Embracing New Territories: The Journey of Emotionally Focused Therapy (EFT) in Kenya

This is particularly relevant in Kenya, where an increase in adult relationship instability has been reported, resulting in relationship distress and subsequent dissolution (Musau et al., 2015). In Kenya’s largely patriarchal society, intimate relationships are often strained by factors such as financial challenges, intimate partner violence (IPV), infidelity, alcohol abuse, and HIV/Aids (Fagmamigbe et al., 2020; Musau et al., 2015; Njiru & Purkayastha, 2018). Given the inherently collectivistic cultural value systems in Kenya, relational health and couple therapies are well-suited to address the unique cultural and contextual issues faced by individuals in intimate relationships. One such relational therapy that has gained momentum in many parts of the world, including Africa, is emotionally focused couple therapy (EFCT; Johnson, 2004). The main objective of this article is to provide the context and highlight experiences from the first ever formal training (commonly known as the EFT externship) in EFCT held in Nairobi, Kenya, June 24-27, 2024.

The context of relationships and training of MFTs in Kenya

Considering the significant influence of Kenyan culture on couple relationships, formalized training in EFT and attachment theory concepts underscores the theory’s cultural sensitivity and relevance in addressing the unique relational and dyadic challenges commonly encountered by Kenyans. Amongst collectivistic cultures, EFT has been found to work well due to its “focus on emotion, attachment theory, close interpersonal relationships, and model-specific interventions that match cultural values” (Sandberg et al., 2024, p.648). Marriage, as a rite of passage, is celebrated and honored in many African communities, yet it is not without its challenges. The dissolution of couple relationships and divorce are not foreign concepts in many African settings, including in Kenya (Malinga et al., 2022). Thus, Kenyan therapists should prioritize marital communication due to the different causes of conflict among couples. Communication is essential for resolving conflicts and is crucial in developing and maintaining a satisfying, long-lasting marital relationship (Shifaw, 2022). To ensure clinicians are qualified to handle these matters, they need proper education and training in using empirically based relational health interventions. This underscores the need for developing more marriage and family therapy (MFT) programs in the country. It is encouraging to note that the quality of all mental health programs improved significantly once the Kenyan government established the Counselors and Psychologists Board under the Ministry of Health. This regulatory body not only oversees the professions but also ensures that all practitioners possess the adequate training and skills necessary to address client needs.

Furthermore, while Kenya takes pride in being the first and currently only African country to have accredited MFT programs, the need for the systemic family therapy field to expand throughout the continent is paramount. The unique cultural challenges that couples and families face in Kenya underscore the need for expanding systemic family therapy training not only in Kenya, but also in the East African region. Systemic practices align well with African values (Hertlein, 2023). Additionally, development of MFT programs in higher education institutions is critical. These programs will produce more qualified practitioners and researchers, emphasizing the need for ongoing professional development and training, particularly for those working with couples and families. This is crucial given the significant need to address relational trauma among the Kenyan population. Additionally, the increase in the number of people entering the helping professions in Kenya creates several other needs. Firstly, there is a greater demand for local Kenyan professional trainers in systemic models of therapy. Secondly, Kenyan universities need to develop graduate-level programs. This will help increase the number of Kenyan faculty members and enhance research capabilities. Ultimately, these changes aim to reduce the reliance on resources and institutions outside of Kenya.

Brief overview of Emotionally Focused Couple Therapy

EFCT is a systemic and experiential model with more than 40 years of research supporting its efficacy in helping couples navigate relational distress, and build strong relational bonds (Greenman & Johnson, 2022). The EFCT model is grounded in adult attachment theory, framing distress in adult romantic relationships as a protest against disconnection. According to this theory, a romantic partner’s consistent emotional availability and appropriate responsiveness to the attachment needs of their partner promote relational well-being by facilitating a felt sense of security (Johnson, 2012). This sense of security and its associated capacity to effectively regulate emotions alleviate individual and relational distress, ultimately benefiting overall adjustment and health (Greenman & Johnson, 2022). Firstly, the EFCT model works to assist each partner to understand how their own and their partners’ attachment needs and fears inform their negative cycle. Secondly, it aims to bring about corrective experiences in which each partner is assisted to vulnerably express these attachment needs and fears and respond to such vulnerable sharing by a partner in an accepting and comforting way. The premise is that vulnerable exchanges will increase relationship safety and security, and, ultimately, decrease relationship distress (Wiebe & Johnson, 2017). The EFCT model employs a variety of interventions to deepen and expand partners’ attachment-related emotions and to support them in sharing these with their partners. These interventions lead to corrective and attuned responses between partners and corrective or shifting emotional experiences that strengthen bonding.

