Emotion Focused Therapy for Couples in Addiction Treatment

201 Pages·2014·6.62 MB·English

by  Bonnie Bassett

Running head: EFT WITH ADDICTION RECOVERY
EMOTION FOCUSED THERAPY FOR COUPLES IN ADDICTION TREATMENT: THE
RELATIONSHIP BETWEEN QUALITY OF RECOVERY, ATTACHMENT STYLE, AND
RELATIONAL SATISFACTION
Bonnie Bassett
Liberty University
A Dissertation Presented in Partial Fulfillment
Of the Requirements for the Degree
Doctor of Philosophy
Liberty University
April 2014
EFT WITH ADDICTION RECOVERY
© Bonnie Bassett, 2014
EFT WITH ADDICTION RECOVERY
EMOTION FOCUSED THERAPY FOR COUPLES IN ADDICTION TREATMENT: THE
RELATIONSHIP BETWEEN QUALITY OF RECOVERY, ATTACHMENT STYLE, AND
RELATIONAL SATISFACTION
by
Bonnie Bassett
has been approved
© April 2014
APPROVED, ACCEPTED, AND SIGNED:
__________________________________________
David Jenkins, Ph.D., Committee Chair
__________________________________________
John C. Thomas, Ph.D., Ph.D., Committee Member
__________________________________________
Fred Volk, Ph.D., Committee Member
EFT WITH ADDICTION RECOVERY
ABSTRACT
This study investigates the efficacy of Emotion Focused Therapy (EFT) for couples in an
addiction recovery program. The literature review revealed that individuals with a secure
attachment style experience increased relational satisfaction and report better ability to manage
life’s challenges as compared with individuals with an insecure attachment style. A pretest-
posttest design was used to investigate the effect of EFT on quality of recovery from addiction.
The primary measure’s percentile rank scores were comparatively analyzed. A single case
multiple baseline design was implemented to draw inferences based on examining the
participants’ assessment scores across baseline and intervention phases. The purpose of this
study was to demonstrate the effect of EFT by showing that participants reported increased
quality of recovery from addiction, movement away from an insecure attachment style and
toward a secure attachment style, and increased relational satisfaction when and only when the
intervention was applied. This research serves to further the understanding of the role of EFT
couple therapy in addiction recovery. Increased knowledge related to how an interpersonal
connection can facilitate the recovery process is helpful to practitioners serving this population.
i
EFT WITH ADDICTION RECOVERY
DEDICATION
I dedicate my dissertation work to my professors, family, and friends who have supported
me along this journey. Thank you all for participating in this amazing experience together with
me.
I am grateful to my chair, Dr. Jenkins, whose inspirational instruction and counsel gave
me a deep appreciation for the research process. His clever ideas and enthusiastic navigation
through challenges allowed for the completion of this study. I appreciate Dr. Thomas and Dr.
Volk for serving on my committee and for providing their expertise and time. I give special
thanks to Dr. Sosin for her kindness in reaching out to me to provide encouragement.
I extend my heartfelt gratitude to my family: Dad, Lou, Sharie, Brayden, Bryce, and
above all to my helpmate, Mom, for everlasting encouragement throughout my years of study.
My heartfelt thanks go to my friends, Carrie, Martha, Mary, Wendy, Claudia, and Laura for
walking with me in this process and continuing to express interest well after the novelty wore
off. I appreciate the friendships of my fellow doctoral students: Angel, Starr, and Susan; who
were in it with me all the while. Collaboratively we processed ideas that took us on cognitive
adventures. I am obliged to my coworkers at Tapestry for inspiring me and to Ed at WellStar for
generously supporting my academic pursuits. I appreciate Ella, my study break buddy, for
reminding me to find joy in moments of play. Finally, I am grateful to my beloved, James, who
encouraged me through the research process and created happy and beautiful memories with me
along the way.
ii
EFT WITH ADDICTION RECOVERY
ACKNOWLEDGEMENTS
I wish to express my gratitude toward the clinicians who gave their time and expertise to make
this study a success. As I thank them I want to recognize them for their passion in providing
loving care for hurting couples.
Michael Barnett: for supervision of clinicians and model fidelity checks
Janet Fluker & Patrice Alexander: for facilitating therapy and administering assessments
Sue Johnson: for advice toward a sound design
Bonnie Bassett
iii
EFT WITH ADDICTION RECOVERY
TABLE OF CONTENTS
Page
Abstract…………………………………………………………………………………..………...i
Dedication…………………………………………………………………………….…………...ii
Acknowledgements……………………………………………………………………………….iii
List of Tables ..................................................................................................................................ix
List of Figures .................................................................................................................................x
CHAPTER ONE: INTRODUCTION ...........................................................................................1
Background to the Problem ...........................................................................................................3
Purpose of the Study ......................................................................................................................4
Research Hypotheses......................................................................................................................5
Assumptions and Limitations.........................................................................................................5
Significance of the Study................................................................................................................6
Definition of Terms…….................................................................................................................6
Theoretical and Conceptual Framework ........................................................................................9
Organization of the Remaining Chapters......................................................................................10
Chapter Summary..........................................................................................................................10
CHAPTER TWO: REVIEW OF THE LITERATURE ................................................................12
Introduction....................................................................................................................................12
Attachment Theory........................................................................................................................12
The Strange Situation.................................................................................................................... 13
The Attachment System……........................................................................................................ 14
Internal Working Model of Self and Others................................................................................. 15
iv
EFT WITH ADDICTION RECOVERY
Mental Model of Self........................................................................................................ 16
Mental Model of Others………………………………………………………………….16
Internal Working Models………………………………………………………………...17
Attachment Styles………………………………………………………………………………..18
Secure Attachment……………………………………………………………………….19
Insecure Attachment……………………………………………………………………..21
Attachment Styles Summary ............................................................................................27
Romantic Attachment………………………….…………………………………...……………27
Relational Conflict……………………………………………………………………….29
Romantic Attachment Summary…………………………………………………………30
Attachment Theory Summary…………………………………………………………………....30
Emotion Focused Therapy…………………………………………………………………….…31
Emotion Focused Therapy Stages………………………………………………………..32
Emotion Focused Therapy Efficacy…………………………………………………...…34
Section Summary……………………………………………………………………………...…35
Addiction and Recovery………………………………………………………………………....35
Addiction and Attachment……………………………………………………………….36
Addiction and Marital Duress…………………………………………………………....39
Couple Therapy for the Treatment of Addiction…………………………………..…….41
Section Summary………………………………………………………………………..……….43
Chapter Summary………………………………………………………………………………..44
CHAPTER THREE: METHODS ................................................................................................ 46
v
EFT WITH ADDICTION RECOVERY
Research Design ...........................................................................................................................48

