SlideShare uma empresa Scribd logo
1 de 12
Baixar para ler offline
Journal of Contemporary Psychotherapy, Vol. 34, No. 2, Summer 2004 (°C 2004)
Emotion-Focused Therapy: An Interview
with Leslie Greenberg
Denise M. Sloan
Over the past 30 years Leslie Greenberg has developed and refined the
EmotionFocused Therapy (EFT) approach. This therapy model stands apart
from other, humanistic-based approaches in its focus on empiricism. In
addition, EFT is one of the few therapy models that is truly integrative in
nature, combining clientcentered, gestalt, and cognitive principles. This paper
includes a recent interview with Greenberg in which he describes the
development of EFT and his views
regardingfuturedirectionsofEFT,aswellashisviewsonthefieldofpsychotherapy
more generally.
KEY WORDS: psychotherapy; emotion; experiential; humanistic; integrative.
Leslie Greenberg was born and raised in Johannesburg South Africa and
attended high school with another well-known clinical psychologist, G. Terence
Wilson. Interestingly, Greenberg didn’t originally pursue a career in
psychology. Instead, he obtained a master’s degree in engineering. After
working in the engineering field for several years Greenberg realized that his
work in the engineering field left him desiring greater human contact.
Fortunately for the field of psychology, Greenberg decided to pursue training in
clinical psychology. He obtained his Ph.D. in psychology in 1975 and became a
faculty member of the Department of Counseling Psychology at University of
British Columbia in 1975. He remained in that position until the mid 1980’s
when he accepted a faculty position in the Department of Psychology at York
University where he remains today.
Early on in his career Greenberg devoted considerable effort to become
informed in a variety of therapy approaches. As a consequence Greenberg
pursued training with a variety of leaders in the psychotherapy field, such as
Rogers, Pascual-Leone, and Minuchin. These diverse psychotherapy training
experiences
106 Sloan
Address correspondence to Denise M. Sloan, Department of Psychology Temple University,
Philadelphia, Pennsylvania 19122; e-mail: dsloan@temple.edu.
105
0022-0116/04/0300-0105/0 °C 2004 Human Sciences Press, Inc.
ultimately culminated in Greenberg’s development of EFT, which is truly an
integrativetherapyapproach.WhatsetsEFTapartfrommanyotherintegrativetherapy
approaches is its emphasis on empirical support. Throughout the development of
EFT Greenberg has attempted to demonstrate the efficacy of EFT and has taken
on the difficult task of attempting to identify the change processes in
psychotherapy. Demonstrating his dedication as a clinical scientist, Greenberg
has published over 100 journal articles. He has also written several books on the
topics of EFT, empathy, and change processes in psychotherapy. In addition,
Greenberg has served as President of the Society for Psychotherapy Research
and has served on a number of journal editorial boards including, Journal of
Consulting and Clinical Psychology, Journal of Psychotherapy Integration, and
Journal of Marriage and Family Therapy. Has also been the recipient of several
large grants from both Canadian and American funding agencies.
In this interview Greenberg describes how he came to develop EFT, the
core features of the model, and his predictions for the future of EFT. Greenberg
also describes his views regarding the psychotherapy field more generally.
DS (Denise Sloan): Could you briefly describe emotion-focused therapy (EFT)?
LG (Leslie Greenberg): Basically EFT is based on two fundamental ideas.
Empathic attunement to affect is very important so that within an understanding
relationship being attuned to someone else’s feelings is very important in
helping to build affect regulation. So within the context of an empathically
attuned affect regulating relationship one pays attention to particular kinds of
processing difficulties that people have. Then you try to do different things at
different times to facilitate different kinds of emotion processes. So everything
is saying that it’s important to pay attention to emotion but that there is both a
relational form of helping regulate affect through empathy but then you are also
engaging in specific differential interventions. Doing different things at different
times. You can either be paying attention to the moment by moment processes
by asking someone to pay attention to what’s going on inside their body—this is
making a specific moment by moment intervention. Or by asking someone to
imagine somebody or talk to somebody you’re trying to facilitate the kind of
processing they do within a larger task. There are these larger tasks that we have
identified, initially we identified about six or seven types of affectively based
problems, like unresolved bad feelings towards a significant other and internal
conflict. So we’ve defined different kinds of problems that are then worked on
with a focus on emotion. That’s another form of active intervention.
DS: How is EFT distinct from other therapy models?
LG: First, EFT is focused on emotion and it sees emotion as the prime mover in
human experience so that cognition and behavior are, so to speak, dependent on
Emotion-focused therapy 107
affect. In EFT you are trying to work to change people’s emotions. Many non-
empirically based therapies do work in different ways with emotion. EFT is also
different in that it’s empirically based. Its effectiveness has been shown and it’s
a systematic way of working with affect. There are other approaches that work
with affect but they haven’t been studied, they are not as systematic and they
haven’t been spelled out and based on observation.
DS: In terms of affect driving cognition, what is your view on CBT based
approach of cognition or behavior driving therapy. That is, if you act or think in
a particular way, you will then feel that way?
LG: Right. I see problems with that. I think cognitive therapy is useful as a brief
intervention to teach people coping skills. Coping is a laudable thing but coping
isn’t quite the same of basic restructuring or basic change. To be able to talk to
yourself and say, “it’s okay, don’t get anxious” or “think of something more
positive like don’t worry.” I think those things do help people cope and people
want to be able to cope better but I’m not sure that the coping necessarily leads
to change so then you spend the rest of your life coping. What I’m trying to do
is get to the deeper underlying determinants that I see as affectively based. If
you can get a change in that then you no longer have to do the coping because
you’ve actually changed. I do think that practicing things in the real world and
having success experience will lead you to change. So that sometimes if you
cope better and you act in the world and then you have success experience you
are then actually getting experiential feedback that will change your deeper
structures. In that case, you might get change over the long run with coping but
I’ve seen too many people who cope and they live by coping but when things
get too intense or a crisis occurs the coping skills can’t cope and then they
collapse. These people need to go through a deeper change process.
DS: How many sessions are needed in order for a deeper change process to
occur?
LG: What we found in our research is that people that come in for therapy for
clinical depression, which is what we’ve studied most, can benefit substantially
by 16 sessions. If when they come in they have a capacity to experience, that is,
they are able to attend to their own bodily felt experiences and they are able to
label them, and at least they experience at this level. However, people that have
come in and are very cut off from their emotional experience, that is, they are
not able to symbolize their own experience, for these individuals by about the
end of 16 sessions they began to look like the people who were successful in
treatment who came in with a capacity to experience. So it seems like these
people who are not able to be minimally aware of their experience at the
beginning were not as successful at the end of therapy. I would say that if we
gave these people another 16 sessions that would be about right for them. So it
really depends on the person.
108 Sloan
But overall I would say about 16 sessions is a good minimum dose for helping
someone with these more active emotionally-focused methods to help get to
core issues and begin to deal with them. But people who come into therapy
without good emotion skills would need at least 32 sessions. People with more
chronic or severe concerns would need longer.
DS:32sessionsstillseemslikeashortdurationforchangingthetypesofunderlying
structures you’re talking about.
LG:Yes.Thisisnottotalpersonalityrestructuringeitherbuttheemotionalmethods are
very effective or powerful at getting to core issues very rapidly in a deeper way
so then it’s in line with the claim that the therapy gets at core material. You can
make quite a lot of gains in a fairly short period of time.
DS: Do clients have “homework” assignments between sessions?
LG: We have begun instituting more and more homework. This is something
that hasn’t been emphasized much but I think the idea of practice between
sessions is really a good one. The kind of homework or practice that we use is
often more awareness-type homework. However, we don’t rely on the
homework to produce the change but more to consolidate things that have
happened in sessions already. We don’t give homework to go out and try
something that the person hasn’t done already but if they get a shift in their self-
critical voice such that it becomes more compassionate we would ask people to
pay attention to that and practice being more self-compassionate during the
week. But we wouldn’t do something like this until it had happened in a session
first. So it’s more practice or consolidation of gains already made.
DS: EFT seems to have key elements of other therapy models yet its different in
some seemingly critical ways, so I’m curious how EFT was developed?
LG: Yes. I’ve also been talking mostly about the individual therapy but not the
couples therapy that is also part of the whole EFT package. I was trained
originally as a client-centered therapist and then as a gestalt therapist but I was
also worked with Laura Rice who was a student of Carl Rogers so I very much
started out as a process researcher as well as being trained in psychotherapy. I
was studying tapes of therapy from day one. A lot of EFT was developed
through the research focus on what makes people change. The first book Laura
Rice and I wrote was called Patterns of Change and we were studying how
people change. I then looked at these therapies I was being trained in for what
seemed to be the most active change processes. We tried to look at how to
measure these processes and so on. At this point I began integrating client
centered and gestalt therapy and I was very interested in cognition at the level of
cognitive science. I did my minor in cognitive development at that same time I
studied with Pascual-Leone, a student of Piaget, and so I was very interested in
the processes of cognition and affect. But I wasn’t interested in cognitive
therapy, which is a very primitive view of cognition. Instead, I was very
interested in the role of attention, in Piaget notion of schemes or schema, and
Emotion-focused therapy 109
then in emotion theory. So I was bringing all of that to bear on studying the
process of change through the lens of cognition and emotion and how these
processes take place. So I integrated all of these things but essentially I was
integrating a client-centered relationship with gestalt therapies more active
interventions, with a type of cognitive view of how meaning is created in
people. And then I was psychodynamically informed as well. I had read a lot of
psychodynamic material. I began to study specifically how people resolve
intrapsychic conflict within themselves, or in gestalt terms splits, which are
more conscious conflicts, and I built my first model of change process. The
resolution process looked like a conflict between two people except it was
between two voices in one person. I was simultaneously very interested in
couples and family therapy so I did training in family therapy with people like
Virginia Satir and then Minuchin, and then I went to Palo Alto and studied with
people there who used a systemic approach. After that I began to direct my
attention at how couples resolved conflicts and we built an emotionally focused
couples therapy based on similar sorts of ideas that emotion was very important
but now there was interaction as well. So what I did was integrated lots of
different things and from my family therapy
experienceItooktherapistdirectiveness,fromfamilyworkwherethetherapistwas
more structuring and guiding and this all fed back into influencing my approach
to individual therapy. From this I came up with the idea of the therapist as an
emotion coach- - that what the therapist is actually doing is acting as a
facilitative coach where they are helping people be more aware of their feelings,
regulate their feelings, transform their feelings, and so on. So EFT is an
integration of lots of different strands but at its most fundamental it’s an
integration of client-centered and gestalt within a cognitive-affective science
framework.
DS: Given the different influences in the development of this therapy model
what would you say have been the major changes to the model over time?
LG: I guess I would say that I started off with much more of a following rather
than leading approach. It was more a mirroring kind of approach with more of a
view that there were resources within the individual that they needed help to
access—an actualizing tendency within. It’s moved to more of an interpersonal,
co-constructive view where what I’m doing in the room is contributing
something more to the environment. I’m not only helping people to access their
resources and mirroring what they said but I’m also leading, adding something
but in a very subtle way, by guiding the process within a client’s proximal zone
of development, just trying to guide with what could be useful at this time and
that it’s the two of us together that are creating something new. So now not
everything is coming from the individual, whom my presence helps to free up,
but that there’s something actually happening between the two of us, that is, the
change process. I think that’s one of the important evolutions of the model. I
think doing couples therapy and family therapy made me more comfortable with
being more active, that is, giving more suggestions without feeling like the
therapist is potentially distorting the client or being too intrusive. We’ve always
110 Sloan
adopted the approach that the therapist is not the expert on the client’s
experience. It’s really the client who is the expert so the issue was how do you
make a contribution without imposing it on clients or distorting their own
experience. Eventually we came up with the idea that we are more process
directive not content directive, so we don’t tell the client what they are feeling
or suggest to them what they’re feeling, but we suggest to them ways that they
might use to better connect with or process their own feelings. For example,
guiding clients to pay attention to what’s going on in their body or to speak to
somebody in an empty chair, I’m making suggestions that I think will help
clients process their emotions in particular ways so I’m being quite directive in
process but not in content.
DS: It seems like empathy is a real core feature in EFT and that a therapist needs
to establish empathy first and then build off of that. In a lot of clinical training
programs empathy is not something that tends to be part of training.
LG: Yes, you’re right. I think that’s the greatest tragedy. When I was in graduate
school I started from day one in training in empathy and that was what my
fundamental training was. At York University I run a fourth year counseling
course and it has a lab component that is two hours per week and that’s all
empathy training. I also have graduate students in their first year do their
practicum that is based on empathy and empathy training. I really believe
empathy is fundamental and the waves of fads in training are amazing to watch.
It’s one of the great losses because it used to be that empathy was being taught
and trained in many programs and now that’s just disappeared completely
mainly with the dominance of CBT as an empirically-supported treatment.
Somehow the emphasis on empathy has just been lost. Rapport is what is talked
about in CBT. Rapport is not empathy.