Historical context of the Pamoja/Together EFT Training and the Training Team

In July 2023, a team of 10 Kenyan therapists traveled to Kampala, Uganda, to attend the first-ever EFT externship facilitated by Conexa East Africa. Most of these professionals were members and leaders of local mental associations in Kenya, such as the Systemic Family Therapy Association (SFTA) Kenya and Peace Together. Inspired by their experiences at this training, they partnered with Conexa East Africa to form the “Pamoja” team (meaning “Together” in Swahili) and host the EFT training in Nairobi, Kenya. The four-day EFCT training was held at Sarova Panafric Hotel in Nairobi, June 24-27, 2024. The training was led by a team of 15 multicultural EFT experts, including EFT therapists, supervisors, and trainers from five different countries namely, the U.S., South Africa, Canada, Spain, and Uganda.

Partner associations

The June 2024 EFT externship training in Kenya was organized by Conexa East Africa in partnership with the Systemic Family Therapy Association (SFTA) Kenya and Peace Together.

Conexa is a non-profit organization based in California that focuses on community transformation through mental and relational health in diverse cultural and marginalized settings both locally and globally. Specifically, the mission of Conexa is to develop localized healing resources in mental and relational health, with an emphasis on increasing these resources, making them more accessible and affordable to communities in need. After success in collaboration with the Ugandan Counseling Association to train and empower professionals in EFT and trauma, Conexa formed Conexa East Africa to specifically focus the Conexa mission in East African countries led by East African organizations. Conexa employs rigorous grassroots fundraising efforts to address the financial disparity of training costs, allowing for a wide range of professionals to attend despite limitations in income or location, as well as continue in development after training through collaboration with local organizations and community building. More information is here. For the EFT training in Kenya, Conexa assembled a team of multicultural EFT experts from various EFT communities across the North American region to volunteer as facilitators at the training.

The Systemic Family Therapy Association–Kenya (SFTAK) is a professional membership organization for marriage and family therapy practitioners and students in Kenya. Supported by AAMFT, SFTA-K serves members practicing in all areas of mental health, including academia, community mental health centers, private practice, managed care, and social service organizations in Kenya. As a professional body, SFTA-K strives to maintain the professional standards of MFT by championing the unique systemic framework in clinical practices, innovation, and research.

PEACE Together is a community-led initiative that partners on a multi-level platform for Psychosocial Education Advocacy Capacity-building and Engagement (PEACE) as a collective (Together means PAMOJA in Kiswahili). It encompasses all aspects of mental health, well-being, and resilience for sustainable peace and cohesive, thriving communities through redefining peace perspectives from the inside out, emphasizing a wide range of social activation towards healing and restorative peaceful connections. As local hosts, both SFTA Kenya and Peace Together pooled their network of resources and professionals, in addition to managing all ground logistics to ensure a successful training. Finally, the training was approved by the International Center of Excellence in Emotionally Focused Therapy (ICEEFT) who facilitated two esteemed ICEEFT-certified trainers to lead the training. More information is here.

Members of the Conexa and SFTA-K Team that Organized and facilitated the EFCT Externship in Nairobi, Kenya

Members of the Conexa Team and SFTA-K Team during a visit to one of the local universities

Participants

The SFTA-Kenya and Peace Together, in partnership with Conexa, extended invitations to mental health practitioners and students across the East African region. A total of 122 participants attended, including representatives from Kenya (N=106), Ethiopia (N= 4), and Uganda (N=4). Additionally, participants from outside the East African region included professionals from Botswana (1), Ukraine (1), the U.S. (2), the Netherlands (2), South Sudan (1) and Nicaragua (1). Most of these attendees were living and practicing in Kenya at the time of the training.

