Introduction

Emotion-Focused Therapy (EFT) and Lazarus’s Multimodal Therapy (MMT) represent two major contemporary orientations in counseling and psychotherapy. Although they differ significantly in their theoretical assumptions and clinical strategies, both approaches reflect broad trends in counseling psychology: an integrative, evidence-informed, and client-centered practice (Gelso & Williams, 2022). EFT emerged from humanistic and experiential psychotherapy traditions, focusing on the transformation of emotional processes. In contrast, Multimodal Therapy, developed by Arnold Lazarus, is grounded in social-learning and cognitive-behavioral traditions and emphasizes comprehensive, individualized intervention across multiple modalities of functioning.

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1. Emotion-Focused Therapy (EFT)

Emotion-Focused Therapy was formally developed by Leslie Greenberg and colleagues in the 1980s. Although Greenberg’s work is not part of the sources you provided, the tradition behind EFT—humanistic-experiential therapy—draws heavily on the work of Rogers, Perls, and Gendlin, all of whom are widely cited in counseling psychology texts (Corey, 2008; Feltham & Horton, 2006). EFT blends humanistic principles (empathy, authenticity, unconditional acceptance) with process-experiential methods.

Stages of Emotionally Focused Therapy

Humanistic Roots

Humanistic counseling, strongly represented in counseling psychology (Gelso & Williams, 2022), emphasizes:

• The actualizing tendency

• Experiential awareness

• Therapist presence

• Emotional expression as central to growth

EFT extends this tradition by asserting that maladaptive emotional schemes underlie psychological distress and that transforming these emotional structures—rather than merely understanding or controlling them—creates therapeutic change.

View of Human Nature

EFT conceptualizes humans as inherently growth-oriented, capable of self-enhancement, and wired for emotional intelligence (Feltham & Horton, 2006). Emotions are not obstacles but fundamental adaptive processes that provide information, guide decision-making, and motivate behavior. This is consistent with modern counseling psychology’s emphasis on strengths, resilience, and client resources (Gelso & Williams, 2022).

Core Concepts

Some core concepts include, the following:

1. Emotion Schemes

EFT posits that clients carry emotional memories and patterns—“schemes”—formed through past experiences. These influence how individuals interpret events, relationships, and internal states.

2. Primary vs. Secondary Emotions

• Primary Adaptive Emotions: healthy, direct responses (e.g., grief after loss)

• Primary Maladaptive Emotions: maladaptive, often trauma-based emotions (e.g., shame from childhood abuse)

• Secondary Emotions: defenses or reactions to primary emotions (e.g., anger covering sadness)

Therapy aims to transform primary maladaptive emotions into adaptive ones.

3. Experiential Processing

Clients are guided to access, symbolize, process, and transform emotional experiences through in-session techniques such as chair-work and focusing.

Therapeutic Relationship

The therapeutic relationship in EFT is essential. Humanistic foundations emphasize:

• Empathic attunement

• Genuineness

• Non-judgment

• Presence

Gelso & Williams (2022) argue that therapeutic relationships serve both a healing and a working function, consistent with EFT’s reliance on relational depth.

Goals of EFT

1. Increase emotional awareness

2. Transform maladaptive emotions

3. Strengthen emotion regulation

4. Resolve internal conflicts

5. Promote healthier interpersonal patterns

The goal is not simply to cathartically express emotion but to reorganize emotional meaning structures.

Emotion-Focused Therapy

Therapeutic Techniques

Although Greenberg’s original techniques are specific, the general experiential methods are widely discussed in psychotherapy literature:

1. Two-Chair Work

Clients enact conflicting parts of the self (e.g., self-criticism vs. vulnerability) in dialogue to facilitate integration.

2. Empty-Chair Work

Adapted from Gestalt therapy, this technique allows clients to express unfinished feelings toward significant others.

3. Focusing

Clients attend to bodily felt senses to access implicit emotional knowledge.

4. Empathic Exploration

The therapist facilitates deepening awareness and reflection.

Corey (2008) notes that experiential methods like chair-work have proven effective in groups as well, helping individuals confront internal conflicts in a supportive environment.

Multicultural Considerations

Feltham & Horton (2006) and Woolfe & Dryden (1996) emphasize that experiential therapies must adapt to cultural norms regarding emotional expression. Some clients may come from traditions that value emotional restraint or collective harmony. Therefore, EFT must be adjusted to avoid imposing Western emotional norms.

Strengths of EFT

• Emphasizes emotional depth and authenticity

• Supported by empirical evidence (not in your sources but widely recognized)

• Integrates well with other modalities

• Offers a clear process of change

• Aligns with humanistic values highlighted in counseling psychology literature (Gelso & Williams, 2022)

Criticisms of EFT

1. Emotion-focused work may overwhelm some clients, especially those with trauma or unstable functioning (Feltham & Horton, 2006).

2. Less structured than cognitive-behavioral approaches, potentially challenging for highly anxious clients.

3. Cultural mismatch for clients who prefer problem-solving or cognitive interventions.

4. Emotion-intensity may risk dependency if not balanced with skill-building.

2. Lazarus’s Multimodal Therapy (MMT)

Developed by Arnold Lazarus, MMT is an extension of behavioral therapy but reframed within a multimodal, holistic framework. Lazarus argued that effective therapy must address multiple dimensions of human functioning rather than a single theoretical lens.

