Establishing Safety in Emotionally Focused Couple Therapy: A Single-Case Process Study

Emotionally Focused Couple Therapy (EFT) is an effective approach to working with distressed couples. It is not only effective in reducing relationship distress, but also in successfully maintaining gains over time. In the current study, we sought to understand the therapy processes that result in the creation of safety during stage one of EFT. Safety is a key ingredient in stage one, setting the stage for deeper interpersonal and intrapsychic work in later stages of treatment. In order to achieve the study aim, we analyzed video recordings of the first six sessions of a single couple case from an EFT randomized controlled trial. Using a theory building case study approach, results reveal that all expected components related to the creation of safety were achieved. Additional findings from our analyses indicate that the therapist was highly active, especially in seizing key moments in the therapy provided by this particular case, which shifted the couple in the direction of safety and deescalated their interactional cycle. Implications of key findings are discussed.