Quiz for Final--EFT

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Which of the following is not a goal of EFT --- A. To expand and reprocess the key emotional responses that make up the "music" of the dance between intimates. B. To create a more secure bond between partners. C. To restructure interactions toward accessibility, responsiveness, and engagement. D. To de-escalate arguments so that the couple are effective negotiators.

ANSWER: D

Which of the following is not an essential role of the EFT therapist --- A. Process consultant. B. Creator of a safe haven and secure base in each session. C. Surrogate processor of emerging experience. D. Supportive, collaborative partner in the change process. E. Choreographer of key change events in therapy. F. Coach in the practice of specific new communication skills.

ANSWER: F

Change occurs in EFT primarily through which two ways ---- A. New corrective emotional experiences. Core attachment responses then take on a new shape and color. B. New emotional moves create new relational events that redefine the security of the bond between partners. C. Revision of the dominant story of a distressed relationship and the externalizing of problems. D. Creating new problem-solving and communications skill sequences. E. Insight into past childhood dynamics and unconscious wishes.

ANSWER: A & B

Pick three contraindications for EFT ---- A. Ongoing abusiveness/violence in a relationship, especially if the "victim" expresses fear and/or the "perpetrator" does not take responsibility. B. Discordant goals; for example, where one partner has already disengaged and exited from the relationship and the other desires reconnecting. C. The inability to create any kind of collaborative alliance. D. Depression or posttraumatic stress in one partner. E. An "inexpressive" style in the male partner. F. Less education and lower socioeconomic status of clients.

ANSWER: A, B & C

Of the three elements of the therapeutic alliance -- bond with the therapist, agreement about goals of therapy, and the perceived relevance of therapy tasks -- the element of the therapeutic relationship found to be the most predictive of outcome in EFT is: A. The bond aspect of the alliance between each partner and the therapist. B. The goal agreement aspect of the alliance between each partner and the therapist. C. The task aspect of the alliance: how relevant processes and tasks feel in the sessions.

ANSWER: C

Sue Johnson coined the phrase: A. The dance of intimacy, B. The boxer's challenge, C. Empathic attunement, D. The dance of emotions

ANSWER: A

Which of the following is NOT a technique used in EFT? A. Heightening, B. Evocative responding, C. Empathic attunement, D. Unconditional positive regard

ANSWER: D

Which of the following is NOT part of the Attachment theory according to EFT? A. Attachment offers a safe haven, B. Attachment offers a secure base, C. The level of attachment a parent has with their child, D. Fear and uncertainty activate attachment needs

ANSWER: C

T or F:
EFT showed in meta-analysis a 70-73% recovery rate in 10-12 sessions.

True.

T or F:
EFT has a relapse problem, after therapy is discontinued.

False.

What are the four steps in Stage 1 of EFT?

step 1) assessment step 2) identify negative interaction cycle step 3) access unacknowledged emotions step 4) reframe the problem in terms of the cycle

what are the three stages of EFT?

1) cycle de-escalation, 2) changing interactional positions, 3) consolidation and integration

what are the three steps in Stage 2 of EFT?

1--step 5) promote identification with disowned attachment emotions, 2--step 6) promote acceptance of each partner by the other, 3--step 7) facilitate expression of needs to restructure interaction based on new understanding

what are the two steps in Stage 3 of EFT?

1--step 8) facilitate emergence of new solutions to old problems, 2--step 9) consolidate new positions and cycles of attachment behaviors

What are the three primary tasks of the EFT therapist throughout the treatment process?

1) create an alliance, 2) facilitate the identification, expression, and restructuring of emotional responses, 3) restructure interactions and choreograph new relationship events

What is a "focus point" for EFT?

Strong affect interruptions, absence of affect, landmarks, responses to positive behaviors

what is "the dance" in EFT?

the recurring sequences of interaction that perpetuate the distress

in EFT, negative interaction cycles are seen in terms of

separation protest and attachment insecurity

common interventions in EFT include:

1) empathic conjecture, 2) evocative responding, 3) validation, 4) reflecting emotional experience, 5) RISSC, 6) heightening, 7) reframing, 8) tracking the cycle

RISSC stands for?

repeat, images, slow, soft, simple, client's words

◦ Secure

▪ Confidence in connection with loved one, resulting in ability to modulate distress on
separation
▪ I can count on you to be there for me when I need you. I can trust you. I am lovable and able to elicit caring
▪ Less likely to sit back in the corner and say well he didn't notice that I am sad today. Secure people let their spouse know.
▪ Able to acknowledge & give clear signals about attachment needs & to reach for & make reassuring contact with attachment figure
▪ Able to return to exploring environment

◦ Anxious

▪ Clinging, pursuit, frequent bids for reassurance/Always need to be complimented
▪ Attachment emotions/concerns go into overdrive
▪ Become vigilant for threat
▪ Bids for attention escalate into angry blaming & coercive demands
▪ Ambiguous cues about other's availability are received negatively
▪ Reactive, less coherent
▪ Tend to view themselves as flawed or unlovable
▪ Actively worried about abandonment
▪ Any type of threat, they up the anxious behaviors
▪ "Sometimes I can count on you but sometimes I can't. I don't know if I can trust you. Am I lovable?"
▪ Views of their selves comes from past relationships

