks of infidelity: a review of infidelity-based attachment trauma
Published in Sexual and Relationship Therapy, 2021
Benjamin Warach, Lawrence Josephs
Emotionally focused therapy (EFT) is an evidence-based couples therapy modality that has demonstrated success in assisting relationship partners resolve attachment injuries, including those related to infidelity (Greenberg, Warwar, & Malcolm, 2010; Johnson, Hunsley, Greenberg, & Schindler, 1999; Wiebe & Johnson, 2016). EFT conceptualizes emotional disengagement and maladaptive patterns of emotional communication between romantic partners as forces that undermine secure relationship attachment (Greenberg et al., 2010; Johnson et al., 1999; Wiebe & Johnson, 2016). This modality accordingly assists couples in becoming more emotionally engaged and attuned with each other to strengthen their attachment security.