A Study on the Intervention Effect of Emotion-Focused Therapy in Adolescent Adjustment Disorder ()
1. Research Background
Since the 21st century, studies in the field of Emotion-Focused Therapy have emerged in large numbers. Emotion-Focused Therapy (hereafter referred to as EFT) is an emotion-centered therapeutic approach, which holds that the occurrence of symptoms stems from the dysregulation of emotional functions (Zhang & Wu, 2024). Research by Leslie S. Greenberg, the founder of EFT, has found that the exploration, arousal, expression, and transformation of emotions are key factors determining the effectiveness of psychotherapy (Greenberg, 2015). According to existing literature, studies on the application of EFT in treating various psychological problems have achieved positive outcomes. For example, a study on the use of EFT to treat emotional dysregulation in veterans with Post-Traumatic Stress Disorder (PTSD) showed that EFT can reduce their emotional dysregulation, suicidal ideation, and sense of hopelessness (Mikaeili et al., 2017); additionally, EFT can serve as an appropriate intervention method to improve emotional regulation ability, reduce anxiety, and enhance quality of life in women with breast cancer (Salarirad et al., 2022). With the increase in relevant studies, the definition and content of EFT have been increasingly refined. However, recent studies on EFT have also exposed some problems that urgently need to be addressed. Currently, research on the application of EFT mainly focuses on the treatment of diseases such as PTSD, conversion disorder, and Generalized Anxiety Disorder (GAD), while studies on its intervention in adolescent adjustment disorder are relatively scarce.
Meanwhile, as the number of adolescents experiencing anxiety symptoms due to school enrollment or transition increases, “adjustment disorder” has become a hot topic of public concern, and its incidence rate is relatively high (Xu & Yang, 2009). Most studies on adjustment disorder focus on its influencing factors and defense mechanisms. For instance, relevant research results show that factors such as fathers being away from home, major family changes in the past year, and experiences of school transfer or enrollment in the past six months are influencing factors of school-related adjustment disorder in adolescents. Adolescents with school-related adjustment disorder score lower in school attitude and emotion, peer relationships, and teacher-student relationships compared to healthy adolescents. This suggests that adolescents with school-related adjustment disorder may have a poorer perception of campus life and poor interpersonal relationships (Fu et al., 2024). This study indicates that adjustment disorder has a significant impact on adolescents and their families. Currently, clinical treatment of adolescent adjustment disorder mainly relies on medications such as sertraline; however, long-term use of antidepressants may lead to side effects, and the risk of recurrence is high (Yang et al., 2024). Therefore, relevant treatment methods need further research and improvement. A large number of studies have shown that EFT has a significant improvement effect as a clinical treatment method, but studies on the effect of EFT as an intervention for adolescent adjustment disorder are currently insufficient.
Based on this, this paper systematically summarizes and concludes studies related to EFT and adjustment disorder, aiming to provide references for subsequent research on EFT intervention in adolescent adjustment disorder and to offer basic data for further studies on the effect of EFT in treating adolescent adjustment disorder.
2. Current Research Status at Home and Abroad
2.1. Relevant Definitions of EFT
Emotion-Focused Therapy (hereafter referred to as EFT) is an evidence-based, integrated, experiential, and emotion-centered therapeutic approach. It holds that the occurrence of symptoms is caused by the dysregulation of emotional functions (Fu et al., 2024), and the emergence of individual psychological problems results from over-regulation or under-regulation of emotions. EFT views emotions from a dialectical perspective and classifies them into adaptive emotions and maladaptive emotions. Among them, the former is the core driving force for promoting positive changes in individuals, while the latter hinders individuals’ healthy adaptation, maintains problematic states, and may further trigger psychological problems if not properly regulated. For example, after an adolescent transfers to a new school, they may experience moderate anxiety in the unfamiliar class because they are afraid to initiate communication. This anxiety makes them aware of their need to integrate into the group and further motivates them to try social behaviors such as taking the initiative to greet others—this is an adaptive emotion. On the contrary, if they fall into extreme fear after a single setback, thinking “Everyone hates me, and I will never fit in,” and thus avoid going to school, which affects their academic performance and other aspects, this kind of fear is a maladaptive emotion. Research by Leslie S. Greenberg, the founder of EFT, has found that the exploration, arousal, expression, and transformation of emotions are key factors determining the effectiveness of psychotherapy (Zhang & Wu, 2024). The essence of EFT lies in its dialectical structure: it accepts a series of seemingly contradictory phenomena, attempts to transform them into creative tension, and promotes therapists and clients to break through old predicaments, gain new growth-oriented experiences, and achieve effective changes (Elliott & Greenberg, 2007). Through comparisons with the therapeutic effects of other approaches, numerous studies have proven that EFT has equivalent or even better effects (Elliott, Watson, Greenberg et al., 2013).