◦ Avoidant

▪ Attachment emotions & concerns are generally deactivated & repressed
▪ Deactivation is deployed when avoidant partners or their partners become vulnerable or needy
▪ Prefer to focus on objects & instrumental tasks, away from attachment issues, & cues (emotions)
▪ Arousal is high, but awareness & expression of emotions is blunted & masked
▪ More likely to somatize, become hostile, engage in promiscuous sexuality (Do not want to think)
▪ Tend to disown vulnerability (will never admit they are lonely to spouse)
▪ See others as unreliable & untrustworthy
▪ State goals of wanting arguments to stop rather than changing relationship, closeness, or caring (Instrumental, not emotive)
▪ Feel very overwhelmed by an anxious person. Completely shut down
▪ Can start in infancy (ex. Orphanage)
▪ I can't count on you. I can't trust you. I don't need you.

◦ Stage 1--De-escalation of Negative cycle of Interaction.

• Key change events & the order in which they occur
▪ First shift and is also the first-order of change, in that the way interactions are organized remains the same, but the elements of the cycle are modified somewhat.
▪ Goal - for the partners to have a meta-perspective on their interactions

▪ Stage 2 - Restructuring the Bond

▪ Withdrawer engagement in Stage Two of Therapy
▪Second shift--This second shift occurs when the more withdrawn partner begins to become more active

◦ Blamer softening in Stage Two of Therapy

Third shift--▪ This third shift occurs when the previously hostile and more active spouse risks expressing his or her own attachment needs and vulnerabilities, allowing for interactions that challenge the trust level in the relationship.

▪ Steps to 3rd shift

▪ Begins to focus more on self, accessing attachment-related fears
▪ Example (I'm afraid you are not going to be there)

• Elements of the interactional cycle (diagram)

◦ Partner Name ◦ Neg. Cycle Marker ▪ Pursue/Withdrawal ▪ Criticize/Avoid
▪ Withdraw/Withdraw ▪ Attack/Attack

◦ Action Tendencies

▪ Behavioral response to emotional reactions
▪ Anger --> assert & defend ▪ Sadness --> seek support & withdraw ▪ Surprise --> attend & explore ▪ Disgust --> hide, expel, & avoid
▪ Fear --> flee, freeze, give up goal ▪ Joy --> contact & engage

◦ Secondary Emotions

▪ Obscures primary ▪ Reaction/attempt 2 cope
▪ Instrumental

◦ Primary Emotions

▪ Here & now ▪ Direct response

◦ Unmet Attachment Needs

▪ Either avoidant or anxious

◦ Stage One: Cycle De-escalation

▪ Goal:For the partners to have a meta-perspective on their interactions

▪ 1st Session EFT

▪ To connect with both partners & create alliance where both partners feel safe & accepted
▪ To assess the nature of the problem & the relationship
▪ To assess each partner's goals & agendas for therapy
▪ To create a therapeutic agreement between couple & therapist

Stage One

▪ To begin to make hypotheses about each's vulnerabilities & attachment issues ▪ To track & describe the typical & recurring sequences of interaction ▪ To begin to understand how their relationship evolved & what brought them to therapy ▪ To begin hypothesizing about the blocks to secure attachment & emotional engagement
▪ To sense how the couple responds to interventions & how difficult therapy is going to be

◦ Stage Two: Restructuring the Bond

▪ Goals:▪Access needs, fears, models of self and other ▪ Promote the acceptance of the other--expand the dance ▪ Structure the emotional engagement--express attachment needs

◦ Stage Three: Consolidation & Integration

▪ Goal: Reinforce new positions ▪ Help process thru recurrences of negative cycles ▪ Heighten new stories by tracking positive stances & interaxns ▪ Reflect new sol'ns to old issues--how far they have come, risks taken, there for each other, etc.

◦ Interventions - what are they & what are general descriptions

▪ Validation

▪ Validation

▪ Conveys the message that the partner's emotions and responses are legitimate and understandable.
-- their responses are the best solutions

▪ Empathic conjecture

▪ Encourages one of the partners to process his or her experience one step further

▪ Tracking & reflecting

▪ Pieces together the typical problematic interactions the couple engages in and tracks this cycle.

▪ Reframing

▪ Reframes each partner's behavior in terms of cycles of interaction and in terms of the other partner's behavior. ▪ Reframes help partners to see how they unwittingly help to create the other's distress and resulting negative responses.

▪ Evocative Responding

▪ Expanding felt sense of an emotional experience

• Typologies of abusers (Gottman, 1999)

◦ Type One: Violent Males (Cobras) ◦ Type Two: Violent Males (Pit Bulls)

2ndary emotion fear

comfort response helps

2ndary emotion anger

review response helps

2ndary emotion sadness

soothing response helps

Can I count on you... "no" =

insecure...avoidant/dismissing OR insecure/fearful

Can I count on you... "maybe" =

insecure... anxious/preoccupied

Can I count on you... "yes" =

Secure

Therapist challenges to doing EFT

-accurate empathy -tolerate and manage intense affect -understand the influence of attachment needs -accept mixed emotional signals/ambiguities -be willing to direct sessions as needed

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