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Common Questions

What is Attachment Therapy


Attachment therapy is based on the idea that early emotional attunement of a mother/caregiver (or lack of it) profoundly affects the child's psychological development .During the last 15 to 20 years, attachment theory has exerted more influence in the field of psychotherapy than just about any other model, approach, or movement.

Research supports that people who are insecurely attached are likely to demonstrated emotional, social and cognitive problems (Siegal, 2010).  The Adult Attachment Interview, which takes about 1 hour to administer allows the therapist to determine the nature of the attachment type of the client and work appropriately based on the results.   Furthermore, the interview has been found capable of targeting, with more than 80-percent predictability, 18 months before the child is even born, how a child of the adult interviewee would be attached to his/her parent.

The insecurely attached infant never got the maternal neural imprinting that would help her learn to regulate their own nervous system, thus making them susceptible to uncontrollable storms of inconvenient and unpleasant feelings throughout much of her life gets a chance at neurobiological-psychological repair from an attuned therapist, ready to meet them emotionally where they were—via nonverbal, affect-mediating, right-brain-to-right-brain communication—to help them undertake a kind of affective makeover.  An emotionally rich connection with a therapist can also change both brain and mind in a positive way.

Though not a clinical methodology, it has justified a whole range of therapeutic perspectives and practices. Among them are a particular sensitivity to the role of traumatic or neglectful ties with early caregivers; the fundamental importance of affect regulation to successful therapy; the importance of establishing relationships with clients characterized by close, intense, emotional, and physical attunement; and the ultimate goal of recreating in therapy an attachment experience that makes up, at least to some degree, for what the client missed the first time around. That attachment theory itself has amassed a vast body of empirical evidence is often taken, by extension, to cast a glow of scientific credibility on attachment-based therapy.  

Adapted from Wylie & Turner, (2013)

 What is EFT (Emotionally Focuses Therapy)

"All of us, from the cradle to the grave, are happiest when life is organized as a series of excursions, long or short, from the secure base provided by our attachment figures."
- John Bowlby
Couples come into therapy when they are experiencing distress. Most often, they are caught in a circular argument over a particular issue or issues. Over and over again they keep repeating the same negative interaction the leaves them feeling disconnect, distant and emotionally isolated from their partners.
When we are caught in theses negative patterns, it is difficult to see, that the negative cycle is causing more distress than the original difference or argument.
That's where marriage counselling comes in!
Marriage counselling or couples therapy provides a place where both partners can share their thoughts, feelings and concerns with an unbiased other who can help weed throughout the distress to uncover what's really going on for each partner. Couples therapy helps by slowing things down allowing for a new conversation to emerge.
The model I use while working with couples was originally created 30 years ago by Sue Johnson of Ottawa University and Les Greenberg of Toronto (York University) and is call Emotionally Focused Therapy.  Since that time Sue Johnson and her colleagues Gail Palmer and Alison Lee of the Ottawa Couple and Family Institute have made EFT what it is today - one of the most used models of couples therapy.
Emotionally Focused Therapy for Couples (EFT) offers a comprehensive theory of adult love and attachment, as well as a therapy process for healing distressed relationships.  It recognizes that relationship distress results from a perceived threat to basic adult needs for safety, security, and closeness in intimate relationships. EFT helps couples by working to strengthen attachment bonds. Having strong attachment bonds means couples feel safe together, know they are most important to their partner, are more flexible in problem solving, communicate, and feel securely connected.  The same old fight is finally resolved. The walls that kept you away from each other crumble away and the feelings that brought you together in the beginning revive and grow.
EFT research has been published in professional journals proving its effectiveness. As a model of therapy, it is respected widely in the field as is the therapy co-originator, award winning psychologist, Dr. Susan Johnson.  Over the past 30 years many research studies have proven EFT works!
It is less about the content/issues that couples fight about and more about how couples fight/ interact that makes them feel unsafe and therefore defensive.
EFT helps couples de-escalate, slow things down and start to feel, think and express to their partner, what is really going on for them under the surface, to help them connect in a more powerful and loving way.