DS: I agree. Empathy is really an essential skill for therapist and I doubt anyone
could be an effective therapist without having good empathy skills. I also think
many people don’t appreciate just how difficult it is to learn how to truly listen
to clients.
LG: Exactly. Empathy is the most critical skill. From the base of empathy you
can also understand the tension between following versus leading. It’s really
crucial to first have these following or listening skills before you get into
leading. It took me many years before I started integrating the two. Many
students in training and therapists in general want to lead, they want to do
something, but the real skill is to listen, to be present and to really hear what’s
going on. So ideally I would like to have students do two years of basic empathy
training and just be in that listening mode before they begin to do more active
interventions. It’s very difficult to listen really clearly and then to listen to
affect. Listening to emotion is very important.
Emotion-focused therapy 111
DS: Clearly the therapist ability to listen and listen to affect is critical in the EFT
model. Given that, do you think it’s important for students in training to be in
therapy themselves?
LG: I think it’s very beneficial, particularly when working with emotions. It’s an
a-rational process so you can’t just teach people rationally how to work with
emotions without them actually experiencing the emotions themselves. To tell
people that avoidance of emotions is not good and that experiencing pain is
useful you have to really experience that facing your own pain has been useful
for you, as the therapist, to believe it. There are certainly a lot of rational
reasons for thinking experiencing pain would not be helpful. I think experiential
learning is important.
Nowwhetherthat’sthroughpersonaltherapyorsomeformoftrainingthatinvolves
experiential aspects I think is very important. I do think that to be a good
therapist, personal therapy is probably highly beneficial.
DS: One thing that I’ve noticed in supervising beginning therapist is that they
often collude with the client in avoidance of negative emotions. The beginning
therapist seems to not want to make the client feel bad and doesn’t seem to
appreciate the importance of the client experiencing negative emotions in
therapy.
LG: Exactly. I do find that with my students that those who have been in therapy
haveadeeperappreciationandalsotheyarenotdoingthatsortofthingofcolluding or
trying to help the person feel good and stay away from difficult things.
DS: If a student didn’t want to go to therapy, for whatever reason they had, what
would you recommend to them in place of personal therapy?
LG: That’s an interesting question. Well, in my book, Emotion Coaching, I have
a number of experiential learning exercising that people could do on their own.
I’m not a great fan of self-help books but there are certain books that propose
how you can work on this for yourself with awareness training. Things like
mediation and personal reflection kinds of experiences are useful. One doesn’t
need to be in therapy in order to increase awareness. So there are other ways to
accomplishing this through personal relationships, focusing, self-reflection,
etcetera but it is a matter of always working on oneself to always be more
aware.
DS: Do you think there’s an ideal type of client for EFT?
LG:Theidealclientissomeonewhoisalreadyabletosymbolizetheirowninternal
experience so that they take very readily to this process. But clients who
probably benefit greatly are those who some would call alexithymic, who don’t
have the ability to put words on their emotions. These individuals could benefit
a lot from learning this kind of process but they’re not the ideal client. Basically,
EFT applies to people who are good for therapy in general and that means that
they are not too hostile, avoidant, and don’t have severe personality issues, such
112 Sloan
as borderline personality and self-harming behaviors. These individuals are not
the ideal clients for really any type of therapy.
DS: Given that, what would you suggest for someone who is highly avoidant of
emotions?
LG: I’ve been quite impressed with aspects of the dialectical-behavior therapy
approach for people with severe problems. I think the idea of an intense
psychoeducational program, where you put people in a classroom and you teach
them about the importance of facing emotions and they are given homework
exercises. At the same time the client is in therapy where what they are learning
in the classroom is being put into practice in a more intense manner in a
validating relationship. I think the problem is that if you don’t have the
educative piece you spend a lot of time on the front end of therapy trying to
educate clients and that changes the nature of the relationship between the client
and the therapist. A therapist can’t really be empathic because they have to teach
and kind of convince and persuade. So if it is broken into two components that
run in parallel that would be my suggestion for working with more avoidant
clients. For example, people with more psychosomatic disorders are often quite
avoidant and I think you need to teach them on the one hand, but then you need
a really empathic, nurturing relationship to help them do the work and do it with
another person. If you just do the homework outside the context of a
relationship this does not recognize as important the role of the empathic
relationship in helping us deal with our own affects. It’s not just an individual
skill, it’s actually a relational phenomenon-the dyadic regulation of affect.
DS: I asked you about how you thought EFT has changed over the years, where
do you see the EFT model going?
LG: Well, first let me go back for one moment to say something about how EFT
has changed. The biggest change has been its explicit focus on affect. EFT
didn’t start with its focus being explicitly on emotion. So that’s been one of the
big changes, to
bemoreandmoreclearonitsfocusonemotion.IntermsofwherewillEFTgo,well, what
I think would be important to do is expand its empirical evaluation in relation to
other populations. We’ve mainly worked with depression and interpersonally
based problems but working with anxiety and eating disorders would be good
populations to expand EFT to. Also, moving into more preventive domains of
developing emotional awareness training modules for use with adolescences and
young adults. This training would have to be done at an experiential level, but
the goal would basically be helping people become more emotionally
intelligent. Not in the global sense of do you have intelligence but how do you
actually use your emotion intelligently. Enhancing peoples skills and abilities in
emotion awareness, utilization and transformation. So moving into preventive
domains will be important. In terms of the couples therapy, I think there’s room
for more development theoretically. We’ve dealt a lot with affiliation and
attachment but not a lot with power, definition of reality and autonomy issues.
Emotion-focused therapy 113
In the circumplex model both affiliation and autonomy are important. We’ve
sort of dealt with only a one dimension of affiliation but I’m very interesting in
the affect related to power, dominance, and autonomy and thinking about how
to work with people in relationships dealing with these more autonomy related
emotions.
DS: There’s seems to be a lot of emphasis on manualized treatments,
particularly ones that are empirically-supported. What’s your view of
manualized treatments?
LG: Actually I think the phase of manuals is now dying. The move has been that
way and funding has required it but I think there are mounting criticisms on the
deficiencies of manualization, so I think the romance with manuals is about to
be finished. We were sort of in a position of writing some type of manual but I
don’t think you can manualize a complex interaction. I think manualization is
easier in CBT approaches, which are more much psychoeducational, dydactic
and much more explicit. So you can manualize things that are less interactive
and more dydactic. However, I think there is some benefit to manuals because it
forces one to specify what one does. I also think you could think about first
generation manuals but we’re now probably onto third generation manuals,
which are the manuals that are attempting to get more flexible and more
complex. I think specification of what the therapist does or tries to do is a good
thing but I thing that overly rigid manualization doesn’t really work. I do think
the efforts to continue to specify what the therapists do and write some sort of
complex flexible manual is a good thing and it’s generating fourth and fifth
generation manuals that are more flexible. That is important. For example,
we’ve developed a manual that is more marker guided so it doesn’t state “do
this” rather it states “if this, then this.” If a client is in a particular state, then this
type of intervention would be most appropriate. So this is the kind of thing that
gives you flexibility.
DS: On a broader topic, how do you envision the field of psychotherapy in the
future?
LG: I’ve never been much of a prognosticator. I say moving toward integration.
This is a hope but I think a prediction as well. Eventually I think we will
integrate but more immediately I think we are on the cusp of moving toward an
ABC therapy, which is an affective behavioral cognitive therapy and integrating
these three elements. But I think that still doesn’t do enough justice to the
psychoanalytic and motivational components, which are so complex they are
very difficult to specify and manualize. But eventually Ido see the field moving
to much greater integration and then that would be a biological, affective,
behavioral, cognitive, motivation, interactional, social kind of integration. My
hope would be that eventually students would come into programs and they
wouldn’t be trained in different therapies but instead they would train in how to
work with affect, cognition, behavior, and interaction. They wouldn’t be taught
114 Sloan
cognitive therapy, object relations therapy. There wouldn’t be schools. Instead,
there would be processes being taught.
DS: Do you see that being far into the future?
LG: Yes, I don’t think we’re there yet.
DS: How do you think managed care has affected psychotherapy?
LG: Well in Canada we don’t have managed care but I think it’s been the worst
blow to therapy that’s occurred in the short time therapy has been around
because it’s only been around 50 or 60 years. I have a wonderful anecdote; it is
a Canadian one. A hospital administrator who is an M.B.A. came in and took
over the running of the hospital and he called the head of psychology and said,
“I see that the average time of contact between patient and doctor in the hospital
is 8 minutes but in psychology its one hour. Could you reduce it to 8 minutes?”
This highlights the administrator perspective over the function of what
therapists are doing. So managed care is just how to be quicker, more efficient,
more effective without any attention to what it is that is being done. Managed
care has favored brief interventions that are highly specified and I think it has
damaged the development of psychotherapy quite severely.
DS: What do you think about prescription privileges for psychologists?
LG: At first I was quite in favor of them and I saw the conflict as a power fight
between psychology and psychiatry. However, after speaking to some friends of
mine, most of whom are psychiatrists, I now think that maybe getting
prescription privileges for psychologists would produce more of a headache
than it is really worth. I think it’s not such a desirable thing to get into. I think it
changes the role of the psychologist. I was of the opinion that it’s a fairly simple
process to give prescriptions but if you have to start getting into the full range of
complexities in order to rule out all kinds of medical factors and so on it just
detracts from doing your central psychological interventions, so I’m not so in
favor of it. It’s not something I would push for.
DS: What recommendations would you give to beginning psychotherapists?
LG: For people really interested in psychotherapy I don’t think the academic
establishment is the best way of getting experience. I do think having a good
theoretical background is good but this is sort of the broader question of the split
between research and practice, and the two are not always so close. For a
student I think getting training in empathy and getting supervised clinical
experience are the two most important things in training to be a psychotherapist.
I would emphasize getting lots of good supervision. I still think that the best
form of training is through supervision. Unfortunately, especially in the CBT-
type programs, I think
studentsdon’tgetenough“handson”experiencewithrealclientswhoarecomplex.
Students need supervision beyond doing manual guided treatments, applied to
Emotion-focused therapy 115
all kinds of cases to deal with a full complexity of things. So I think it’s how to
get training that’s doing real psychotherapy and good supervision and for
students to seek that out the best they can.
DS:IagreewithyouthatmanyPh.D.clinicaltrainingprogramsemphasizeresearch at
the expense of clinical training. Do you think that this emphasis has changed the
type of people applying to Ph.D. clinical programs?
LG: Yes. It certainly changes people who pursue it into being that kind of
person, with a research focus. The European model is actually a lot better. In
Europe they are looking at creating standards for the whole of Europe. Basically
their program for psychotherapy is that you get the M.A. degree and then you do
two to three years of specialized training in psychotherapy. A Ph.D. is a
research degree but not a practice degree. I think we have this extreme
confounding in that you need a Ph.D. to be a registered psychologist, and you
need to be a registered psychologist to practice. What we’re really trained to do
is research and not practice. I think there’s a problem in that people that are
more interested in practice probably do seek other ways of training, so they do
Psy.D. programs and so on.
DS: Or they state that they are interested in pursuing research to gain admittance
to Ph.D. clinical programs but what they really desire is to be a clinician.
LG: Exactly. The Psy.D. program was an attempted solution to this problem but
I don’t think it solved it, although I don’t know that much about Psy.D.
programs because we don’t have them in Canada. Ideally you wouldn’t need a
Ph.D. in order to be a registered practitioner and you would have some other
form of real training that was appropriate to practice and then a Ph.D. would
truly be a research degree. I don’t see that happening but that’s how it is in
Europe and it’s actually a better model.
DS: I’ve asked you a lot of questions and I’m wondering if there’s anything you
feel would be important to add.
LG: Well, related to this last topic, I do think there’s a human encounter in
therapy and the human element that’s very undervalued and underemphasized in
a Ph.D.type training environment. Ultimately, therapy is an encounter between
two people and it’s a very personal experience. I think therapy transcends
scientific study or some of the elements transcend scientific study,and thenit’s
not valued sufficiently or paid sufficient attention. I believe in the scientific,
investigative component but it’s how to get a balance between both the human,
interpersonal perspective and the scientific, investigative perspective and to
value them both. Whereas now it’s more valuing of the scientific, objective
perspective and devaluation of the more human helping perspective and this is
unfortunate. It would be best to integrate these two perspectives with respect for
both.
116 Sloan
REFERENCES
Greenberg, L. S. (in press). Emotion coaching. Washington, DC: American Psychological
Association Press.
Greenberg, L. S. (2001). Emotion-focused therapy: Coaching clients to work through their feelings.
Washington, DC: American Psychological Association Press.
Greenberg, L. S., & Johnson, S. (1988). Emotionally focused couples therapy. New York: Guilford
Press.
Greenberg, L. S., & Paivio, S. (1997). Working with emotion in psychotherapy. New York: Guilford
Press.
Greenberg, L. S., Rice, L., & Elliott, R. (1993). The moment by moment process: Facilitating
emotional change. New York: Guilford Press.
Horvath, A., & Greenberg, L. S. (Eds.). (1994). The working alliance: Theory, research and
practice. New York: Wiley.
Rice, L., & Greenberg, L. S. (Eds.). (1984). Patterns of change: An intensive analysis of
psychotherapeutic process. New York: Guilford Press.

