Treating attachment injured couples with emotionally focused therapy: a case study approach

This paper compared the attachment injury resolution process in two distressed couples undergoing ten sessions of Emotional Focused Therapy (EFT), a short-term empirically validated treatment for relational distress. An attachment injury is a newly coined clinical construct that denotes a specific type of betrayal within the couple's relationship. The incident is so potent that it calls into question assumptions about the safety of the relationship. The task analytic method was used to examine the pathways of change as related to attachment injury of each couple. Several outcome and process measures were employed in order to differentiate the therapeutic process between the resolved versus non-resolved couple. Results indicated that the couple who resolved their identified attachment injury at the outset of therapy adhered to the attachment injury resolution model, while the non-resolved couple showed marked deviations from the expected pathways of change. Findings suggest that the resolved couple tended to show more differentiation of interactional positions and greater levels of experiencing throughout the therapeutic process in relation to the non-resolved couple. It is recommended that further research is necessary to examine the clinical utility of the attachment injury resolution model in the context of a larger number of case studies.