Emotionally Focused Therapy was created by Sue Johnson and Les Greenberg almost thirty years ago. Today it has been proven that it is an effective treatment for distressed couples and is considered a short term therapy. In EFT research studies, most couples (over 70%) turned their relationship around in 15 – 20 sessions and over 90% of couples “significantly improved” when seeing a trained  EFT Therapist.
EFT Research
Following the short summary is a list of studies and commentaries on Emotionally Focused Therapy research.
Short Summary of EFT Research
Question: Does EFT conform to any “Gold” standard in terms of research validation and the standards set out for psychotherapy? 
In terms of the gold standard set out by bodies such as APA for psychotherapy research, EFT epitomizes the very highest level set out by this standard. Over the last 25 years, the EFT research program has systematically covered all the factors set out in optimal models of psychotherapy research. 
The meta-analysis (Johnson et al, 1999) of the four most rigorous outcome studies conducted before the year 2000, showed a larger effect size (1.3) than any other couple intervention has achieved to date. Studies consistently show excellent follow-up results, and some studies show that significant progress continues after therapy. EFT has a body of process research showing that change does indeed occur in the way that the theory suggests. This level of linkage between in-session process and rigorous outcome measurement is unusual in the field of psychotherapy. 
EFT is the only model of couple intervention that uses a systematic empirically validated theory of adult bonding as the basis for understanding and alleviating relationship problems. The generalizability of EFT across different kinds of clients and couples facing co-morbidities such as depression and PTSD has been examined and results are consistently positive. Outcome and process research addressing key relationship factors, such as the forgiveness of injuries, has also been conducted with positive results. EFT studies are generally rigorous and published in the best peer reviewed journals. 
In brief, EFT researchers can show that, as set out in the Johnson 2004 seminal text, Creating Connection: The Practice of Emotionally Focused Couple Therapy, EFT works very well, results last, we know HOW it works so we can train therapists to intervene efficiently and we know it works across different populations and problems. It also links congruently to other bodies of research such as those examining the nature of relationship distress and adult attachment processes. 
Recent research involves outcome studies of couples facing trauma (the Dalton and MacIntosh studies, and a study on EFT effects on attachment security with an FMRI component.) The FMRI component shows that EFT changes the way contact with a partner mediates the effect of threat on the brain. There is an outcome study in progress of the new educational program based on EFT (Hold Me Tight® Program: Conversations for Connection). A pilot study has also just been completed at the VA in Baltimore on EFT with veteran couples dealing with PTSD. 
Completed and ongoing EFT research consistently supports the efficacy of the Emotionally Focused Therapy model. Rev. 5 – August 2012 
Page 2 of 5 
Outcome Research
1. Greenman, P.S., & Johnson, S.M. (2012). United We Stand: Emotionally Focused Therapy (EFT) for Couples in the treatment of post-traumatic stress disorder. Journal of Clinical Psychology: In Session, Vol.68(5), 561-569. 
2. Denton, W.H., Wittenborn, A.K., & Golden, R.N. (2012) Augmenting antidepressant medication treatment of depressed women with emotionally focused therapy for couples: A randomized pilot study. Journal of Marital and Family Therapy, Vol.38, Supplement s1, 23-38. 
3. Naaman, S., & Johnson, S. M., & Radwan, K. (in review) Evaluation of the clinical efficacy of emotionally focused therapy on psychological adjustment of couples facing early breast cancer. Psychiatry: Biological and Interpersonal Processes. 
4. Dalton, J., Greeman, P., Classen, C., & Johnson, S. M. (manuscript under review) Nurturing Connections in the Aftermath of Childhood Trauma: A randomized controlled trial of Emotionally Focused Couple Therapy (EFT) for Female Survivors of Childhood Abuse. Couple and Family Psychology: Research and Practice. 
5. Greenman, P.S., Faller, G., & Johnson, S.M. (2011). Finding the words: Working with men in Emotionally Focused Therapy (EFT) for couples. In D.S. Shepard & M. Harway (Eds.), Engaging men in couples therapy (pp. 91-116). New York: Routledge. 
6. McLean, L.M., Walton, T., Rodin, G., Esplen, M.J., & Jones, J.M. (2011) A couple-based intervention for patients and caregivers facing end-stage cancer: outcomes of a randomized controlled trial. Article first published online: Sept.14, 2011 in Psycho-Oncology. 
