Emotion Efficacy: What It Is and Why It Matters

The goal of psychotherapy should be to increase a client’s psychological flexibility. When it comes to clients with emotion regulation disorders, research shows that experiential avoidance and distress intolerance are the two transdiagnostic factors that are responsible for much of the inflexibility that they experience.

One way to address both of these underlying factors at once is to target a client’s emotion efficacy—which refers to how effectively a client can experience and respond to a full range of emotions in a way that is contextually adaptive and consistent with her values—in treatment. Emotion Efficacy Therapy, written by Matthew McKay, PhD, and Aprilia West, PsyD, MT, is an evidence-based, powerful way to treat the emotion regulation difficulties that keep clients stuck.

What is emotion efficacy?

Emotion efficacy refers to both the beliefs people have about their ability to navigate their emotional life, as well as their skills and actual abilities to do so. People with high emotion efficacy are able to effectively experience challenging emotions, regulate their emotions through healthy coping, and express their values through their actions.

When a person has low levels of emotion efficacy, they are often entrenched in patterns of maladaptive behavioral responses. These reactions to emotional pain—or the desire to avoid pain—fuel and maintain psychopathological processes.

When these patterns are present, clients often experience significant emotional challenges. They may lack understanding of their emotional experience; they may find it extremely hard to tolerate and regulate difficult emotions; and it may feel nearly impossible for them to make values-consistent choices when they’re triggered.

Over time, if left unattended, these patterns contribute to chronic emotion dysregulation—which tends to manifest itself as depression, anxiety, and stress.

“These maladaptive patterns become so ingrained that they are all but hardwired and very difficult to change, leaving individuals feeling trapped, stuck, and hopeless,” writes clinical psychologist Matthew McKay, PhD, one of the authors of Emotion Efficacy Therapy.

What is Emotion Efficacy Therapy?

Emotion Efficacy Therapy (EET) is an integrative treatment that draws components from acceptance and commitment therapy (ACT), and dialectical behavior therapy (DBT) to form an exposure-based protocol. It specifically targets the transdiagnostic drivers of experiential avoidance and distress intolerance to increase the client’s emotion efficacy.

The promise of EET is that it will help clients confront and accept their pain, as well as teach them the skills to respond in more adaptive ways to emotional triggers. The emphasis on exposure in treatment provides an opportunity for clients to practice the skills they’re learning in a triggered state, which helps them learn and practice new ways of responding to internal difficulties when they emerge.

Why Emotion Efficacy Therapy?

Emotion-regulation problems are extremely prevalent and are at the heart of a wide range of the issues clients seek help for in the first place. But available treatments tend to be symptoms-focused, and overlook the underlying drivers that are at the heart of the problem.

“Many of the available treatments that focus on teaching clients new skills often lack the experiential component which is an essential part of teaching clients to employ their skills in real time, when they need them,” writes McKay. 

While pain is unavoidable, suffering is not. Suffering comes, in part, from not knowing how to enact values that bring meaning to life. More often, it comes from the unwillingness to experience difficult emotions, which then fuels distress and leads to more suffering.

When clients try to avoid or control their pain through maladaptive behavioral responses, their suffering is maintained and often even increased. When clients learn to powerfully navigate the space between being emotionally triggered and their response, they are empowered to create lives that are increasingly values-consistent and fulfilling.

“High emotion efficacy, or the ability to experience a full range of emotions and respond with mindful acceptance, values-based action, and mindful coping—means a world where more people create lives that are more authentic, powerful, and conscious,” writes McKay.

For more information about EET, check out the book Emotion Efficacy Therapy.