Emotion-focused therapy for distress-based psychopathology in adults: A systematic review and meta-analysis

In the current study, we review and meta-analyze the existing clinical trials of emotion-focused therapy (EFT) for treating a wide variety of distress-based forms of psychopathology, including depression, generalized anxiety, posttraumatic stress disorder (PTSD), and borderline personality symptomology.

We conducted a systematic review and meta-analysis of existing published clinical trials through April 2025 of EFT for distress-based dysfunction.

We located 13 existing articles (n = 348 participants receiving EFT; 201 receiving control) that met inclusion criteria. Most studies examined EFT for depression, while a significant number measured anxiety as an outcome, and two examined PTSD symptoms. EFT significantly outperformed inactive controls (g = 1.39, 95% CI = [1.06, 1.72]) but not other psychotherapies (g = .28, 95% CI = [-.19, .76]). Limitations of the existing research include evidence of publication bias and a strong focus on women and White/Iranian populations. Additionally, the quality of existing research is largely poor with varying methodological problems, including small sample sizes, inadequate randomization, and failure to account for dropouts.

EFT appears to be modestly effective for the examined concerns. Future researchers should prioritize examining EFT with more methodologically rigorous designs in more culturally and gender diverse populations.