7. Halchuk, R., Makinen, J. & Johnson, S. M. (2010) Resolving Attachment Injuries in Couples using Emotionally Focused Therapy: A 3 year follow-up. Journal of Couple and Relationship Therapy, 9, 31-47. 
8. Honarparvaran, N., Tabrizy, M., & Navabinejad, Sh. (2010) The efficacy of emotionally focused couple therapy (EFT-C) training with regard to reducing sexual dissatisfaction among couples. European Journal of Scientific Research, 43(4), 538-545. 
9. MacIntosh, H.B. & Johnson, S. (2008) Emotionally focused therapy for couples and childhood sexual abuse survivors. Journal of Marital and Family Therapy, 34, 298-315. 
10. Couture-Lalande, M.-E., Greenman, P.S., Naaman, S. & Johnson, S.M. (2007) Emotionally focused therapy (EFT) for couples with a female partner who suffers from breast cancer: an exploratory study. Psycho-Oncology, 1, 257–264. (Journal of the Psychological, Social and Behavioral Dimensions of Caner). 
11. Couture-Lalande, M.-E., Greenman, P.S., Naaman, S. & Johnson, S.M. (2007) La therapie de couple axe sur l'emotion (EFT) our traiter les couples donts la femme a le cancer du sein: une etude exploratoire. Psycho-Oncologie, 1, 1-8. 
12. Makinen, J. A. & Johnson, S. (2006) Resolving Attachment Injuries in Couples using EFT: Steps Toward Forgiveness and Reconciliation. Journal of Consulting and Clinical Psychology. 74(6), 1055-1064. 
13. Dessaulles, A., Johnson, S. M. & Denton, W. (2003) Emotion Focused Therapy for Couples in the Treatment of Depression: A Pilot Study. American Journal of Family Therapy, 31, 345-353. 
14. Clothier, P., Manion, I., Gordon-Walker, J. & Johnson, S. M. (2002) Emotionally Focused Interventions for Couples with Chronically Ill Children: A two year follow-up. Journal of Marital and Family Therapy, 28, 391-399.  
15. Denton, W., Burleson, B., Clark, T., Rodriguez, C. & Hobbs, B. (2000) A Randomized Trial of Emotionally Focused Therapy for Couples in a Training Clinic. Journal of Marital and Family Therapy, 26, pp. 65-78. 
16. Johnson, S., Hunsley, J., Greenberg, L. & Schindler, D. (1999) Emotionally Focused Couples Therapy: Status & challenges (A meta-analysis). Journal of Clinical Psychology: Science and Practice, 6, 67-79. NOTE: Also listed under Meta-Analyses 
17. Johnson, S., Maddeaux, C. & Blouin, J. (1998) Emotionally Focused Family Therapy for Bulimia: Changing Attachment Patterns. Psychotherapy: Theory, Research & Practice, 35, 238-247. 
18. Gordon-Walker, J., Johnson, S., Manion, I. & Cloutier, P. (1996) Emotionally Focused Marital Intervention for Couples with Chronically Ill Children. Journal of Consulting & Clinical Psychology, 64, 1029-1036. 
19. McPhee, D. & Johnson, S.M. (1995) Marital Therapy for Women with Low Sexual Desire. Journal of Sex and Marital Therapy, 21, 159-182. 
20. Dandeneau, M. & Johnson, S. (1994) Facilitating Intimacy: Interventions and Effects. Journal of Marital & Family Therapy, 20, 17-33. 
21. Goldman, A. & Greenberg, L. (1992) Comparison of Integrated Systemic and Emotionally Focused Approaches to Couples Therapy. Journal of Consulting and Clinical Psychology, 60(6), 962-969. 
22. James, P. (1991) Effects of a Communication Training Component Added to an Emotionally Focused Couples Therapy. Journal of Marital & Family Therapy, 17, 263-276. 
23. Johnson, S. & Greenberg, L. (1985) Emotionally Focused Couples Therapy: An Outcome Study. Journal of Marital & Family Therapy, 11, 313-317. 
24. Johnson, S. & Greenberg, L. (1985) The Differential Effectiveness of Experiential and Problem Solving Interventions in Resolving Marital Conflict. Journal of Consulting & Clinical Psychology, 53, 175-184. (EFT, CBT and controls tested.) 
Process & Predictors Research
1. Furrow, J.L., Edwards, S.A., Choi, Y., & Bradley, B. (2012) Therapist presence in emotionally focused couple therapy blamer softening events: promoting change through emotional experience. Journal of Marital and Family Therapy, Vol.38, Supplement s1, 39-49. 
2. Wittenborn, A.K. (2012) Exploring the Influence of the Attachment Organizations of Novice Therapists on their Delivery of Emotionally Focused Therapy for Couples. Journal of Marital and Family Therapy, Vol.38, Supplement s1, 50-62. 
3. Zuccarini, D.J., Johnson, S.M., Dalgleish, T. & Makinen, J. (submitted for review) Forgiveness and reconciliation in EFT for couples: The client change process and therapist interventions. Submitted to the Journal of Marriage and Family Therapy. 
4. Denton, W., Johnson, S. & Burleson, B. (2009) Emotion-Focused Therapy-Therapist Fidelity Scale (EFT-TFS): Conceptual Development and Content Validity. Journal of Couple and Relationship Therapy, 8, 226-246. 
5. Bradley, B. & Furrow, J. L. (2004) Toward a Mini-theory of the Blamer Softening Event: Tracking the Moment-by-Moment Process. Journal of Marital and Family Therapy, 30(2), 233- 246. 