Mais conteúdo relacionado

Mais procurados

Strategic Family Therapy
Strategic Family TherapyStrategic Family Therapy
Strategic Family TherapyV Jane Rosser
 
Psicoterapia Sistemica Transgeneracional Fenomenologica por Paul Alan A Alvar...
Psicoterapia Sistemica Transgeneracional Fenomenologica por Paul Alan A Alvar...Psicoterapia Sistemica Transgeneracional Fenomenologica por Paul Alan A Alvar...
Psicoterapia Sistemica Transgeneracional Fenomenologica por Paul Alan A Alvar...Paul Alan Alvarado Garcia
 
Family Therapy
Family TherapyFamily Therapy
Family TherapyClaudia L
 
Técnicas especificas. de intervención fliar. ana martinez
Técnicas especificas. de intervención fliar. ana martinezTécnicas especificas. de intervención fliar. ana martinez
Técnicas especificas. de intervención fliar. ana martinezAna Martinez
 
Genogram: Understanding Your Emotional Tree
Genogram: Understanding Your Emotional TreeGenogram: Understanding Your Emotional Tree
Genogram: Understanding Your Emotional TreeGrace4Families Inc.
 
Healing Trauma through Somatic Experiencing and Gestalt Therapy
Healing Trauma through Somatic Experiencing and Gestalt Therapy Healing Trauma through Somatic Experiencing and Gestalt Therapy
Healing Trauma through Somatic Experiencing and Gestalt Therapy bwitchel
 

Mais procurados (20)

160109 lealtades
160109 lealtades160109 lealtades
160109 lealtades
 
Grief therapy
Grief therapyGrief therapy
Grief therapy
 
Strategic Family Therapy
Strategic Family TherapyStrategic Family Therapy
Strategic Family Therapy
 
Psicoterapia Sistemica Transgeneracional Fenomenologica por Paul Alan A Alvar...
Psicoterapia Sistemica Transgeneracional Fenomenologica por Paul Alan A Alvar...Psicoterapia Sistemica Transgeneracional Fenomenologica por Paul Alan A Alvar...
Psicoterapia Sistemica Transgeneracional Fenomenologica por Paul Alan A Alvar...
 
Lecture 2 Couple assessment: common problems experienced by couple
Lecture 2 Couple assessment: common problems experienced by coupleLecture 2 Couple assessment: common problems experienced by couple
Lecture 2 Couple assessment: common problems experienced by couple
 
Solution Focused Therapy Treatment Manual
Solution Focused Therapy Treatment ManualSolution Focused Therapy Treatment Manual
Solution Focused Therapy Treatment Manual
 
Family Therapy
Family TherapyFamily Therapy
Family Therapy
 
Terapia Breve
Terapia BreveTerapia Breve
Terapia Breve
 
Técnicas especificas. de intervención fliar. ana martinez
Técnicas especificas. de intervención fliar. ana martinezTécnicas especificas. de intervención fliar. ana martinez
Técnicas especificas. de intervención fliar. ana martinez
 
Modelo estructural
Modelo estructuralModelo estructural
Modelo estructural
 
Genogram: Understanding Your Emotional Tree
Genogram: Understanding Your Emotional TreeGenogram: Understanding Your Emotional Tree
Genogram: Understanding Your Emotional Tree
 
Formas de terapia familiar
Formas de terapia familiarFormas de terapia familiar
Formas de terapia familiar
 
lecture 5. cbt theories, models and methods of couple relationships
lecture 5. cbt theories, models and methods of couple relationshipslecture 5. cbt theories, models and methods of couple relationships
lecture 5. cbt theories, models and methods of couple relationships
 
Bowenian
BowenianBowenian
Bowenian
 
Healing Trauma through Somatic Experiencing and Gestalt Therapy
Healing Trauma through Somatic Experiencing and Gestalt Therapy Healing Trauma through Somatic Experiencing and Gestalt Therapy
Healing Trauma through Somatic Experiencing and Gestalt Therapy
 
Family Systems Therapy
Family Systems TherapyFamily Systems Therapy
Family Systems Therapy
 
Lecture 5 social constructionist family therapy: Milan school
Lecture 5 social constructionist family therapy: Milan schoolLecture 5 social constructionist family therapy: Milan school
Lecture 5 social constructionist family therapy: Milan school
 
Lecture 4 strategic family therapy
Lecture 4 strategic family therapyLecture 4 strategic family therapy
Lecture 4 strategic family therapy
 
Bsft
BsftBsft
Bsft
 
Crisis familiares
Crisis familiaresCrisis familiares
Crisis familiares
 

Destaque (8)

Lecture 3 week 3 choosing a method
Lecture 3 week 3 choosing a methodLecture 3 week 3 choosing a method
Lecture 3 week 3 choosing a method
 
How to Manifest Your SoulMate with EFT
How to Manifest Your SoulMate with EFTHow to Manifest Your SoulMate with EFT
How to Manifest Your SoulMate with EFT
 
Couples therapy
Couples therapyCouples therapy
Couples therapy
 
Lecture 10 legal issues across therapy settings
Lecture 10 legal issues across therapy settingsLecture 10 legal issues across therapy settings
Lecture 10 legal issues across therapy settings
 
Lecture 10 existential psychotherapy
Lecture 10 existential psychotherapyLecture 10 existential psychotherapy
Lecture 10 existential psychotherapy
 
EFT Level I Practioner Training
EFT Level I Practioner TrainingEFT Level I Practioner Training
EFT Level I Practioner Training
 
EFT or Tapping - How it Works
EFT or Tapping - How it WorksEFT or Tapping - How it Works
EFT or Tapping - How it Works
 
Lecture 1 introduction to research in counselling
Lecture 1 introduction to research in counsellingLecture 1 introduction to research in counselling
Lecture 1 introduction to research in counselling
 

Semelhante a Emotional focused-therapy-greenberg

5. intergrating eft with traditional counselling cb
5. intergrating eft with traditional counselling cb5. intergrating eft with traditional counselling cb
5. intergrating eft with traditional counselling cbGillcrc
 
How Therapy Works
How Therapy WorksHow Therapy Works
How Therapy WorksJan Rakoff
 
Term paper mental hygiene
Term paper mental hygieneTerm paper mental hygiene
Term paper mental hygieneJoshua Batalla
 
counseling%20psy%20pres.pptx
counseling%20psy%20pres.pptxcounseling%20psy%20pres.pptx
counseling%20psy%20pres.pptxRizwanTahir35
 
Mindful Champion, Mindful Workplace with Dr. Joel Bennett and Lindsay Simone
Mindful Champion, Mindful Workplace with Dr. Joel Bennett and Lindsay SimoneMindful Champion, Mindful Workplace with Dr. Joel Bennett and Lindsay Simone
Mindful Champion, Mindful Workplace with Dr. Joel Bennett and Lindsay SimoneHPCareer.Net / State of Wellness Inc.
 
