Deliberate Practice in Emotionally Focused Couple Therapy

Deliberate practice exercises provide trainees and students an opportunity to build competence in essential emotionally focused couple therapy (EFCT) skills while developing their own personal therapeutic style.

These exercises present role-playing scenarios in which two trainees act as a client and a clinician, switching back and forth under the guidance of a supervisor. The clinician improvises appropriate and authentic responses to client statements organized into three difficulty levels—beginner, intermediate, and advanced—that reflect common client questions and concerns.

Each of the first 12 exercises focuses on a single skill, such as offering evocative inquiries and reflections, deepening the client’s emotional experience of self and other, and choreographing interactions that promote positive emotional engagement. Two comprehensive exercises follow in which trainees integrate these essential skills into a single session.

Step-by-step instructions guide participants through the exercises, identify criteria for mastering each skill, and explain how to monitor and adjust difficulty. Guidelines to help trainers and trainees get the most out of training are also provided.

To demonstrate how deliberate practiceopens in new window can be fully integrated into a professional curriculum, this series features exercises developed and refined within the clinical training curriculum at the Sentio online/hybrid marriage and family therapy (MFT) therapist training programopens in new window in California, which is where we started developing this series. These exercises, which have been tested at clinical training sites around the world, are used to enhance clinical outcomes within the first hybrid MFT program approved by the California Board of Behavioral Sciencesopens in new window to fully integrate deliberate practice into its entire curriculum. By integrating these models into its hybrid MFT program in California, Sentio University demonstrates that therapist training graduate programs can use deliberate practice to bridge the gap between theory and clinical mastery through repetitive, feedback-informed practice to support the development of modern, outcome-focused clinicians.

Series Preface
Tony Rousmaniere and Alexandre Vaz

Acknowledgments

Part I. Overview and Instructions

• Chapter 1. Introduction and Overview of Deliberate Practice and Emotionally Focused Couple Therapy
• Chapter 2. Instructions for the Emotionally Focused Couple Therapy Deliberate Practice Exercises

Part II. Deliberate Practice Exercises for Emotionally Focused Couple Therapy Skills

Exercises for Beginner Emotionally Focused Couple Therapy Skills

• Exercise 1. Evocative Inquiry: Identifying Patterns and Eliciting Attachment Fears and Needs
• Exercise 2. Evocative Reflection: Eliciting and Heightening Emotional Experience
• Exercise 3. Validating Partners’ Experiences and Tracking Dysfunctional Patterns
• Exercise 4. Attachment-Reframed Validation
• Exercise 5. Deepening Emotions With RISSSSC: Speaking Simply, Slowly, and Softly

Exercises for Intermediate Emotionally Focused Couple Therapy Skills

• Exercise 6. Tracking the Therapist’s Inner Experience
• Exercise 7. Providing a Rationale for Emotionally Focused Couple Therapy

Exercises for Advanced Emotionally Focused Couple Therapy Skills

• Exercise 8. Gathering and Assembling Elements of Emotion
• Exercise 9. Enactments: Deepening Emotional Experience and Choreographing Engaged Encounters
• Exercise 10. Slicing the Risk Thinner: Helping Partners Express Difficult Emotions
• Exercise 11. Interrupting Negative Process Early in Therapy: Catching the Bullet I
• Exercise 12. Interrupting Negative Process Later in Therapy: Catching the Bullet II

Comprehensive Exercises

• Exercise 13. Annotated Emotionally Focused Couple Therapy Practice Session Transcript
• Exercise 14. Mock Emotionally Focused Couple Therapy Sessions

Part III. Strategies for Enhancing the Deliberate Practice Exercises 

• Chapter 3. How to Get the Most Out of Deliberate Practice: Additional Guidance for Trainers and Trainees

Appendix A. Difficulty Assessments and Adjustments

Appendix B. Deliberate Practice Diary Form

Appendix C. Sample Emotionally Focused Couple Therapy Syllabus With Embedded Deliberate Practice Exercises

