Date of Award


Access Restriction

Research Projects

Degree Name

Master of Arts


Marital and Family Therapy

School or College

College of Communication and Fine Arts

First Advisor

Jessica Bianchi

Second Advisor

Einat Metzl


This qualitative study examines how art interventions are aligned and integrated with emotionally focused therapy (EFT; Johnson, 2020) in the treatment of relational distress with couples. EFT is a brief humanistic evidence-based treatment, grounded in attachment theory, with experiential and systemic approaches to intervention that engage underlying emotion to create more secure bonds. Notably scant literature exists blending art-based and verbal approaches in EFT, despite the importance of verbal imagery in EFT intervention and the experiential nature of expressive therapies. In this study, NVivo qualitative data analysis software facilitated thematic analysis of semi-structured interviews with five clinicians who integrate the two approaches. Theory-driven analysis with skills of the Emotion-Focused Therapy-Therapist Fidelity Scale (EFT-TFS; Denton et al., 2009) examined alignment and divergence from the EFT model. Patterns in the data revealed a conceptual framework for integrating art interventions with EFT that prioritized fidelity to the EFT model. This framework provides structure and language to describe art interventions in a granular way at the session level, with considerations for the progression of treatment through the steps and stages of EFT in the context of considerations for the therapeutic alliance. This framework has wide applications in clinical practice, teaching, and empirical inquiry integrating art interventions with EFT.