Understanding in treating resistance in OCD through EMDR
Understanding in treating resistance in OCD through EMDRUnderstanding in treating resistance in OCD through EMDR
Understanding in treating resistance in OCD through EMDRTerryDoan2
 
Answers top cognitive behaviour therapy fa qs
Answers top cognitive behaviour therapy fa qsAnswers top cognitive behaviour therapy fa qs
Answers top cognitive behaviour therapy fa qsElbert Moldenhauer
 
The Relational Arts: A Case For Counselling And Psychotherapy
The Relational Arts: A Case For Counselling And PsychotherapyThe Relational Arts: A Case For Counselling And Psychotherapy
The Relational Arts: A Case For Counselling And Psychotherapycyberscribe
 
Cognitive Behavioral Therapy
Cognitive Behavioral TherapyCognitive Behavioral Therapy
Cognitive Behavioral TherapyRyan Sain
 
SA101 Evidence based practice
SA101 Evidence based practiceSA101 Evidence based practice
SA101 Evidence based practiceBealCollegeOnline
 
postmodern approaches
postmodern approachespostmodern approaches
postmodern approachesAmanishraq
 
Third Wave Behavior Therapies
Third Wave Behavior TherapiesThird Wave Behavior Therapies
Third Wave Behavior TherapiesKevin J. Drab
 

Semelhante a Emotional focused-therapy-greenberg (18)

5. intergrating eft with traditional counselling cb
5. intergrating eft with traditional counselling cb5. intergrating eft with traditional counselling cb
5. intergrating eft with traditional counselling cb
 
How Therapy Works
How Therapy WorksHow Therapy Works
How Therapy Works
 
SOLUTION-FOCUSED BRIEF THERAPY (SFBT)
 SOLUTION-FOCUSED BRIEF THERAPY (SFBT) SOLUTION-FOCUSED BRIEF THERAPY (SFBT)
SOLUTION-FOCUSED BRIEF THERAPY (SFBT)
 
Psychotherapy
PsychotherapyPsychotherapy
Psychotherapy
 
Gestalt counselling
Gestalt counsellingGestalt counselling
Gestalt counselling
 
Term paper mental hygiene
Term paper mental hygieneTerm paper mental hygiene
Term paper mental hygiene
 
Lesson 26
Lesson 26Lesson 26
Lesson 26
 
counseling%20psy%20pres.pptx
counseling%20psy%20pres.pptxcounseling%20psy%20pres.pptx
counseling%20psy%20pres.pptx
 
Mindful Champion, Mindful Workplace with Dr. Joel Bennett and Lindsay Simone
Mindful Champion, Mindful Workplace with Dr. Joel Bennett and Lindsay SimoneMindful Champion, Mindful Workplace with Dr. Joel Bennett and Lindsay Simone
Mindful Champion, Mindful Workplace with Dr. Joel Bennett and Lindsay Simone
 
Understanding in treating resistance in OCD through EMDR
Understanding in treating resistance in OCD through EMDRUnderstanding in treating resistance in OCD through EMDR
Understanding in treating resistance in OCD through EMDR
 
Answers top cognitive behaviour therapy fa qs
Answers top cognitive behaviour therapy fa qsAnswers top cognitive behaviour therapy fa qs
Answers top cognitive behaviour therapy fa qs
 
The Relational Arts: A Case For Counselling And Psychotherapy
The Relational Arts: A Case For Counselling And PsychotherapyThe Relational Arts: A Case For Counselling And Psychotherapy
The Relational Arts: A Case For Counselling And Psychotherapy
 
Cognitive Behavioral Therapy
Cognitive Behavioral TherapyCognitive Behavioral Therapy
Cognitive Behavioral Therapy
 
SA101 Evidence based practice
SA101 Evidence based practiceSA101 Evidence based practice
SA101 Evidence based practice
 
Cognitive behavioral group therapy
Cognitive behavioral group therapyCognitive behavioral group therapy
Cognitive behavioral group therapy
 
postmodern approaches
postmodern approachespostmodern approaches
postmodern approaches
 
Third Wave Behavior Therapies
Third Wave Behavior TherapiesThird Wave Behavior Therapies
Third Wave Behavior Therapies
 
Depression suicide ect
Depression suicide ectDepression suicide ect
Depression suicide ect
 

Mais de Silvana Eloisa

Texto base escrita-sinais2
Texto base escrita-sinais2Texto base escrita-sinais2
Texto base escrita-sinais2Silvana Eloisa
 
The gift of therapy yalom
The gift of therapy   yalomThe gift of therapy   yalom
The gift of therapy yalomSilvana Eloisa
 
Texto base escrita-sinais2
Texto base escrita-sinais2Texto base escrita-sinais2
Texto base escrita-sinais2Silvana Eloisa
 
O escafandro-e-a-borboleta-jean-dominique-bauby
O escafandro-e-a-borboleta-jean-dominique-baubyO escafandro-e-a-borboleta-jean-dominique-bauby
O escafandro-e-a-borboleta-jean-dominique-baubySilvana Eloisa
 
Gillian butler-overcoming-social-anxiety-shyness
Gillian butler-overcoming-social-anxiety-shynessGillian butler-overcoming-social-anxiety-shyness
Gillian butler-overcoming-social-anxiety-shynessSilvana Eloisa
 
Sexual functions in men
Sexual functions in menSexual functions in men
Sexual functions in menSilvana Eloisa
 
O retardo mental na família construindo caminhos alternativos
O retardo mental na família  construindo caminhos alternativosO retardo mental na família  construindo caminhos alternativos
O retardo mental na família construindo caminhos alternativosSilvana Eloisa
 
Adolescente com deficiência mental abordagem dos aspectos sexuais
Adolescente com deficiência mental  abordagem dos aspectos sexuaisAdolescente com deficiência mental  abordagem dos aspectos sexuais
Adolescente com deficiência mental abordagem dos aspectos sexuaisSilvana Eloisa
 
Psicodiagnosis psicología infantil y juvenil
Psicodiagnosis  psicología infantil y juvenilPsicodiagnosis  psicología infantil y juvenil
Psicodiagnosis psicología infantil y juvenilSilvana Eloisa
 
O brincar e a música no desenvolvimento da criança com deficiência intelectual
O brincar e a música no desenvolvimento da criança com deficiência intelectualO brincar e a música no desenvolvimento da criança com deficiência intelectual
O brincar e a música no desenvolvimento da criança com deficiência intelectualSilvana Eloisa
 
Terapia familiar sistémica en el tratamiento del trastorno por déficit de ate...
Terapia familiar sistémica en el tratamiento del trastorno por déficit de ate...Terapia familiar sistémica en el tratamiento del trastorno por déficit de ate...
Terapia familiar sistémica en el tratamiento del trastorno por déficit de ate...Silvana Eloisa
 
Mutuar – núcleo de psicologia gestáltica
Mutuar – núcleo de psicologia gestálticaMutuar – núcleo de psicologia gestáltica
Mutuar – núcleo de psicologia gestálticaSilvana Eloisa
 
Music therapy for adolescents
Music therapy for adolescentsMusic therapy for adolescents
Music therapy for adolescentsSilvana Eloisa
 
Paradigma da inclusão
Paradigma da inclusãoParadigma da inclusão
Paradigma da inclusãoSilvana Eloisa
 
O brincar e a música no desenvolvimento da criança com deficiência intelectual
O brincar e a música no desenvolvimento da criança com deficiência intelectualO brincar e a música no desenvolvimento da criança com deficiência intelectual
O brincar e a música no desenvolvimento da criança com deficiência intelectualSilvana Eloisa
 

Mais de Silvana Eloisa (20)

Texto base escrita-sinais2
Texto base escrita-sinais2Texto base escrita-sinais2
Texto base escrita-sinais2
 
The gift of therapy yalom
The gift of therapy   yalomThe gift of therapy   yalom
The gift of therapy yalom
 
Texto base escrita-sinais2
Texto base escrita-sinais2Texto base escrita-sinais2
Texto base escrita-sinais2
 
O escafandro-e-a-borboleta-jean-dominique-bauby
O escafandro-e-a-borboleta-jean-dominique-baubyO escafandro-e-a-borboleta-jean-dominique-bauby
O escafandro-e-a-borboleta-jean-dominique-bauby
 
Gillian butler-overcoming-social-anxiety-shyness
Gillian butler-overcoming-social-anxiety-shynessGillian butler-overcoming-social-anxiety-shyness
Gillian butler-overcoming-social-anxiety-shyness
 
Sexual functions in men
Sexual functions in menSexual functions in men
Sexual functions in men
 
Women discover orgasm
Women discover orgasmWomen discover orgasm
Women discover orgasm
 
O retardo mental na família construindo caminhos alternativos
O retardo mental na família  construindo caminhos alternativosO retardo mental na família  construindo caminhos alternativos
O retardo mental na família construindo caminhos alternativos
 
Adolescente com deficiência mental abordagem dos aspectos sexuais
Adolescente com deficiência mental  abordagem dos aspectos sexuaisAdolescente com deficiência mental  abordagem dos aspectos sexuais
Adolescente com deficiência mental abordagem dos aspectos sexuais
 
Psicodiagnosis psicología infantil y juvenil
Psicodiagnosis  psicología infantil y juvenilPsicodiagnosis  psicología infantil y juvenil
Psicodiagnosis psicología infantil y juvenil
 
O brincar e a música no desenvolvimento da criança com deficiência intelectual
O brincar e a música no desenvolvimento da criança com deficiência intelectualO brincar e a música no desenvolvimento da criança com deficiência intelectual
O brincar e a música no desenvolvimento da criança com deficiência intelectual
 
Terapia familiar sistémica en el tratamiento del trastorno por déficit de ate...
Terapia familiar sistémica en el tratamiento del trastorno por déficit de ate...Terapia familiar sistémica en el tratamiento del trastorno por déficit de ate...
Terapia familiar sistémica en el tratamiento del trastorno por déficit de ate...
 