What is Naturopathic Medicine?

How Can Therapy Help Me?

What is EMDR (EyeMovement Desensitization & Reprocessing)?

What is EFT (Emotion Focused [Couples] Therapy)?

Do I really need therapy?  I can usually handle my problems?

Why do people go to therapy and how do I know if it is right for me? 

What is Therapy Like?

What about medication vs. psychotherapy?

Do you take insurance, and how does that work?

Does what we talk about during therapy remain confidential?

 What is Naturopathic Medicine?

Naturopathic medicine is is a distinct form of primary health care that provides an effective way of treating illness that identifies and eliminates the root cause of illness.  Also focus is on preventing future illness by determining and reducing genetic, dietary and lifestyle stressors and supporting the body to function optimally.
Naturopathic treatment draws from a number of modalities and is tailored to the individual. Depending on the naturopathic doctor’s approach and the needs of the individual patient, treatments may include clinical nutrition, botanical medicine, homeopathic medicine, physical treatments, acupuncture and Asian medicine, lifestyle counselling, or a combination of these.

There are six accredited schools of naturopathic medicine in North America.

A number of benefits are available from participating in therapy. Therapists can provide support, problem-solving skills, and enhanced coping strategies for issues such as depression, anxiety, relationship troubles, unresolved childhood issues, grief, stress management, body image issues and creative blocks. Many people also find that counselors can be a tremendous asset to managing personal growth, interpersonal relationships, family concerns, marriage issues, and the hassles of daily life. Therapists can provide a fresh perspective on a difficult problem or point you in the direction of a solution. Some of the benefits available from therapy include:
  • Attaining a better understanding of yourself, your goals and values
  • Developing skills for improving your relationships
  • Finding resolution to the issues or concerns that led you to seek therapy
  • Learning new ways to cope with stress and anxiety
  • Managing anger, grief, depression, and other emotional pressures
  • Improving communications and listening skills
  • Changing old behavior patterns and developing new ones
  • Discovering new ways to solve problems in your family or marriage
  • Improving your self-esteem and boosting self-confidence
EMDR™ is a fast acting treatment (in as little as 3 sessions) for emotional distress which has been empirically validated in over 24 randomized studies of people struggling with trauma.   It uses bilateral stimulation (the therapist facilitates eye movements or tapping) which allows the brain to integrate old traumas and heal.   In a session the patient brings to mind a disturbing memory or emotion and the therapist facilitates eye movements specifically demonstrated to heal distressing memories.  EMDR has been demonstrated to be more effective than talk therapy in resolving symptoms of  emotional distress.
What is EFT (Emotions Focused [Couples] Therapy)?