References

Index

About the Authors

Hanna Levenson, PhD, is professor emerita at the Wright Institute in Berkeley, California. She also maintains a private practice in Oakland where she sees individuals and couples for therapy and professionals for consultation/supervision. Dr. Levenson has specialized in brief dynamic therapy and supervision for over 40 years. She has authored over 85 professional papers and multiple books, including Deliberate Practice in Psychodynamic Psychotherapy and Deliberate Practice in Accelerated Experiential Dynamic Psychotherapy, and has released five professional videos with APA illustrating her approaches. Dr. Levenson received the Distinguished Contribution to Psychology as a Profession Award given by the California Psychological Association.

Sam Jinich, PhD, is a certified trainer in emotionally focused couples therapy (EFCT). He specializes in clinical practice with couples from diverse backgrounds. He is founder and director of the San Francisco Center for Emotionally Focused Therapy and cofounder of EFT Academia in Argentina. As a bilingual and bicultural trainer, Dr. Jinich has been responsible for establishing EFCT in Mexico, Argentina, Costa Rica, Guatemala, Panama, Brazil, Chile, and Spain through mentoring and supervising practitioners, supervisors, and trainers. He was involved in the first-ever multinational randomized clinical-trial research study in Spanish on the effectiveness of general couples therapy and EFCT.

Alexandre Vaz, PhD, is chief academic officer of Sentio University marriage and family therapy (MFT) program in Californiaopens in new window. This innovative online/hybrid MFT programopens in new window was the first approved by the California Board of Behavioral Science for MFT licensure to fully integrate deliberate practiceopens in new window into its curriculum to ensure superior clinical outcomes. He is also director of clinical training for the Sentio Counseling Centeropens in new window which is Sentio MFT program’s guaranteed practicumopens in new window site where students provide low-cost online couples therapy in Californiaopens in new window. Dr. Vaz is the author/coeditor of many books on deliberate practice and psychotherapy training.

Tony Rousmaniere, PsyD, is president of Sentio University marriage and family therapy (MFT) program in Californiaopens in new window. He led the development of online/hybrid MFT programopens in new window, which is the first MFT therapist training program approved by the California Board of Behavioral Science for MFT licensure that fully integrates deliberate practiceopens in new window. Dr. Rousmaniere is the author/coeditor of many books on psychotherapy training. He is also the executive director of the Sentio Counseling Centeropens in new window, which is Sentio MFT program’s guaranteed practicumopens in new window site where students provide sliding-scale online therapy in Californiaopens in new window, and past president of the APA’s Division 29.

Emotionally focused couple therapy training needs more goal-directed exercises like the ones provided in this book. The deliberate practice exercises make training more specific and more relevant. We need to get this book in front of trainers and supervisors.
—Sue Johnson, EdD, Founding Director, International Centre for Excellence in Emotionally Focused Therapy, Ottawa, ON; Distinguished Research Professor, Alliant University, San Diego, CA, United States; and Professor Emeritus, Clinical Psychology, University of Ottawa, Ottawa, ON, Canada

A highlight in this groundbreaking series, Deliberate Practice in Emotionally Focused Couple Therapy is sure to become essential reading for those learning about or active in the practice of this therapy. Brilliantly structured around well-chosen exercises, the reader is helped not only to understand this approach but also with very specific ways on how to build competence with each of its fundamental methods.
—Jay Lebow, PhD, Clinical Professor and Senior Scholar, The Family Institute at Northwestern and Northwestern University, Evanston, IL, United States

Deliberate Practice in Emotionally Focused Couple Therapy powerfully illustrates and wisely guides a reader through the challenges and opportunities awaiting clinicians seeking to master this time-tested model of relationship change. The authors transform learning into practical confidence and curiosity into clinical competence.
—James L. Furrow, PhD, Couples and Family Therapy Program, Seattle University, Seattle, WA, United States

The focused specificity of the exercises in this book breaks down the therapeutic process into manageable micro moves and in the process empowers therapists to progress from confusion to competency and confidence.
—George Faller, MS, LMFT, EFT Trainer, Founder of New York Center for Emotionally Focused Therapy, New York, NY, United States

