Previous publications on emotion-focused therapy (EFT) have explored couples’ therapy, trauma, and depression. Emotion-Focused Therapy for Generalised Anxiety is the first EFT approach to treating generalised anxiety disorder (GAD) and acts as an important addition to the collection, considering the high prevalence of GAD and sufferers’ susceptibility to relapse following treatment.
EFT, developed in the mid-1980s, sees emotion as the core feature in the formulation of a self-concept. As such, mental illness is seen to develop from the formation of maladaptive emotional schemes, primarily fear, shame and sadness, and an inability to appropriately respond to and regulate these emotions. These schemes and dysfunctional responses mean that individuals who are suffering have great difficulty in relating to themselves and others. To help clients with this, EFT focuses on several key aspects, namely the importance of the role of the therapeutic relationship, which aims to help clients achieve a stronger sense of self, the ability to relate to others and the ability to regulate emotional suffering. In addition, EFT aims to develop a client's narrative, which allows them to re-interpret certain experiences in their lives and heal wounds of the past.
The book has nine chapters, which can be grouped into three areas. The first three chapters explore the history of EFT, critique varying perspectives on GAD, and provide an EFT conceptualisation of GAD. Here readers are introduced to the first of only two conceptual models in the book, explaining that a client's worry and anxiety serves as a protective function against cues that will trigger memories of painful experiences, as well as feelings of fear, shame and sadness and an inability to soothe these emotions.
Chapters 4 and 5 are dedicated to the therapeutic relationship. An argument for the importance of a strong therapeutic relationship is presented, with reference to early Rogerian principles, coupled with modern neuroscientific understandings of the importance of therapist presence. Readers are given a guide on how to express therapeutic attitudes and an introduction on how to use the therapeutic relationship to strengthen the client's sense of self.
The remainder of the book, chapters 6 to 9, presents the elements involved in an EFT approach to GAD. Two-chair dialogues and empty-chair dialogues are explained in detail, where the former refers to a dialogue between the worrying/critical self and the self that experiences the consequences of this. Empty-chair dialogues involve expressing oneself to an imagined other. A particularly useful feature of these chapters involves identifying markers during therapy to using two-chair or empty-chair dialogues.
Chapter 6 also explores the symptom of worry in GAD and how the EFT approach intends to aid clients in taking control of their worry. Chapter 7 focuses on self-criticism and aims to change the client's way of perceiving themselves. Chapter 8 explores painful emotions and painful experiences, and chapter 9 provides a framework for how to help clients relate to themselves in a more compassionate way. Troubleshooting is provided at the end of each of these chapters.
The case formulation of EFT takes a context-specific approach, which means treatment length and the introduction of the various therapeutic elements vary widely. As such, this book is best read from beginning to end, and in its entirety. However, despite this set-up, the book is repetitive, which risks loss of focus when a new concept is masked by repetitive text.
Nonetheless, the text is a useful guide for clinicians intending to practise EFT for GAD. This approach is especially useful for clients presenting a long history of anxiety, disorganised attachments to others throughout childhood and adulthood, and issues relating to themselves or others.
Emotion-Focused Therapy for Generalised Anxiety achieves what it sets out to achieve: a simple, well-structured manual for treating GAD. Expect no elaborate diagrams or pictures, just straightforward, well-conceptualised information, written so elegantly that entire excerpts could be repeated verbatim to clients or colleagues.
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