EFT is the most  clinically proven approach to improving relationships.  Research links the quality of intimate relationships and social support to individual and psychological health, through mechanisms such as the immune system functioning and the amelioration of life stress and trauma.  EFT focuses on emotion as a powerful and necessary agent of change, rather than as simply part of the relationship distress.  Research shows couples undergoing EFT have a 70 to 73 percent recovery rate from marital distress in 10 to 12 sessions and 90 percent of couples see a significant improvement in their relationship.  
Everyone goes through challenging situations in life, and while you may have successfully navigated through other difficulties you've faced, it is a good choice to seek out extra support when you need it. In fact, therapy is for people who have enough self-awareness to realize they need a helping hand. You are taking responsibility by accepting where you are at in life and making a commitment to change the situation by seeking therapy. Therapy provides long-lasting benefits and support, giving you the tools you need to reeach your full potential as a human being by learning new healthier thinking patterns and the skills to overcome whatever challenges you face. 

Why do people go to therapy and how do I know if it is right for me?

People have many different motivations for coming to psychotherapy.   Some may be going through a major life transition (unemployment, divorce, new job, etc.), or are not handling stressful circumstances well.  Some people need assistance managing a range of other issues such as low self-esteem, depression, anxiety, addictions, relationship problems, spiritual conflicts and creative blocks.  Therapy can help provide some much needed encouragement and help with skills to get them through these periods.  Others may be at a point where they are ready to learn more about themselves or want to be more effective with their goals in life.   In short, people seeking psychotherapy are ready to meet the challenges in their lives and ready to make changes in their lives. 
Because each person has different issues and goals for therapy, therapy will be different depending on the individual.  In general, you can expect to discuss the current events happening in your life, your personal history relevant to your issue, and report progress (or any new insights gained) from the previous therapy session.  Depending on your specific needs, therapy can be short-term, for a specific issue, or longer-term, to deal with more difficult patterns or your desire for more personal development.  Either way, it is most common to schedule regular sessions with your therapist (usually weekly, biweekly or monthly).
It is important to understand that you will get more results from therapy if you actively participate in the process.  The ultimate purpose of therapy is to help you bring what you learn in session back into your life. Therefore, beyond the work you do in therapy sessions, your therapist may suggest some things you can do outside of therapy to support your process - such as reading a pertinent book, journaling on specific topics, noting particular behaviors or taking action on your goals. People seeking psychotherapy are ready to make positive changes in their lives, are open to new perspectives and take responsibility for their lives.   
It is well established that the long-term solution to mental and emotional problems and the pain they cause cannot be solved solely by medication. Instead of just treating the symptom, therapy addresses the cause of our distress and the behavior patterns that curb our progress. You can best achieve sustainable growth and a greater sense of well-being with an integrative approach to wellness.  Working with your medical doctor you can determine what's best for you, and in some cases a combination of medication and therapy is the right course of action. 

To determine if you have mental health coverage through your insurance carrier, the first thing you should do is call them.  Check your coverage carefully and make sure you understand their answers.  Some helpful questions you can ask them:
  • What are my mental health benefits?
  • What is the coverage amount per therapy session?
  • How many therapy sessions does my plan cover?
  • How much does my insurance pay for an out-of-network provider?
  • Is approval required from my primary care physician? 
Confidentiality is one of the most important components between a client and therapist. Successful therapy requires a high degree of trust with highly sensitive subject matter that is usually not discussed anywhere but the therapist's office.   Every therapist should provide a written copy of their confidential disclosure agreement, and you can expect that what you discuss in session will not be shared with anyone.  This is called “Informed Consent”.  Sometimes, however, you may want your therapist to share information or give an update to someone on your healthcare team (your Physician, Naturopath, Attorney), but by law your therapist cannot release this information without obtaining your written permission.
However, provincial law and professional ethics require therapists to maintain confidentiality except for the following situations:
* Suspected past or present abuse or neglect of children, adults, and elders to the authorities, including Child Protection and law enforcement, based on information provided by the client or collateral sources.
* If the therapist has reason to suspect the client is seriously in danger of harming him/herself or has threated to harm another person.



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