Therapy Approaches: Cognitive-Behavioural Therapy (CBT) vs. Emotion-Focused Therapy (EFT) What is Right for Me?

Clients more than ever come to see a new therapist armed with treatment knowledge, possible diagnostics and self-insight. Many people know enough to say to a new therapist, “I chose you because you offer Emotion-focused therapy and mentioned attachment styles on your website”.

So it bears the question…Cognitive-behavioural Therapy vs. Emotion-focused Therapy? I find these are the most searched approaches.  Which is more effective? How do you know what works for you?

You will likely find that CBT is “evidence-based” and highly recommended. But I would suggest it is not that simple. All therapeutic approaches are effective, or they would not stand the test of time.

CBT was initially heavily researched as it can be offered either short-term or in a group format, so insurance companies and hospital treatment centres push CBT as best, less funding to help many people.

So what if you are willing to pay, have benefits and can choose what is right for you rather than worry about such practicalities?

Therapy Approaches: Emotion-Focused Therapy (EFT)

EFT is bottom-up way of processing, or starts with focusing on feelings and then processes through the neocortex, the logical parts of our brain, to fully process an emotion.

This process-oriented technique works with the theory feelings hit our body and amygdala first and can be blocked, frozen or stuck, not fully getting processed through the system. This can be for many reasons, including childhood trauma, when our brain was not fully developed.

Your therapist will use many ways to help you sit with, identify and fully process both present and past “frozen” feelings.

This can include somatic and mindful questioning exercises. Ex. Let’s use a visualization to find out what is happening in your body as you tell me that challenging story. What sensations do you feel right now?”

This will fully process those feeling sensations, enabling self-insight and, more importantly, the mitigation of mental health symptoms Ex. Anxiety.

This type of therapy can either be only 3 months or many years, depending on your personal and mental health history as well as identified goals.

You can choose one issue and target it, or see your therapist for an ongoing process until you feel significantly better.

This is a process therapy and takes patience and trusting your therapist and the therapeutic process. It can also transform your life.

Therapy Approaches: Cognitive-Behavioural Therapy (CBT)

CBT is a technique-based approach that teaches you a tool, or series of tools to address what this related theory sees as “disordered thoughts”.

An example of a disordered thought pattern that is common is “catastrophization” in which you tell yourself the consequences to a life event Ex. The power is out tonight, will have dire, long-lasting consequences, picturing the worst possible outcome. This is believed to cause the anxiety symptoms. The thoughts act as a fuel, causing further distress.

A CBT therapist will work with you through series of exercises to reframe or reshape this thought pattern so thoughts become more balanced, realistic.

They will also help you determine your “hot thought” that feeds your anxiety-provoking thoughts Ex. You cannot handle this, you are weak and inadequate to deal with simple life events”.

Exercises will be introduced to identify and treat these hot thoughts that lead to your distress. These are likely thoughts you have learned and believed most of your life, messaging you integrated.

This treatment can be short-term and taught in group settings. My fav book for CBT is Mind

Over Mood if you want to try these concrete exercises.

Dialectical-behavioural Therapy (DBT) is also a technique or exercise-based approach, but it is used to specifically target affect regulation, how to calm huge and seemingly out of control emotions. 

Clients who prefer CBT or technique-based therapies enjoy feeling in control of their treatment and the concreteness of doing something when distressed.

However, it is assumed to be a short-term treatment. This is not true. Many people take a CBT 8-week course, learn a point or two they like, feel symptom reduction and some relief.

However, the most effective way to use a technique like CBT is to learn the techniques thoroughly and deeply, long after the final session. Use these exercises for years to mitigate mental health symptoms and manage chronic anxiety, enabling automaticity.

In conclusion:

I hope a few things have occurred to you as you read this blog today.

Personality type is the biggest reason I find people choose the approach that speaks to them.

Some people want to feel in control and see a concrete path to recovery.

Some are ok with trusting a professional to guide and process through to recovery. Process-oriented therapies may not include homework, is likely longer term but includes less work after the treatment is concluded.

However, I would love to introduce the idea that CBT and EFT are not mutually exclusive at all. They can work really well together.

Many people come to me to try process-oriented therapy after learning CBT. They find it helps, but also crave a deeper therapy that further explores old patterns and includes learning to identify and fully process intense, repeating feelings.

In Canada, the majority of therapists identify as “eclectic” or are fully trained in several therapeutic approaches. This means you do not have to choose, you can integrate several approaches to tailor the perfect approach to reach your goals. Your only limitations are the training and experience of a chosen therapist.

Info on Eclectic Therapy, tailored to suit your needs

Eclectic Tailored Therapy for Personality Disorders

EFT with Lisa

DBT with Desiree

CBT with Hillary

Lisa S.