Mutuar – núcleo de psicologia gestáltica
Mutuar – núcleo de psicologia gestálticaMutuar – núcleo de psicologia gestáltica
Mutuar – núcleo de psicologia gestáltica
 
Music therapy for adolescents
Music therapy for adolescentsMusic therapy for adolescents
Music therapy for adolescents
 
Paradigma da inclusão
Paradigma da inclusãoParadigma da inclusão
Paradigma da inclusão
 
O brincar e a música no desenvolvimento da criança com deficiência intelectual
O brincar e a música no desenvolvimento da criança com deficiência intelectualO brincar e a música no desenvolvimento da criança com deficiência intelectual
O brincar e a música no desenvolvimento da criança com deficiência intelectual
 
Lealtades invisibles
Lealtades invisiblesLealtades invisibles
Lealtades invisibles
 
Martin buber eu e tu
Martin buber   eu e tuMartin buber   eu e tu
Martin buber eu e tu
 
Tonalidades afetivas
Tonalidades afetivasTonalidades afetivas
Tonalidades afetivas
 
Making love last_
Making love last_Making love last_
Making love last_
 

Último

VIP Mumbai Call Girls Hiranandani Gardens Just Call 9920874524 with A/C Room ...
VIP Mumbai Call Girls Hiranandani Gardens Just Call 9920874524 with A/C Room ...VIP Mumbai Call Girls Hiranandani Gardens Just Call 9920874524 with A/C Room ...
VIP Mumbai Call Girls Hiranandani Gardens Just Call 9920874524 with A/C Room ...Garima Khatri
 
Best Rate (Hyderabad) Call Girls Jahanuma ⟟ 8250192130 ⟟ High Class Call Girl...
Best Rate (Hyderabad) Call Girls Jahanuma ⟟ 8250192130 ⟟ High Class Call Girl...Best Rate (Hyderabad) Call Girls Jahanuma ⟟ 8250192130 ⟟ High Class Call Girl...
Best Rate (Hyderabad) Call Girls Jahanuma ⟟ 8250192130 ⟟ High Class Call Girl...astropune
 
Call Girls Siliguri Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Siliguri Just Call 9907093804 Top Class Call Girl Service AvailableCall Girls Siliguri Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Siliguri Just Call 9907093804 Top Class Call Girl Service AvailableDipal Arora
 
Top Rated Bangalore Call Girls Richmond Circle ⟟ 8250192130 ⟟ Call Me For Gen...
Top Rated Bangalore Call Girls Richmond Circle ⟟ 8250192130 ⟟ Call Me For Gen...Top Rated Bangalore Call Girls Richmond Circle ⟟ 8250192130 ⟟ Call Me For Gen...
Top Rated Bangalore Call Girls Richmond Circle ⟟ 8250192130 ⟟ Call Me For Gen...narwatsonia7
 
The Most Attractive Hyderabad Call Girls Kothapet 𖠋 6297143586 𖠋 Will You Mis...
The Most Attractive Hyderabad Call Girls Kothapet 𖠋 6297143586 𖠋 Will You Mis...The Most Attractive Hyderabad Call Girls Kothapet 𖠋 6297143586 𖠋 Will You Mis...
The Most Attractive Hyderabad Call Girls Kothapet 𖠋 6297143586 𖠋 Will You Mis...chandars293
 
(Rocky) Jaipur Call Girl - 09521753030 Escorts Service 50% Off with Cash ON D...
(Rocky) Jaipur Call Girl - 09521753030 Escorts Service 50% Off with Cash ON D...(Rocky) Jaipur Call Girl - 09521753030 Escorts Service 50% Off with Cash ON D...
(Rocky) Jaipur Call Girl - 09521753030 Escorts Service 50% Off with Cash ON D...indiancallgirl4rent
 
Call Girls Coimbatore Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Coimbatore Just Call 9907093804 Top Class Call Girl Service AvailableCall Girls Coimbatore Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Coimbatore Just Call 9907093804 Top Class Call Girl Service AvailableDipal Arora
 
Call Girls Bhubaneswar Just Call 9907093804 Top Class Call Girl Service Avail...
Call Girls Bhubaneswar Just Call 9907093804 Top Class Call Girl Service Avail...Call Girls Bhubaneswar Just Call 9907093804 Top Class Call Girl Service Avail...
Call Girls Bhubaneswar Just Call 9907093804 Top Class Call Girl Service Avail...Dipal Arora
 
Call Girls Ludhiana Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Ludhiana Just Call 9907093804 Top Class Call Girl Service AvailableCall Girls Ludhiana Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Ludhiana Just Call 9907093804 Top Class Call Girl Service AvailableDipal Arora
 
Top Rated Hyderabad Call Girls Erragadda ⟟ 6297143586 ⟟ Call Me For Genuine ...
Top Rated  Hyderabad Call Girls Erragadda ⟟ 6297143586 ⟟ Call Me For Genuine ...Top Rated  Hyderabad Call Girls Erragadda ⟟ 6297143586 ⟟ Call Me For Genuine ...
Top Rated Hyderabad Call Girls Erragadda ⟟ 6297143586 ⟟ Call Me For Genuine ...chandars293
 
Call Girls Visakhapatnam Just Call 9907093804 Top Class Call Girl Service Ava...
Call Girls Visakhapatnam Just Call 9907093804 Top Class Call Girl Service Ava...Call Girls Visakhapatnam Just Call 9907093804 Top Class Call Girl Service Ava...
Call Girls Visakhapatnam Just Call 9907093804 Top Class Call Girl Service Ava...Dipal Arora
 
Chandrapur Call girls 8617370543 Provides all area service COD available
Chandrapur Call girls 8617370543 Provides all area service COD availableChandrapur Call girls 8617370543 Provides all area service COD available
Chandrapur Call girls 8617370543 Provides all area service COD availableDipal Arora
 
Bangalore Call Girl Whatsapp Number 100% Complete Your Sexual Needs
Bangalore Call Girl Whatsapp Number 100% Complete Your Sexual NeedsBangalore Call Girl Whatsapp Number 100% Complete Your Sexual Needs
Bangalore Call Girl Whatsapp Number 100% Complete Your Sexual NeedsGfnyt
 
Call Girls Service Surat Samaira ❤️🍑 8250192130 👄 Independent Escort Service ...
Call Girls Service Surat Samaira ❤️🍑 8250192130 👄 Independent Escort Service ...Call Girls Service Surat Samaira ❤️🍑 8250192130 👄 Independent Escort Service ...
Call Girls Service Surat Samaira ❤️🍑 8250192130 👄 Independent Escort Service ...CALL GIRLS
 
Russian Call Girls in Jaipur Riya WhatsApp ❤8445551418 VIP Call Girls Jaipur
Russian Call Girls in Jaipur Riya WhatsApp ❤8445551418 VIP Call Girls JaipurRussian Call Girls in Jaipur Riya WhatsApp ❤8445551418 VIP Call Girls Jaipur
Russian Call Girls in Jaipur Riya WhatsApp ❤8445551418 VIP Call Girls Jaipurparulsinha
 
Call Girls Dehradun Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Dehradun Just Call 9907093804 Top Class Call Girl Service AvailableCall Girls Dehradun Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Dehradun Just Call 9907093804 Top Class Call Girl Service AvailableDipal Arora
 
Night 7k to 12k Chennai City Center Call Girls 👉👉 7427069034⭐⭐ 100% Genuine E...
Night 7k to 12k Chennai City Center Call Girls 👉👉 7427069034⭐⭐ 100% Genuine E...Night 7k to 12k Chennai City Center Call Girls 👉👉 7427069034⭐⭐ 100% Genuine E...
Night 7k to 12k Chennai City Center Call Girls 👉👉 7427069034⭐⭐ 100% Genuine E...hotbabesbook
 
💎VVIP Kolkata Call Girls Parganas🩱7001035870🩱Independent Girl ( Ac Rooms Avai...
💎VVIP Kolkata Call Girls Parganas🩱7001035870🩱Independent Girl ( Ac Rooms Avai...💎VVIP Kolkata Call Girls Parganas🩱7001035870🩱Independent Girl ( Ac Rooms Avai...
💎VVIP Kolkata Call Girls Parganas🩱7001035870🩱Independent Girl ( Ac Rooms Avai...Taniya Sharma
 
VIP Call Girls Indore Kirti 💚😋 9256729539 🚀 Indore Escorts
VIP Call Girls Indore Kirti 💚😋  9256729539 🚀 Indore EscortsVIP Call Girls Indore Kirti 💚😋  9256729539 🚀 Indore Escorts
VIP Call Girls Indore Kirti 💚😋 9256729539 🚀 Indore Escortsaditipandeya
 
VIP Hyderabad Call Girls Bahadurpally 7877925207 ₹5000 To 25K With AC Room 💚😋
VIP Hyderabad Call Girls Bahadurpally 7877925207 ₹5000 To 25K With AC Room 💚😋VIP Hyderabad Call Girls Bahadurpally 7877925207 ₹5000 To 25K With AC Room 💚😋
VIP Hyderabad Call Girls Bahadurpally 7877925207 ₹5000 To 25K With AC Room 💚😋TANUJA PANDEY
 

Último (20)

VIP Mumbai Call Girls Hiranandani Gardens Just Call 9920874524 with A/C Room ...
VIP Mumbai Call Girls Hiranandani Gardens Just Call 9920874524 with A/C Room ...VIP Mumbai Call Girls Hiranandani Gardens Just Call 9920874524 with A/C Room ...
VIP Mumbai Call Girls Hiranandani Gardens Just Call 9920874524 with A/C Room ...
 
Best Rate (Hyderabad) Call Girls Jahanuma ⟟ 8250192130 ⟟ High Class Call Girl...
Best Rate (Hyderabad) Call Girls Jahanuma ⟟ 8250192130 ⟟ High Class Call Girl...Best Rate (Hyderabad) Call Girls Jahanuma ⟟ 8250192130 ⟟ High Class Call Girl...
Best Rate (Hyderabad) Call Girls Jahanuma ⟟ 8250192130 ⟟ High Class Call Girl...
 
