Transdiagnostic Emotion-Focused Therapy for Couples with Co-Morbid Relational and Mood, Anxiety and Related Difficulties

Abstract There is a clear association between relational dissatisfaction in romantic relationships and elevated mental health issues such as depression and anxiety. The association can run in both directions and adds complexity to both relationship and individual difficulties. One of the most studied relationship therapy approaches, emotion-focused therapy (EFT) for couples, focuses on the interactional cycle between partners and also stresses the importance of soothing individual vulnerabilities in order to transform troublesome relational interactions. Thus far, there has not been an attempt to describe a systematic framework for using EFT to work with couples with co-morbid mental health issues. This paper aims to address this gap. It builds upon both recent work in transdiagnostic EFT for individuals, and the EFT for couples framework as optimal scaffolding for a transdiagnostic EFT approach that targets relational issues as well as depression- and anxiety-related presentations in couples. The paper outlines several ways how individual’s chronic emotional vulnerability has the potential to rise to clinical levels of distress and complicate a romantic relationship. The paper then outlines specific therapeutic strategies how to work with individual’s emotional vulnerability and symptom distress it may bring, in the context of the couple relationship. The individual’s emotional vulnerability work is tracked along with relational interactions, in an effort to provide healing and transformational interactions and emotional experiences. A case example from a current research project is outlined to illustrate the use of specific therapeutic strategies and the clinical application of the transdiagnostic EFT approach to couple therapy.