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Mental health is a growing public health concern in Ireland, where 18.5% of the Irish population reported having a mental health illness, such as depression, anxiety and bipolar disorder. Cognitive Behaviour Therapy (CBT) is the most common treatment to help people struggling with mental health and mood disorders. However, CBT is not always the preferred treatment by patients, so researchers are exploring alternatives, such as treatments that focus on emotion.

In this blog post, researchers, Ladislav Timulak and Daragh Keogh, Trinity College Dublin, discuss emotion-focused Therapy (EFT), an evidence-based intervention that has been shown to be effective for a range of psychological problems, and their randomised control trial to test and establish whether EFT could be a recommendable approach, comparative with the predominant CBT.

Over the last few decades, a widespread practice in psychotherapy research has been to develop specific psychotherapeutic treatments for specific psychological problems. So, for example, different versions of Cognitive Behaviour Therapy (CBT) have been developed for depression, generalised anxiety, panic disorder, social anxiety, post-traumatic stress disorder, obsessive-compulsive disorder, and so forth. However, research has shown that individuals with mental health difficulties often struggle with more than one psychological problem at the same time, e.g., a patient might suffer from both depression and social anxiety.

Research also indicates that while these different problems may seem unalike, they often share common causes and can be maintained by common processes. For these reasons, a recent development in psychotherapy research has been to develop what are called ‘transdiagnostic’ interventions, whereby the same intervention can be used to treat patients presenting with a range of different problems and/or patients struggling with more than one problem.

Emotion-focused therapy

To date most transdiagnostic interventions are adaptations of CBT. However not all patients benefit from or prefer CBT, and so there is an argument that patient well-being can be improved by increasing the range or choice of evidence-based interventions available. Emotion-focused Therapy (EFT) is an evidence-based intervention that has been shown to be effective for a range of psychological problems (e.g., depression, complex trauma, social anxiety, generalised anxiety).

The current study seeks to adapt and test the effectiveness of EFT as a transdiagnostic treatment for depression, anxiety and several related disorders. The outcomes (that is, the extent to which participants experience a change in their symptoms) for 20 patients treated with EFT in a community-based counselling service will be compared with the outcomes for 20 patients placed on a waiting list. Wait-list patients will receive therapy at a later point. The study will test the potential of EFT as a transdiagnostic treatment, whilst also allowing for further adaptations of the EFT model. It is envisaged that at a later stage transdiagnostic EFT will be tested against transdiagnostic CBT in a public health service context, in a trial large enough to establish relative efficacy of the two interventions.

Developing and adapting treatments

The current study is conducted by a team of psychologists from Trinity College Dublin and other workplaces including the Health Service Executive. The study is registered with ISRCTN Registry https://doi.org/10.1186/ISRCTN11430110 We chose to publish the study protocol as it is customary practice to publish study protocols in the area of psychotherapy research. We specifically opted for HRB Open Research (https://hrbopenresearch.org/articles/3-7/v1) as our  principal investigator,Dr. Ladislav Timulak,was recipient of two previous HRB grants which contributed to the development and adaptation of emotion-focused therapy, specifically for generalised anxiety disorder. The current project is a continuation of those previous HRB funded projects (https://emotionfocusedtherapygroup.ie/research-current-projects). We were impressed by the speed of publication with HRB Open Research and appreciate its open and transparent peer-review process. We will definitely consider this platform in the future.