Variables………………………………………………………………………………………....50

Independent Variable…………………………………………………………………….50

Dependent Variables……………………………………………………………………..51

Selection of Participants .............................................................................................................. 51

Instrumentation ............................................................................................................................ 52

Background and Demographic Information…………………………………………..…53

Addiction Recovery……………...………………………………………………………54

Attachment Styles …………………………………………………………..………...…65

Romantic Relationship Satisfaction…………………………………………………..….67

Research Procedures……………………………………………………………………………..71

Data Processing and Analysis…………………………………………………………………....72

Research Questions and Null Hypotheses…………………………………………………….....76

Chapter Summary……………………………………………………………………………..…76

CHAPTER FOUR: DATA ANALYSIS AND RESULTS………………..…………………….78
Restatement of the Purpose……………………………………………………………………...78
Preanalysis Steps …………………………………………..……………………………………81
Data Imputation………………………………………………………………………………….84
Results …………………………………………………….…………………………………….85
First Research Question …………………………………………………………………86
Second Research Question………..……………….…………………………………….89
Third Research Question………………………………………………..……………...111
vi
EFT WITH ADDICTION RECOVERY
Chapter Summary ………………………………………………......………………………….149
CHAPTER FIVE: SUMMARY, CONCLUSIONS, & RECOMMENDATIONS……………..151
Summary………………………………………………………………………………………..151
Participant Selection……………………………………………………………………151
Analysis………………………………………………………………………………...152
Conclusions…………………………………………………………………………………….153
Research Question One………………………………………………………………...154
Second Research Question………… ……….....………………………………………156
Third Research Question…….…………………………………………………………157
Section Summary ………………………….....……………...…………………………159
Implications for Practice………………………………………………………………………..159
Implications for Research………………………………………………………………………160
Limitations of the Study …………….…………………………………………..……………..162
Chapter Summary………………………………………………………………………………163
REFERENCES…………………………………………………………………...…………….165
Appendixes
Appendix A: Pre-Post Inventory……………………..…………………………………178
Appendix B: Experiences in Close Relationships Scale……………………..…………179
Appendix C: Dyadic Adjustment Scale ……………………..........................................181
Appendix D: Informed Consent Form……………………………...……………. .…...182
vii