Call Girls Siliguri Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Siliguri Just Call 9907093804 Top Class Call Girl Service AvailableCall Girls Siliguri Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Siliguri Just Call 9907093804 Top Class Call Girl Service Available
 
Top Rated Bangalore Call Girls Richmond Circle ⟟ 8250192130 ⟟ Call Me For Gen...
Top Rated Bangalore Call Girls Richmond Circle ⟟ 8250192130 ⟟ Call Me For Gen...Top Rated Bangalore Call Girls Richmond Circle ⟟ 8250192130 ⟟ Call Me For Gen...
Top Rated Bangalore Call Girls Richmond Circle ⟟ 8250192130 ⟟ Call Me For Gen...
 
The Most Attractive Hyderabad Call Girls Kothapet 𖠋 6297143586 𖠋 Will You Mis...
The Most Attractive Hyderabad Call Girls Kothapet 𖠋 6297143586 𖠋 Will You Mis...The Most Attractive Hyderabad Call Girls Kothapet 𖠋 6297143586 𖠋 Will You Mis...
The Most Attractive Hyderabad Call Girls Kothapet 𖠋 6297143586 𖠋 Will You Mis...
 
(Rocky) Jaipur Call Girl - 09521753030 Escorts Service 50% Off with Cash ON D...
(Rocky) Jaipur Call Girl - 09521753030 Escorts Service 50% Off with Cash ON D...(Rocky) Jaipur Call Girl - 09521753030 Escorts Service 50% Off with Cash ON D...
(Rocky) Jaipur Call Girl - 09521753030 Escorts Service 50% Off with Cash ON D...
 
Call Girls Coimbatore Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Coimbatore Just Call 9907093804 Top Class Call Girl Service AvailableCall Girls Coimbatore Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Coimbatore Just Call 9907093804 Top Class Call Girl Service Available
 
Call Girls Bhubaneswar Just Call 9907093804 Top Class Call Girl Service Avail...
Call Girls Bhubaneswar Just Call 9907093804 Top Class Call Girl Service Avail...Call Girls Bhubaneswar Just Call 9907093804 Top Class Call Girl Service Avail...
Call Girls Bhubaneswar Just Call 9907093804 Top Class Call Girl Service Avail...
 
Call Girls Ludhiana Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Ludhiana Just Call 9907093804 Top Class Call Girl Service AvailableCall Girls Ludhiana Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Ludhiana Just Call 9907093804 Top Class Call Girl Service Available
 
Top Rated Hyderabad Call Girls Erragadda ⟟ 6297143586 ⟟ Call Me For Genuine ...
Top Rated  Hyderabad Call Girls Erragadda ⟟ 6297143586 ⟟ Call Me For Genuine ...Top Rated  Hyderabad Call Girls Erragadda ⟟ 6297143586 ⟟ Call Me For Genuine ...
Top Rated Hyderabad Call Girls Erragadda ⟟ 6297143586 ⟟ Call Me For Genuine ...
 
Call Girls Visakhapatnam Just Call 9907093804 Top Class Call Girl Service Ava...
Call Girls Visakhapatnam Just Call 9907093804 Top Class Call Girl Service Ava...Call Girls Visakhapatnam Just Call 9907093804 Top Class Call Girl Service Ava...
Call Girls Visakhapatnam Just Call 9907093804 Top Class Call Girl Service Ava...
 
Chandrapur Call girls 8617370543 Provides all area service COD available
Chandrapur Call girls 8617370543 Provides all area service COD availableChandrapur Call girls 8617370543 Provides all area service COD available
Chandrapur Call girls 8617370543 Provides all area service COD available
 
Bangalore Call Girl Whatsapp Number 100% Complete Your Sexual Needs
Bangalore Call Girl Whatsapp Number 100% Complete Your Sexual NeedsBangalore Call Girl Whatsapp Number 100% Complete Your Sexual Needs
Bangalore Call Girl Whatsapp Number 100% Complete Your Sexual Needs
 
Call Girls Service Surat Samaira ❤️🍑 8250192130 👄 Independent Escort Service ...
Call Girls Service Surat Samaira ❤️🍑 8250192130 👄 Independent Escort Service ...Call Girls Service Surat Samaira ❤️🍑 8250192130 👄 Independent Escort Service ...
Call Girls Service Surat Samaira ❤️🍑 8250192130 👄 Independent Escort Service ...
 
Russian Call Girls in Jaipur Riya WhatsApp ❤8445551418 VIP Call Girls Jaipur
Russian Call Girls in Jaipur Riya WhatsApp ❤8445551418 VIP Call Girls JaipurRussian Call Girls in Jaipur Riya WhatsApp ❤8445551418 VIP Call Girls Jaipur
Russian Call Girls in Jaipur Riya WhatsApp ❤8445551418 VIP Call Girls Jaipur
 
Call Girls Dehradun Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Dehradun Just Call 9907093804 Top Class Call Girl Service AvailableCall Girls Dehradun Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Dehradun Just Call 9907093804 Top Class Call Girl Service Available
 
Night 7k to 12k Chennai City Center Call Girls 👉👉 7427069034⭐⭐ 100% Genuine E...
Night 7k to 12k Chennai City Center Call Girls 👉👉 7427069034⭐⭐ 100% Genuine E...Night 7k to 12k Chennai City Center Call Girls 👉👉 7427069034⭐⭐ 100% Genuine E...
Night 7k to 12k Chennai City Center Call Girls 👉👉 7427069034⭐⭐ 100% Genuine E...
 
💎VVIP Kolkata Call Girls Parganas🩱7001035870🩱Independent Girl ( Ac Rooms Avai...
💎VVIP Kolkata Call Girls Parganas🩱7001035870🩱Independent Girl ( Ac Rooms Avai...💎VVIP Kolkata Call Girls Parganas🩱7001035870🩱Independent Girl ( Ac Rooms Avai...
💎VVIP Kolkata Call Girls Parganas🩱7001035870🩱Independent Girl ( Ac Rooms Avai...
 
VIP Call Girls Indore Kirti 💚😋 9256729539 🚀 Indore Escorts
VIP Call Girls Indore Kirti 💚😋  9256729539 🚀 Indore EscortsVIP Call Girls Indore Kirti 💚😋  9256729539 🚀 Indore Escorts
VIP Call Girls Indore Kirti 💚😋 9256729539 🚀 Indore Escorts
 
VIP Hyderabad Call Girls Bahadurpally 7877925207 ₹5000 To 25K With AC Room 💚😋
VIP Hyderabad Call Girls Bahadurpally 7877925207 ₹5000 To 25K With AC Room 💚😋VIP Hyderabad Call Girls Bahadurpally 7877925207 ₹5000 To 25K With AC Room 💚😋
VIP Hyderabad Call Girls Bahadurpally 7877925207 ₹5000 To 25K With AC Room 💚😋
 