Participants at the externship engaging in group discussions

Externship goals

Broadly, the goals of the EFT externship are to train practitioners on 1) how to better understand couples’ issues and treat them from an attachment theory lens (a theory of human connection and adult bonding), 2) identify working couples’ trauma experiences in therapy, 3) how to help couples and families process emotions that maintain dysfunction and distress in relationships, and 4) how to help couples and families form new and healthy ways of interacting, bonding, and problem solving. Similar to the EFT Project Uganda, the overall goal of the Kenya Project Pamoja was to equip Kenyan mental health professionals with empirically based clinical skills they could use to restore and transform Kenyan families and communities.

Participants from Ethiopia with some members of the Conexa team

Training impact stories/outcomes

This link includes a short clip capturing voices and faces of various participants at the Kenya externship sharing their experiences. For most professionals, this was their first-ever formal training in EFT. Unanimously, participants we spoke to agreed that the EFT training experience was overall positive and greatly needed in Kenya, especially given the increase in relationship distress and the precarious state of many relationships. One participant I (RA) spoke to described the current state of romantic relationships in Kenya as a “ticking time bomb” and shared that the training was much needed to support individuals struggling in relationships. Several participants referred to the training experience using words such as “powerful, “timely,” and “game-changing.” One participant stated, “honestly, I loved it. I really did.” Another stated, “I came into this not only to learn to help other people but also to help myself; it helped me to learn how best I can better my own relationship so that I am able to help other people.” Professionals also appreciated the power of EFT to foster emotional accessing and processing, as one participant described, “it will help me to slow down in my own therapy process” and “it will help me tap into the client’s emotions.”

Participant Rehema Nyambura stated that:

Having experienced the EFT externship, I gained invaluable and practical information that helped in overcoming a seven-month conflict of a couple I was assisting, profoundly altering my practice. Through de-escalation, EFCT revealed the deep-seated emotional patterns and attachment disorders that underpinned the couple’s ongoing conflict; helping them navigate their complex emotional landscapes, I was able to guide them in accessing and expressing their vulnerable emotions rather than reverting to defensive or confrontational behaviors. The externship emphasized the significance of fostering emotional safety and connection between partners, allowing for genuine empathy and understanding (Johnson, 2004; Bradley & Furrow, 2004). As a result, my ability to help other couples resolve their disputes has greatly improved. I now expertly use EFT techniques to help clients identify their couple dance, increase awareness of their negative cycles, reprocess underlying emotions, and create stable attachment ties, ultimately leading to durable and satisfying relationships. This training not only improved my therapy, it also reinforced the transforming power of treating emotional needs in couples therapy.

Conversely, like any other therapeutic modality introduced into a new cultural setting, participants reflected on some anticipated challenges of using EFT in their own culture. A common challenge highlighted revolved around the difficulties in accessing and expressing emotions, as well as the lack of emotional literacy in Kenyan culture. One participant expressed these concerns this way: “Emotions are not easily acceptable, when someone shows emotions, it’s seen as scary; we aren’t taught how to manage or handle emotions.” This challenge was highlighted both during the four-day training and during interviews. Despite this challenge, some professionals saw it as an opportunity to challenge the status quo and innovate. Recognizing that emotions are universal, participants highlighted that a key to the successful implementation of EFT in Kenya would be “figuring out unique ways in which Kenyans, especially men, show emotions and how to normalize, rather than shame that emotional expression.”

Another challenge highlighted was the prevalence of individuals in multiple relationships, especially among men who often have more than one partner. Professionals raised questions about how EFCT, which conceptualizes romantic relationships as attachments to a single partner, would address such dynamics. These and many other challenges were highlighted by Kenya professionals. Overall, the unanimous mood amongst many professionals at the externship was that of excitement and hopefulness that EFCT will transform their personal lives as well as the lives of clients they serve.

Next steps

The next steps for continued development in EFCT practice in Kenya will be to conduct level two (Core skills training) and establish support mechanisms (like EFT communities in North America) where professionals in Kenya can learn and grow alongside each other in the model. Further, ongoing research efforts to understand how/whether EFCT is relatable to Kenyan couples and families need to be conducted with the EFCT model.