Fev 2010 Entrevista Sociedade Portuguesa de Psicoterapias 50MINUTES Construtivistas Robert Elliott Emotion Focused Therapy PROCESS-EXPERIENTIAL/EMOTION FOCUSED THERAPY Robert Elliott is, with Leslie Greenberg and others, co-originator of Emotion-focused Therapy. He is intervening in the Society’s Psychotherapy Specialization, offering EFT training, as Les Greenberg does. This 50 minutes conversation took place the 11th February 2010, at Lisbon. The distinctive features of P-E/EFT were among other topics discussed. FEATURING EMOTION FOCUSED basis of contemporary emotion client that’s kind of a delicate kind of THERAPY theory and thinking about attachment feeling your way into what’s not and things like that. So is neo- quite clear, that’s on the edge of what humanistic, is also process oriented – the client’s been able to say, and that PART I - On PE/EFT main distinctive the original name of the therapy was exploratory but at the same time features, role of empathy, homework assignments, manuals and creativity .. process-experiential because we empathic response style – which is wanted to capture this sort of intense not non directive but it’s also not A.H.: Thank you so much Robert for look at the therapeutic process and directing the content – it’s a sort of willing to have this conversation. the differentiation of the therapeutic guiding the client deep to a deeper How would you describe Process- process into tasks and responses and process. I think that’s fairly Experiential /Emotion Focused modes of engagement and all the distinctive. Therapy main and distinctive different elements. So there’s quite a features? high degree of process differentiation A.H.: You are following and you are in the therapy. So it is very process leading? R.E: There are a set of characteristics oriented. And it’s also, of course, I think that set Process - Experiential emotion focused. We do see emotion R.E.: We’re both following and Emotion Focused Therapy apart. It’s as this sort of crux of the change leading at the same time. It’s really a no one feature, I think it’s the process for clients, and also as the kind of mutual process. And the combination of those things. First of sort of core of what it means to be therapy is also evidence based. So all this is a neo-humanistic therapy - human so it’s emotion focused. it’s built on a program of research, is a therapy based on humanistic There’s a particular exploratory principles that have been response style that the therapist first into particular therapeutic tasks reformulated and renewed on the provides in the relationship with the – which is how clients resolve [1] certain issues that they bring into therapist - this therapist needs to be they’re too busy worrying about…, therapy – and then outcome research highly skilled in empathy and I think right? So there’s this beginning phase and more recently randomized that things like chair processes, two- of the therapy, which is the clinical trials and things like that. So chair work, empty-chair work relationship building phase and we have these things. They kind of actually place greater demands on the alliance formation, where you’re not come together in a package in therapist empathy than other kinds of doing chair tasks and then you can’t Process-Experiential Emotion therapeutic work. So empathy is do a chair task every session. It’s Focused Therapy which I think absolutely foundational. I think the very intense, it needs to be worked we’ve believed is distinctive. therapy is potentially dangerous into, it needs to be processed without that solid foundation of afterwards and sometimes you stop A.H.: How is EFT distinct from other empathy. And at the same time… we in the middle and do something else approaches and models of therapy? do see empathy as having two and come back to the chair task. So different roles to play in the change even in a session that’s mostly chair R. E.: Right! I think what I’m saying process. First empathy is a core work or unfolding, or one of the is that it’s actually that combination change process too, so the process of other main active tasks, even in those of things. I mean, there are other being known, the empathic process is sessions at least half of it it’s not emotion focused therapies and there healing to clients and takes clients a chair work. And then you can’t sort are other evidence-based therapies long way in their journey, even of bang on with chair work every and there are other humanistic without the tasks. And secondly single session. The client needs a therapies and there are other process- empathy is the foundation for doing breather, there’s different kinds of oriented therapies, right? But things like chair work or focusing. work that can be done using other somehow to bring all those things All of them need to be based on kinds of… we would say basically together… I think that’s what makes empathy. So empathy is both a means straight empathic exploration. And so it distinctive, yes. So we’re not to an end and an end in itself in the the mix of the straight empathic claiming we’re totally unique in therapy. exploration and different kinds of anyone particular feature but it’s the tasks I think is more effective than package. J.S.: You think it’s healing in it self? simply trying to… and of course the clients don’t present the markers in A.H.: Can we identify clear phases or R.E.: I do think empathy is healing in every session. So, you know, we’re stages in EFT? itself, right, yeah. And if you look at not going to do chair work, two-chair the research literature person- work unless there’s a marker for it. R.E.: I think that therapy in general centered therapy actually holds up has to be stages and that includes pretty well in terms of the outcome A.H.: So you find that Isn’t there an EFT. I think there’s an opening and literature. EFT looks to me like it’s a excessive focus on tasks in EFT relationship building stage of the little bit better. The comparative training manuals therapy, there’s a main working studies, the effect sizes, looks like it phase in which there’s deep does a bit better but person-centered R.E.: Yes, so our books, you know, exploration and restructuring that therapy does quite well also. I think especially the first book, the 1993 happens and there’s a closing phase empathy does get you a long way and book Facilitating Emotional Change, where we help the client to without it you can’t have effective with Greenberg, Rice and Elliott, that consolidate their gains and sort of EFT either. book was criticized - and I think aim themselves out of the therapy rightly – for the lack of emphasis on and beyond the therapy. So that’s true A.H.: Depending on each client’s the relational conditions on empathy whether it is psychodynamic, process, it looks as tasks can take and an almost exclusive focus on the cognitive-behavioral, EFT, right?… less than half the time an EFT chair tasks, focusing systematic process takes. If this is really the evocative unfolding. And people like A.H.: Empathy appears as a core case, what is going on during the Germain Lietaer and others took us feature and skill in EFT. Do you see remaining therapy time? to task for just the very thing, you empathy as a core construct in EFT know, excessively focusing on those or just a mean to achieve a goal? R.E.: What do we do the rest of the tasks. Now, we tried to readdress that time we are not doing chair work? in the Learning Emotion Therapy R.E.: It is a core concept and a core (laugh). First of all you can’t do chair book, the 2004 book, so we put the process. The whole therapy is based work until somewhere around relational work upfront, we have on empathy. You can’t do EFT session four because the client has to extensive coverage to empathy and effectively without this solid have internalized you as an empathic also relationship building processes foundation of empathy, both in terms presence, strongly enough to be able and they come before the active of the immediate therapeutic process to take their eyes off you to look at tasks. I think we get a better balance but of course also the skill of the the other chair, right? So before that [2] there in the 2004 book. But of course the empirically-supported. How do you see chair work is, you know, it’s sexy and this trend? exciting and it’s what people always 50MINUTES 2010 want to see and want to talk about. It’s R.E.: A manual is a funny thing, right? I flashy, right? mean you can write a ten page description of the therapy and call it a J.S.: So EFT is also marker guided? manual and people do that. So you can write a little tiny thing and call it a R. E.: Yeah its marker guided, yeah. manual, right? Or you can write a three That was the other distinctive feature hundred page book - like the Learning that I forgot to mention, right? Yes, its Emotion-Focused Therapy book is a marker guided.