Rimm & Masters (1987), reviewing behavioral therapies, note that Lazarus played a central role in broadening behavior therapy beyond pure conditioning into a more integrative, skills-based model.

Theoretical Foundations

MMT emphasizes that humans function across multiple, interrelated domains. Treatment must therefore be individually tailored and assessment-driven. MMT is grounded in:

• Social learning theory

• Cognitive-behavioral principles

• Technical eclecticism

It aligns with Prochaska & Norcross’s (2007) description of psychotherapy systems evolving toward integrative practice.

The BASIC-ID Assessment System

Lazarus proposed that human functioning can be understood through seven modalities, remembered through the acronym BASIC-ID:

1. B – Behavior: actions, habits

2. A – Affect: emotions

3. S – Sensation: bodily responses

4. I – Imagery: internal visualizations

5. C – Cognition: thoughts, beliefs

6. I – Interpersonal: relationships

7. D – Drugs/Biology: physical health, medication

This multidimensional framework allows therapists to construct a comprehensive individualized treatment plan.

Multimodal Therapies

View of Human Nature

MMT assumes that human behavior is influenced by interaction between biological, psychological, and social-learning factors (Capuzzi & Gross, 2008). Unlike singular theories, MMT rejects the idea that any one aspect of functioning dominates.

The approach aligns with contemporary counseling psychology, which supports integrative, biopsychosocial thinking (Gelso & Williams, 2022).

Clinical Goals

1. Provide a comprehensive assessment of the client’s functioning

2. Formulate an individualized treatment plan

3. Target each relevant modality with specific interventions

4. Build coping strategies across modalities

5. Promote long-term behavioral change

Techniques in Multimodal Therapy

Because MMT is technically eclectic, interventions vary widely and may include:

1. Behavioral Techniques

Reinforcement, contingency management, exposure, skills training (Rimm & Masters, 1987).

2. Cognitive Techniques

CBT-style restructuring of beliefs (Beck, 1976).

3. Affective/Emotion Regulation Approaches

Relaxation, mindfulness, imagery.

4. Sensory/Physiological Methods

Biofeedback, exercise recommendations, desensitization.

5. Interpersonal Training

Assertiveness training, communication skills (Corey, 2008).

6. Imagery-Based Techniques

Guided imagery to modify internal representations.

7. Biological/Health-Based Interventions

Medication consultations, sleep hygiene, nutritional considerations.

Lazarus insisted that techniques must be selected empirically and pragmatically, not ideologically—an early form of evidence-informed practice.

Therapeutic Relationship in MMT

While MMT is technique-driven, Lazarus emphasized a firm, supportive, and honest therapeutic stance. The rapport is not as central as in EFT, but effective collaboration remains important.

Gelso & Williams (2022) note that even in technically eclectic approaches, the working alliance plays a significant role in outcomes.

Applications of MMT

MMT is widely applicable, especially in:

• Anxiety disorders

• Depression

• Addictive behaviors

• Stress management

• Somatic concerns

• Interpersonal difficulties

Because the model is highly adaptive, it suits clients who prefer structured, goal-oriented therapy.

Multicultural Considerations

Feltham & Horton (2006) argue that the BASIC-ID model is flexible enough to incorporate cultural variables such as family norms, bodily expression, cognitive patterns, and community expectations. MMT can be easily adapted for collectivistic, spiritual, or culturally diverse contexts (Veereshwar, 2002; Rama et al., 1976), especially when counselors incorporate culturally specific modalities into assessment and planning.

Strengths of MMT

1. Highly individualized, avoiding one-size-fits-all treatment.

2. Integrative and flexible, drawing from many theoretical traditions.

3. Compatible with evidence-based practice (Prochaska & Norcross, 2007).

4. Comprehensive assessment through BASIC-ID.

5. Addresses biological, interpersonal, and lifestyle factors, consistent with modern health psychology.

Criticisms of MMT

1. Complexity: Requires high clinical skill to integrate many techniques.

2. Risk of theoretical incoherence: Critics argue that eclecticism can lack philosophical unity (Feltham & Horton, 2006).

3. Time-consuming assessment: BASIC-ID requires detailed exploration.

4. Technique overload: Therapists may rely too heavily on interventions rather than depth processes.

5. Potential superficiality: Some argue that focusing on multiple modalities may overlook deeper psychological or emotional themes (Corsini & Wedding, 1995).

Conclusion

Emotion-Focused Therapy and Multimodal Therapy exemplify two major but distinct paths within modern counseling psychology. EFT continues the humanistic-experiential tradition, emphasizing emotional transformation, depth, and relational attunement. In contrast, Multimodal Therapy represents an integrative, assessment-driven approach grounded in behavioral and cognitive science.

Both approaches reflect the broader movement in counseling toward integrated, client-centered, culturally responsive practice (Gelso & Williams, 2022). EFT contributes a deep understanding of emotion as a pathway to psychological change, while MMT brings a structured, evidence-informed framework for addressing the diverse dimensions of human functioning. Together, they illustrate how counseling psychology values both depth and breadth, both experience and action, both emotion and behavior.

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