Emotional focused-therapy-greenberg

  • 1. Journal of Contemporary Psychotherapy, Vol. 34, No. 2, Summer 2004 (°C 2004) Emotion-Focused Therapy: An Interview with Leslie Greenberg Denise M. Sloan Over the past 30 years Leslie Greenberg has developed and refined the EmotionFocused Therapy (EFT) approach. This therapy model stands apart from other, humanistic-based approaches in its focus on empiricism. In addition, EFT is one of the few therapy models that is truly integrative in nature, combining clientcentered, gestalt, and cognitive principles. This paper includes a recent interview with Greenberg in which he describes the development of EFT and his views regardingfuturedirectionsofEFT,aswellashisviewsonthefieldofpsychotherapy more generally. KEY WORDS: psychotherapy; emotion; experiential; humanistic; integrative. Leslie Greenberg was born and raised in Johannesburg South Africa and attended high school with another well-known clinical psychologist, G. Terence Wilson. Interestingly, Greenberg didn’t originally pursue a career in psychology. Instead, he obtained a master’s degree in engineering. After working in the engineering field for several years Greenberg realized that his work in the engineering field left him desiring greater human contact. Fortunately for the field of psychology, Greenberg decided to pursue training in clinical psychology. He obtained his Ph.D. in psychology in 1975 and became a faculty member of the Department of Counseling Psychology at University of British Columbia in 1975. He remained in that position until the mid 1980’s when he accepted a faculty position in the Department of Psychology at York University where he remains today. Early on in his career Greenberg devoted considerable effort to become informed in a variety of therapy approaches. As a consequence Greenberg pursued training with a variety of leaders in the psychotherapy field, such as Rogers, Pascual-Leone, and Minuchin. These diverse psychotherapy training experiences
  • 2. 106 Sloan Address correspondence to Denise M. Sloan, Department of Psychology Temple University, Philadelphia, Pennsylvania 19122; e-mail: dsloan@temple.edu. 105 0022-0116/04/0300-0105/0 °C 2004 Human Sciences Press, Inc. ultimately culminated in Greenberg’s development of EFT, which is truly an integrativetherapyapproach.WhatsetsEFTapartfrommanyotherintegrativetherapy approaches is its emphasis on empirical support. Throughout the development of EFT Greenberg has attempted to demonstrate the efficacy of EFT and has taken on the difficult task of attempting to identify the change processes in psychotherapy. Demonstrating his dedication as a clinical scientist, Greenberg has published over 100 journal articles. He has also written several books on the topics of EFT, empathy, and change processes in psychotherapy. In addition, Greenberg has served as President of the Society for Psychotherapy Research and has served on a number of journal editorial boards including, Journal of Consulting and Clinical Psychology, Journal of Psychotherapy Integration, and Journal of Marriage and Family Therapy. Has also been the recipient of several large grants from both Canadian and American funding agencies. In this interview Greenberg describes how he came to develop EFT, the core features of the model, and his predictions for the future of EFT. Greenberg also describes his views regarding the psychotherapy field more generally. DS (Denise Sloan): Could you briefly describe emotion-focused therapy (EFT)? LG (Leslie Greenberg): Basically EFT is based on two fundamental ideas. Empathic attunement to affect is very important so that within an understanding relationship being attuned to someone else’s feelings is very important in helping to build affect regulation. So within the context of an empathically attuned affect regulating relationship one pays attention to particular kinds of processing difficulties that people have. Then you try to do different things at different times to facilitate different kinds of emotion processes. So everything is saying that it’s important to pay attention to emotion but that there is both a relational form of helping regulate affect through empathy but then you are also engaging in specific differential interventions. Doing different things at different times. You can either be paying attention to the moment by moment processes by asking someone to pay attention to what’s going on inside their body—this is making a specific moment by moment intervention. Or by asking someone to imagine somebody or talk to somebody you’re trying to facilitate the kind of processing they do within a larger task. There are these larger tasks that we have identified, initially we identified about six or seven types of affectively based problems, like unresolved bad feelings towards a significant other and internal conflict. So we’ve defined different kinds of problems that are then worked on with a focus on emotion. That’s another form of active intervention. DS: How is EFT distinct from other therapy models? LG: First, EFT is focused on emotion and it sees emotion as the prime mover in human experience so that cognition and behavior are, so to speak, dependent on
  • 3. Emotion-focused therapy 107 affect. In EFT you are trying to work to change people’s emotions. Many non- empirically based therapies do work in different ways with emotion. EFT is also different in that it’s empirically based. Its effectiveness has been shown and it’s a systematic way of working with affect. There are other approaches that work with affect but they haven’t been studied, they are not as systematic and they haven’t been spelled out and based on observation. DS: In terms of affect driving cognition, what is your view on CBT based approach of cognition or behavior driving therapy. That is, if you act or think in a particular way, you will then feel that way? LG: Right. I see problems with that. I think cognitive therapy is useful as a brief intervention to teach people coping skills. Coping is a laudable thing but coping isn’t quite the same of basic restructuring or basic change. To be able to talk to yourself and say, “it’s okay, don’t get anxious” or “think of something more positive like don’t worry.” I think those things do help people cope and people want to be able to cope better but I’m not sure that the coping necessarily leads to change so then you spend the rest of your life coping. What I’m trying to do is get to the deeper underlying determinants that I see as affectively based. If you can get a change in that then you no longer have to do the coping because you’ve actually changed. I do think that practicing things in the real world and having success experience will lead you to change. So that sometimes if you cope better and you act in the world and then you have success experience you are then actually getting experiential feedback that will change your deeper structures. In that case, you might get change over the long run with coping but I’ve seen too many people who cope and they live by coping but when things get too intense or a crisis occurs the coping skills can’t cope and then they collapse. These people need to go through a deeper change process. DS: How many sessions are needed in order for a deeper change process to occur? LG: What we found in our research is that people that come in for therapy for clinical depression, which is what we’ve studied most, can benefit substantially by 16 sessions. If when they come in they have a capacity to experience, that is, they are able to attend to their own bodily felt experiences and they are able to label them, and at least they experience at this level. However, people that have come in and are very cut off from their emotional experience, that is, they are not able to symbolize their own experience, for these individuals by about the end of 16 sessions they began to look like the people who were successful in treatment who came in with a capacity to experience. So it seems like these people who are not able to be minimally aware of their experience at the beginning were not as successful at the end of therapy. I would say that if we gave these people another 16 sessions that would be about right for them. So it really depends on the person.
  • 4. 108 Sloan But overall I would say about 16 sessions is a good minimum dose for helping someone with these more active emotionally-focused methods to help get to core issues and begin to deal with them. But people who come into therapy without good emotion skills would need at least 32 sessions. People with more chronic or severe concerns would need longer. DS:32sessionsstillseemslikeashortdurationforchangingthetypesofunderlying structures you’re talking about. LG:Yes.Thisisnottotalpersonalityrestructuringeitherbuttheemotionalmethods are very effective or powerful at getting to core issues very rapidly in a deeper way so then it’s in line with the claim that the therapy gets at core material. You can make quite a lot of gains in a fairly short period of time. DS: Do clients have “homework” assignments between sessions? LG: We have begun instituting more and more homework. This is something that hasn’t been emphasized much but I think the idea of practice between sessions is really a good one. The kind of homework or practice that we use is often more awareness-type homework. However, we don’t rely on the homework to produce the change but more to consolidate things that have happened in sessions already. We don’t give homework to go out and try something that the person hasn’t done already but if they get a shift in their self- critical voice such that it becomes more compassionate we would ask people to pay attention to that and practice being more self-compassionate during the week. But we wouldn’t do something like this until it had happened in a session first. So it’s more practice or consolidation of gains already made. DS: EFT seems to have key elements of other therapy models yet its different in some seemingly critical ways, so I’m curious how EFT was developed? LG: Yes. I’ve also been talking mostly about the individual therapy but not the couples therapy that is also part of the whole EFT package. I was trained originally as a client-centered therapist and then as a gestalt therapist but I was also worked with Laura Rice who was a student of Carl Rogers so I very much started out as a process researcher as well as being trained in psychotherapy. I was studying tapes of therapy from day one. A lot of EFT was developed through the research focus on what makes people change. The first book Laura Rice and I wrote was called Patterns of Change and we were studying how people change. I then looked at these therapies I was being trained in for what seemed to be the most active change processes. We tried to look at how to measure these processes and so on. At this point I began integrating client centered and gestalt therapy and I was very interested in cognition at the level of cognitive science. I did my minor in cognitive development at that same time I studied with Pascual-Leone, a student of Piaget, and so I was very interested in the processes of cognition and affect. But I wasn’t interested in cognitive therapy, which is a very primitive view of cognition. Instead, I was very interested in the role of attention, in Piaget notion of schemes or schema, and
  • 5. Emotion-focused therapy 109 then in emotion theory. So I was bringing all of that to bear on studying the process of change through the lens of cognition and emotion and how these processes take place. So I integrated all of these things but essentially I was integrating a client-centered relationship with gestalt therapies more active interventions, with a type of cognitive view of how meaning is created in people. And then I was psychodynamically informed as well. I had read a lot of psychodynamic material. I began to study specifically how people resolve intrapsychic conflict within themselves, or in gestalt terms splits, which are more conscious conflicts, and I built my first model of change process. The resolution process looked like a conflict between two people except it was between two voices in one person. I was simultaneously very interested in couples and family therapy so I did training in family therapy with people like Virginia Satir and then Minuchin, and then I went to Palo Alto and studied with people there who used a systemic approach. After that I began to direct my attention at how couples resolved conflicts and we built an emotionally focused couples therapy based on similar sorts of ideas that emotion was very important but now there was interaction as well. So what I did was integrated lots of different things and from my family therapy experienceItooktherapistdirectiveness,fromfamilyworkwherethetherapistwas more structuring and guiding and this all fed back into influencing my approach to individual therapy. From this I came up with the idea of the therapist as an emotion coach- - that what the therapist is actually doing is acting as a facilitative coach where they are helping people be more aware of their feelings, regulate their feelings, transform their feelings, and so on. So EFT is an integration of lots of different strands but at its most fundamental it’s an integration of client-centered and gestalt within a cognitive-affective science framework. DS: Given the different influences in the development of this therapy model what would you say have been the major changes to the model over time? LG: I guess I would say that I started off with much more of a following rather than leading approach. It was more a mirroring kind of approach with more of a view that there were resources within the individual that they needed help to access—an actualizing tendency within. It’s moved to more of an interpersonal, co-constructive view where what I’m doing in the room is contributing something more to the environment. I’m not only helping people to access their resources and mirroring what they said but I’m also leading, adding something but in a very subtle way, by guiding the process within a client’s proximal zone of development, just trying to guide with what could be useful at this time and that it’s the two of us together that are creating something new. So now not everything is coming from the individual, whom my presence helps to free up, but that there’s something actually happening between the two of us, that is, the change process. I think that’s one of the important evolutions of the model. I think doing couples therapy and family therapy made me more comfortable with being more active, that is, giving more suggestions without feeling like the therapist is potentially distorting the client or being too intrusive. We’ve always
  • 6. 110 Sloan adopted the approach that the therapist is not the expert on the client’s experience. It’s really the client who is the expert so the issue was how do you make a contribution without imposing it on clients or distorting their own experience. Eventually we came up with the idea that we are more process directive not content directive, so we don’t tell the client what they are feeling or suggest to them what they’re feeling, but we suggest to them ways that they might use to better connect with or process their own feelings. For example, guiding clients to pay attention to what’s going on in their body or to speak to somebody in an empty chair, I’m making suggestions that I think will help clients process their emotions in particular ways so I’m being quite directive in process but not in content. DS: It seems like empathy is a real core feature in EFT and that a therapist needs to establish empathy first and then build off of that. In a lot of clinical training programs empathy is not something that tends to be part of training. LG: Yes, you’re right. I think that’s the greatest tragedy. When I was in graduate school I started from day one in training in empathy and that was what my fundamental training was. At York University I run a fourth year counseling course and it has a lab component that is two hours per week and that’s all empathy training. I also have graduate students in their first year do their practicum that is based on empathy and empathy training. I really believe empathy is fundamental and the waves of fads in training are amazing to watch. It’s one of the great losses because it used to be that empathy was being taught and trained in many programs and now that’s just disappeared completely mainly with the dominance of CBT as an empirically-supported treatment. Somehow the emphasis on empathy has just been lost. Rapport is what is talked about in CBT. Rapport is not empathy. DS: I agree. Empathy is really an essential skill for therapist and I doubt anyone could be an effective therapist without having good empathy skills. I also think many people don’t appreciate just how difficult it is to learn how to truly listen to clients. LG: Exactly. Empathy is the most critical skill. From the base of empathy you can also understand the tension between following versus leading. It’s really crucial to first have these following or listening skills before you get into leading. It took me many years before I started integrating the two. Many students in training and therapists in general want to lead, they want to do something, but the real skill is to listen, to be present and to really hear what’s going on. So ideally I would like to have students do two years of basic empathy training and just be in that listening mode before they begin to do more active interventions. It’s very difficult to listen really clearly and then to listen to affect. Listening to emotion is very important.
