Using Micro-analyzing Tools to Investigate Therapist Skills in Emotionally Focused Couples Therapy With Couples in a High-Conflict Relationship
Abstract
The study focuses on the initial phase of emotionally focused therapy (EFT) and explores techniques and skills therapists employ to break and de-escalate conflictual cycles in relationships. Using micro-analysis, the researchers examined a 50-minute therapy session with a couple in a high-conflict relationship that was conducted by Dr. Susan Johnson. The research team identified and classified the therapist's skills with moment-by-moment interactional processes. A tiering system was developed to examine skills. A total of 404 therapist skills were analyzed. We observed reflecting 90 times, reframing 84 times, cycle work 56 times, validating 50 times, asking evocative questions 48 times, accessing underlying emotions 32 times, heightening emotions 28 times, and enactmentlike skills 16 times. Results showed that the therapist combined active listening methods with EFT-specific strategies such as accessing underlying emotions, highlighting emotions, tracking interactional cycles, and facilitating communication via enactments. Findings are discussed along with implications for clinical training.
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Emotional IPV victimization is associated with adverse mental health outcomes, including PTSD, anxiety, depression, suicidal thoughts, borderline personality disorder, and psychological distress.
“Emotional IPV victimization has been associated with adverse mental health outcomes, including post-traumatic stress disorder (PTSD), anxiety, depression, suicidal thoughts, borderline personality disorder, and psychological distress”
From Systematic review on the treatment of emotional abuse victimization in women by an intimate partner (2025) · cites this paper as Karakurt et al., 2023a, b
When emotional abuse is present at baseline, batterer intervention treatments are less effective, and perpetrators are more likely to continue being abusive.
“Past research also indicated that when emotional abuse is present at the baseline, treatment effectiveness is much lower for the batterer intervention treatments in that perpetrators are more likely to continue to be the abuser in the relationship (Karakurt et al., 2023a, b).”
From Systematic review on the treatment of emotional abuse victimization in women by an intimate partner (2025) · cites this paper as Karakurt et al., 2023a, b
For emotional abuse survivors, clinicians focusing on microinteractions during therapy sessions help detect subtle signs of progress, and highlighting pivotal moments is particularly crucial.
“For emotional abuse survivors, clinicians focusing on microinteractions during therapy sessions help detect subtle signs of progress, and highlighting pivotal moments is particularly crucial (Karakurt et al., 2023a, b).”
From Systematic review on the treatment of emotional abuse victimization in women by an intimate partner (2025) · cites this paper as Karakurt et al., 2023a, b
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References 45 · Cited by 1
- Authors
- Karakurt, G., Katta, P., Apte, S., Choi, J., Doan, C., Gole, S., & Jordan, S.
- Affiliations
- Case Western Reserve University, Cleveland, Ohio
- Case Western Reserve University (US)
- University of Nevada, Las Vegas (US)
- Venue
- Journal of Systemic Therapies
- Publisher
- Guilford Publications
- Published
- 2023-03
- Volume
- 42
- Issue
- 1
- Pages
- 74-95
- ISSN
- 1195-4396 (ISSN-L)
- OpenAlex
- W4385455144
- Cited by
- 1
- References
- 45
- Citations by year
- 2025: 1
- FWCI
- 0.29
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Systemic Therapies (publishedVersion)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Counseling, Therapy, and Family Dynamics
- Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
- Social Sciences › Psychology › Social Psychology › Counseling Practices and Supervision
- Keywords
- emotionally focused therapy, couple therapy, therapist skills, microanalysis, de-escalation, reflection, reframing, validation, enactment, active listening, clinical teaching
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