Whether you are new to the emotionally focused therapy approach to working with distressed dyads or an experienced clinician or mentor, this book is an excellent resource! An evidence-based approach to learning and mastery, this volume offers both a theoretical and scientific overview of the model and a step-by-step approach to not only skill development but also, as the authors aptly describe, the sweet spot for deliberate practice, the balance between procedural and declarative knowledge—art and science, method and map, fluidity and clarity. This book will sharpen the skills of any therapist and is a brilliant companion to anyone teaching the model!
—T. Leanne Campbell, PhD, ICEEFT Certified Trainer in EFT; coauthor with Dr. Sue Johnson of "A Primer for Emotionally Focused Individual Therapy (EFIT): Cultivating Fitness and Growth in Every Client"; and coauthor of "Becoming an Emotionally Focused Therapist: The Workbook"

This book is part of the Essentials of Deliberate Practice series by Tony Rousmaniere and Alexandre Vaz. The materials on this site include a Deliberate Practice Reaction Form that can be used with every book in this series, as well as volume-specific materials.

These documents are offered for your personal use in clinical training or teaching courses. If you reprint or adapt them for publication, permission is required from the publisher.

Deliberate Practice Reaction Form

The Deliberate Practice Reaction Form can be used with any of the deliberate practice exercises throughout the series to measure how challenging it was for the trainees and to adjust the difficulty as needed. Appendix A, which is the same across all books in the series, includes a black-and-white version of the form with instructions for assessing and modifying an exercise’s difficulty. A color version of the Deliberate Practice Reaction Form is also available for individual download.

• Appendix A: Difficulty Assessments and Adjustmentsopens in new window (PDF)
• Deliberate Practice Reaction Formopens in new window (PDF)

Volume-specific materials

The materials presented below are unique to Deliberate Practice in Emotion-Focused Therapy. They include a guide for understanding different types of empathic responses, with examples, and a sample syllabus that integrates the deliberate practice exercises into a standard clinical course.

• Appendix B: Distinguishing Between Empathic Responses (PDFopens in new window | Wordopens in new window)
• Appendix C: Sample Emotion-Focused Therapy Syllabus With Embedded Deliberate Practice Exercises (PDFopens in new window | Wordopens in new window)

Video demonstration

A YouTube series (Practice Time! with Amy DeSmidt and Jamie Manseropens in new window) highlights authentic deliberate practice sessions featuring exercises from this book and other releases in the Essentials of Deliberate Practice series.

Additional resources

Video resources are available to accompany this book.opens in new window

Supplemental resources for therapist training

Designed for faculty at graduate institutions, these supplemental resources provide a framework and clear examples for implementing deliberate practice within existing therapist training curricula. Sentio University is where we started to develop what would become the APA Essentials of Deliberate Practice series. We provide a comprehensive suite of free psychotherapy training resources based on the deliberate practice methodologyopens in new window. These materials are designed to supplement modern hybrid and online therapist training curricula and are used extensively within our own clinical programs.

• California MFT program integration: These materials are a core component of the Sentio hybrid MFT program in Californiaopens in new window, the first in the state to fully integrate DP into its entire curriculum and receive California Board of Behavioral Sciences approval for licensure.
• Free deliberate practice exercises: Access our library of therapist skill-building worksheetsopens in new window used to enhance the online California MFT degree through repetitive, feedback-informed practice.
• Deliberate practice video demonstrations: Visit our YouTube channel for free therapist training videosopens in new window to view clinical demonstrations from the APA Essentials of Deliberate Practice book series. These videos illustrate key skills used to enhance the online California MFT degree through repetitive, feedback-informed practice.
• AI and emerging therapy resources: Learn how deliberate practice can be used to safely and ethically integrate AI for therapist trainingopens in new window. Review our AI research programopens in new window and our clinical guidelines on using AIopens in new window to prepare for the modern landscape of digital mental health.