  • 7. Emotion-focused therapy 111 DS: Clearly the therapist ability to listen and listen to affect is critical in the EFT model. Given that, do you think it’s important for students in training to be in therapy themselves? LG: I think it’s very beneficial, particularly when working with emotions. It’s an a-rational process so you can’t just teach people rationally how to work with emotions without them actually experiencing the emotions themselves. To tell people that avoidance of emotions is not good and that experiencing pain is useful you have to really experience that facing your own pain has been useful for you, as the therapist, to believe it. There are certainly a lot of rational reasons for thinking experiencing pain would not be helpful. I think experiential learning is important. Nowwhetherthat’sthroughpersonaltherapyorsomeformoftrainingthatinvolves experiential aspects I think is very important. I do think that to be a good therapist, personal therapy is probably highly beneficial. DS: One thing that I’ve noticed in supervising beginning therapist is that they often collude with the client in avoidance of negative emotions. The beginning therapist seems to not want to make the client feel bad and doesn’t seem to appreciate the importance of the client experiencing negative emotions in therapy. LG: Exactly. I do find that with my students that those who have been in therapy haveadeeperappreciationandalsotheyarenotdoingthatsortofthingofcolluding or trying to help the person feel good and stay away from difficult things. DS: If a student didn’t want to go to therapy, for whatever reason they had, what would you recommend to them in place of personal therapy? LG: That’s an interesting question. Well, in my book, Emotion Coaching, I have a number of experiential learning exercising that people could do on their own. I’m not a great fan of self-help books but there are certain books that propose how you can work on this for yourself with awareness training. Things like mediation and personal reflection kinds of experiences are useful. One doesn’t need to be in therapy in order to increase awareness. So there are other ways to accomplishing this through personal relationships, focusing, self-reflection, etcetera but it is a matter of always working on oneself to always be more aware. DS: Do you think there’s an ideal type of client for EFT? LG:Theidealclientissomeonewhoisalreadyabletosymbolizetheirowninternal experience so that they take very readily to this process. But clients who probably benefit greatly are those who some would call alexithymic, who don’t have the ability to put words on their emotions. These individuals could benefit a lot from learning this kind of process but they’re not the ideal client. Basically, EFT applies to people who are good for therapy in general and that means that they are not too hostile, avoidant, and don’t have severe personality issues, such
  • 8. 112 Sloan as borderline personality and self-harming behaviors. These individuals are not the ideal clients for really any type of therapy. DS: Given that, what would you suggest for someone who is highly avoidant of emotions? LG: I’ve been quite impressed with aspects of the dialectical-behavior therapy approach for people with severe problems. I think the idea of an intense psychoeducational program, where you put people in a classroom and you teach them about the importance of facing emotions and they are given homework exercises. At the same time the client is in therapy where what they are learning in the classroom is being put into practice in a more intense manner in a validating relationship. I think the problem is that if you don’t have the educative piece you spend a lot of time on the front end of therapy trying to educate clients and that changes the nature of the relationship between the client and the therapist. A therapist can’t really be empathic because they have to teach and kind of convince and persuade. So if it is broken into two components that run in parallel that would be my suggestion for working with more avoidant clients. For example, people with more psychosomatic disorders are often quite avoidant and I think you need to teach them on the one hand, but then you need a really empathic, nurturing relationship to help them do the work and do it with another person. If you just do the homework outside the context of a relationship this does not recognize as important the role of the empathic relationship in helping us deal with our own affects. It’s not just an individual skill, it’s actually a relational phenomenon-the dyadic regulation of affect. DS: I asked you about how you thought EFT has changed over the years, where do you see the EFT model going? LG: Well, first let me go back for one moment to say something about how EFT has changed. The biggest change has been its explicit focus on affect. EFT didn’t start with its focus being explicitly on emotion. So that’s been one of the big changes, to bemoreandmoreclearonitsfocusonemotion.IntermsofwherewillEFTgo,well, what I think would be important to do is expand its empirical evaluation in relation to other populations. We’ve mainly worked with depression and interpersonally based problems but working with anxiety and eating disorders would be good populations to expand EFT to. Also, moving into more preventive domains of developing emotional awareness training modules for use with adolescences and young adults. This training would have to be done at an experiential level, but the goal would basically be helping people become more emotionally intelligent. Not in the global sense of do you have intelligence but how do you actually use your emotion intelligently. Enhancing peoples skills and abilities in emotion awareness, utilization and transformation. So moving into preventive domains will be important. In terms of the couples therapy, I think there’s room for more development theoretically. We’ve dealt a lot with affiliation and attachment but not a lot with power, definition of reality and autonomy issues.
  • 9. Emotion-focused therapy 113 In the circumplex model both affiliation and autonomy are important. We’ve sort of dealt with only a one dimension of affiliation but I’m very interesting in the affect related to power, dominance, and autonomy and thinking about how to work with people in relationships dealing with these more autonomy related emotions. DS: There’s seems to be a lot of emphasis on manualized treatments, particularly ones that are empirically-supported. What’s your view of manualized treatments? LG: Actually I think the phase of manuals is now dying. The move has been that way and funding has required it but I think there are mounting criticisms on the deficiencies of manualization, so I think the romance with manuals is about to be finished. We were sort of in a position of writing some type of manual but I don’t think you can manualize a complex interaction. I think manualization is easier in CBT approaches, which are more much psychoeducational, dydactic and much more explicit. So you can manualize things that are less interactive and more dydactic. However, I think there is some benefit to manuals because it forces one to specify what one does. I also think you could think about first generation manuals but we’re now probably onto third generation manuals, which are the manuals that are attempting to get more flexible and more complex. I think specification of what the therapist does or tries to do is a good thing but I thing that overly rigid manualization doesn’t really work. I do think the efforts to continue to specify what the therapists do and write some sort of complex flexible manual is a good thing and it’s generating fourth and fifth generation manuals that are more flexible. That is important. For example, we’ve developed a manual that is more marker guided so it doesn’t state “do this” rather it states “if this, then this.” If a client is in a particular state, then this type of intervention would be most appropriate. So this is the kind of thing that gives you flexibility. DS: On a broader topic, how do you envision the field of psychotherapy in the future? LG: I’ve never been much of a prognosticator. I say moving toward integration. This is a hope but I think a prediction as well. Eventually I think we will integrate but more immediately I think we are on the cusp of moving toward an ABC therapy, which is an affective behavioral cognitive therapy and integrating these three elements. But I think that still doesn’t do enough justice to the psychoanalytic and motivational components, which are so complex they are very difficult to specify and manualize. But eventually Ido see the field moving to much greater integration and then that would be a biological, affective, behavioral, cognitive, motivation, interactional, social kind of integration. My hope would be that eventually students would come into programs and they wouldn’t be trained in different therapies but instead they would train in how to work with affect, cognition, behavior, and interaction. They wouldn’t be taught
  • 10. 114 Sloan cognitive therapy, object relations therapy. There wouldn’t be schools. Instead, there would be processes being taught. DS: Do you see that being far into the future? LG: Yes, I don’t think we’re there yet. DS: How do you think managed care has affected psychotherapy? LG: Well in Canada we don’t have managed care but I think it’s been the worst blow to therapy that’s occurred in the short time therapy has been around because it’s only been around 50 or 60 years. I have a wonderful anecdote; it is a Canadian one. A hospital administrator who is an M.B.A. came in and took over the running of the hospital and he called the head of psychology and said, “I see that the average time of contact between patient and doctor in the hospital is 8 minutes but in psychology its one hour. Could you reduce it to 8 minutes?” This highlights the administrator perspective over the function of what therapists are doing. So managed care is just how to be quicker, more efficient, more effective without any attention to what it is that is being done. Managed care has favored brief interventions that are highly specified and I think it has damaged the development of psychotherapy quite severely. DS: What do you think about prescription privileges for psychologists? LG: At first I was quite in favor of them and I saw the conflict as a power fight between psychology and psychiatry. However, after speaking to some friends of mine, most of whom are psychiatrists, I now think that maybe getting prescription privileges for psychologists would produce more of a headache than it is really worth. I think it’s not such a desirable thing to get into. I think it changes the role of the psychologist. I was of the opinion that it’s a fairly simple process to give prescriptions but if you have to start getting into the full range of complexities in order to rule out all kinds of medical factors and so on it just detracts from doing your central psychological interventions, so I’m not so in favor of it. It’s not something I would push for. DS: What recommendations would you give to beginning psychotherapists? LG: For people really interested in psychotherapy I don’t think the academic establishment is the best way of getting experience. I do think having a good theoretical background is good but this is sort of the broader question of the split between research and practice, and the two are not always so close. For a student I think getting training in empathy and getting supervised clinical experience are the two most important things in training to be a psychotherapist. I would emphasize getting lots of good supervision. I still think that the best form of training is through supervision. Unfortunately, especially in the CBT- type programs, I think studentsdon’tgetenough“handson”experiencewithrealclientswhoarecomplex. Students need supervision beyond doing manual guided treatments, applied to
  • 11. Emotion-focused therapy 115 all kinds of cases to deal with a full complexity of things. So I think it’s how to get training that’s doing real psychotherapy and good supervision and for students to seek that out the best they can. DS:IagreewithyouthatmanyPh.D.clinicaltrainingprogramsemphasizeresearch at the expense of clinical training. Do you think that this emphasis has changed the type of people applying to Ph.D. clinical programs? LG: Yes. It certainly changes people who pursue it into being that kind of person, with a research focus. The European model is actually a lot better. In Europe they are looking at creating standards for the whole of Europe. Basically their program for psychotherapy is that you get the M.A. degree and then you do two to three years of specialized training in psychotherapy. A Ph.D. is a research degree but not a practice degree. I think we have this extreme confounding in that you need a Ph.D. to be a registered psychologist, and you need to be a registered psychologist to practice. What we’re really trained to do is research and not practice. I think there’s a problem in that people that are more interested in practice probably do seek other ways of training, so they do Psy.D. programs and so on. DS: Or they state that they are interested in pursuing research to gain admittance to Ph.D. clinical programs but what they really desire is to be a clinician. LG: Exactly. The Psy.D. program was an attempted solution to this problem but I don’t think it solved it, although I don’t know that much about Psy.D. programs because we don’t have them in Canada. Ideally you wouldn’t need a Ph.D. in order to be a registered practitioner and you would have some other form of real training that was appropriate to practice and then a Ph.D. would truly be a research degree. I don’t see that happening but that’s how it is in Europe and it’s actually a better model. DS: I’ve asked you a lot of questions and I’m wondering if there’s anything you feel would be important to add. LG: Well, related to this last topic, I do think there’s a human encounter in therapy and the human element that’s very undervalued and underemphasized in a Ph.D.type training environment. Ultimately, therapy is an encounter between two people and it’s a very personal experience. I think therapy transcends scientific study or some of the elements transcend scientific study,and thenit’s not valued sufficiently or paid sufficient attention. I believe in the scientific, investigative component but it’s how to get a balance between both the human, interpersonal perspective and the scientific, investigative perspective and to value them both. Whereas now it’s more valuing of the scientific, objective perspective and devaluation of the more human helping perspective and this is unfortunate. It would be best to integrate these two perspectives with respect for both.
  • 12. 116 Sloan REFERENCES Greenberg, L. S. (in press). Emotion coaching. Washington, DC: American Psychological Association Press. Greenberg, L. S. (2001). Emotion-focused therapy: Coaching clients to work through their feelings. Washington, DC: American Psychological Association Press. Greenberg, L. S., & Johnson, S. (1988). Emotionally focused couples therapy. New York: Guilford Press. Greenberg, L. S., & Paivio, S. (1997). Working with emotion in psychotherapy. New York: Guilford Press. Greenberg, L. S., Rice, L., & Elliott, R. (1993). The moment by moment process: Facilitating emotional change. New York: Guilford Press. Horvath, A., & Greenberg, L. S. (Eds.). (1994). The working alliance: Theory, research and practice. New York: Wiley. Rice, L., & Greenberg, L. S. (Eds.). (1984). Patterns of change: An intensive analysis of psychotherapeutic process. New York: Guilford Press.