Academic journal article Journal of Marital and Family Therapy

Harnessing the Power of Play in Emotionally Focused Family Therapy with Preschool Children

Academic journal article Journal of Marital and Family Therapy

Harnessing the Power of Play in Emotionally Focused Family Therapy with Preschool Children

Article excerpt

Emotionally focused therapy (EFT) is an effective and widely used clinical model in the marriage and family therapy field (Byrne, Carr, & Clark, 2004; Johnson, 2004; Johnson & Wittenborn, 2012). It is a systemic, experiential, and attachment-focused model originally designed for adult couples that includes an emphasis on both intrapsychic and interpersonal processes. As such, EFT focuses both on the feelings and thoughts of each partner, as well as the interaction the couple has around the expression of these thoughts and feelings. Specifically, in EFT, therapists seek to facilitate couples' secure attachment by helping partners more fully experience and process their primary emotions. This leads to clearer expression of their attachment needs and communication of their feelings to their partner, who in turn is primed to remain engaged, open, and receptive. As individuals begin to recognize and express their needs more fully to their partner who is beginning to appreciate and genuinely validate their perspective, the couple's emotional experience of one another changes. The new experience of allowing oneself to be vulnerable with another who is responding empathically can shift partners' rigid negative interactional stances toward positions of greater emotional accessibility, flexibility, and sensitivity. These processes support the couple in developing attunement and understanding that can strengthen their emotional bond (Schore, 2003).

In the last 20 years, scholars have increasingly applied EFT concepts to working with families (Efron, 2004; Efron & Bradley, 2007; Johnson, 2004; Johnson & Lee, 2005; Johnson, Maddeaux, & Blouin, 1998; Johnson et al., 2005). They observed that parents and children frequently engage in demand-withdraw interactions similar to those seen in distressed couples treated with EFT, and that EFT techniques could also be helpful for building family cohesion and emotional connectedness in emotionally focused family therapy (EFFT: Johnson & Lee, 2005). Compared to EFT for couples, which is now a standardized and empirically supported therapeutic approach (Johnson & Wittenborn, 2012), EFFT is in an earlier stage of development. Nevertheless, EFFT has been used successfully with a variety of youth-based issues including bulimia, conduct problems, divorce, and family life cycle transitions (Dankoski, 2001; Johnson et al., 1998; Palmer & Efron, 2007; Schade, 2013; Wittenborn, Faber, Harvey, & Thomas, 2006).

An important contribution of EFFT related to working with children is its emphasis on strengthening affective bonds in family relationships. According to attachment theory, children's bond with their primary caregivers is central to helping children cultivate abilities, such as emotional regulation, self-esteem, and interpersonal skills, which can help them navigate life's challenges (Bowlby, 1983; Kobak & Mandelbaum, 2003; Sroufe, 2005). Key secondary family or other close emotional relationships, such as sibling relationships, also play an important role in children's development through increased opportunities for social skills building and emotional support (Dunn, 2000). When children's primary attachment relationships are distressed, they are likely to experience symptoms such as depression, anxiety, or behavior problems (Schore, 2003).

Children's attachment needs, including the need for closeness or comfort, are usually most powerful during times of family transition, such as loss, divorce/remarriage, adolescence, or the birth of a child (Dankoski, 2001). It is during such transitionary periods when parental time, patience, and energy are strained and family members may end up competing for attention (Johnson et al., 2005). Child referrals for mental health services are commonly associated with children's emotional or behavioral disturbances in response to such circumstances.

Emotionally focused family therapy offers a valuable framework for working with troubled children by facilitating attachment-building interactions in family relationships. …

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