The Development of a Brief Session-Level Process Measure for Emotion-Focused Couple Therapy

Emotion-focused therapy for couples (EFT-C) has a strong tradition of delineating mechanisms of change. These change processes are typically examined using labor-intensive observational methods, which may not be practical for clinicians or researchers who aim to routinely monitor changes in therapy processes as they unfold across therapy sessions. The current study describes the EFT-C Process Measure (ECPM), a short, easily administered, eight-item questionnaire that can complement more traditional observational methods. The ECPM uses a systemic framework (assessing one's experience as well as one's perception of the partner's experience) and can be administered at the end of each session to capture the key processes of change in EFT-C (cycle understanding, accessing vulnerability, sharing vulnerabilities, responsive expression). We used data from 1033 session reports obtained from 44 couples receiving EFT-C to examine the validity of this measure. The results indicated that the ECPM evidenced convergent and discriminant validity (it was associated with reports of the therapeutic alliance), criterion validity (it was associated with reports of session evaluation and relationship satisfaction), and incremental validity for its systemic framework. Additionally, the ECPM proved sensitive in tracking change processes from session to session and capturing the expected increase in process engagement throughout the course of therapy. Although a complete validation of this tool requires a larger sample, the ECPM may be used by researchers and clinicians to obtain insights into the change process in EFT-C.