2.1.1. EFT for Adolescent Conversion Disorder
This study explored the applicability of EFT in the treatment of psychosomatic symptoms in adolescents. The client was a 13-year-old female in India who had recently transferred from a private school to a public school and faced challenges in social and academic adaptation. Psychological assessment showed that she met the ICD-10 diagnostic criteria for conversion disorder, with high dissociation and severe anxiety. After four weeks of EFT intervention (aimed at cultivating a sense of security, enhancing awareness, and reestablishing the connection between the body and emotions), the client was finally able to name and locate her emotional feelings, and the levels of dissociation and anxiety decreased. The research results indicate that EFT has clinical utility in the treatment of adolescent conversion disorder; its emphasis on physical and mental integration and emotional reconnection can effectively address dissociation and culturally influenced fear schemas. Moreover, this approach is flexible, can adapt to children’s cognitive and emotional characteristics, and is suitable as a treatment method for children’s psychosomatic disorders (Ahmed & Singh, 2025).
2.1.2. EFT for Anxiety in Women with Breast Cancer
A relevant study used a quasi-experimental design to evaluate the effect of EFT on improving anxiety and quality of life in women with breast cancer. Compared with the control group, EFT significantly reduced the anxiety level of patients in the treatment group and improved their quality of life. EFT, which focuses on emotional processing and expression, improved the patients’ emotional regulation ability and can serve as an appropriate intervention method (Salarirad et al., 2022). The research results show that EFT has a significant effect in intervening in individuals’ anxiety, helping to enhance patients’ emotional regulation ability, transform pathological emotions, and thereby improve their quality of life.
2.1.3. EFT for Veterans with Post-Traumatic Stress Disorder
To explore the effectiveness of EFT on emotional dysregulation, hopelessness, and suicidal ideation in veterans with Post-Traumatic Stress Disorder (PTSD), this study adopted a quasi-experimental design. After controlling for the influence of the pre-test, there were significant differences in the mean scores of emotional dysregulation, suicidal ideation, and hopelessness between the two groups in the post-test (p < 0.05), indicating that EFT can reduce emotional dysregulation, suicidal ideation, and hopelessness in veterans with PTSD (Mikaeili et al., 2017).
2.1.4. EFT for Generalized Anxiety Disorder
Relevant studies have shown that EFT has a significant effect in the treatment of Generalized Anxiety Disorder (GAD). As a newly developed approach for GAD, EFT has shown good prospects in open trials, and studies have begun to explore the feasibility of EFT as an alternative to Cognitive Behavioral Therapy (CBT) for the treatment of GAD (Timulak et al., 2018). Compared with treatment using paroxetine alone, EFT combined with paroxetine in the treatment of GAD can improve clinical efficacy, promote the improvement of patients’ anxiety symptoms and sleep quality, reduce stress, regulate neurotransmitter levels, and thereby enhance quality of life (Zhu & Su, 2025).
2.2. Relevant Definitions of Adjustment Disorder
Adjustment disorder can present as adverse emotional reactions (depression, anxiety) and behaviors (social withdrawal, etc.). Adolescents with adjustment disorder mainly exhibit emotional and behavioral abnormalities, often accompanied by anxiety, distress, depressed mood, etc., which seriously harm the physical and mental health and social functions of adolescents and cause severe damage to the development of individuals and families (Yang et al., 2024; World Health Organization (WHO), 1993).
2.2.1. Cognitive Behavioral Therapy for Adjustment Disorder
In a study on the treatment of adjustment disorder with Cognitive Behavioral Therapy (CBT), the control group consisted of adolescents with adjustment disorder who received only conventional medication treatment and were matched in gender and age with the study group during the same period. The observation group consisted of adolescents with adjustment disorder who received both CBT and conventional medication treatment. After the intervention, the scores of social adaptation ability, interpersonal communication ability, socializing, and interpersonal skills in the observation group were higher than those before the intervention and higher than those in the control group. This result indicates that CBT can significantly improve anxiety, depression, interpersonal relationships, and social adaptation functions in adolescents with adjustment disorder (Yang et al., 2024).
2.2.2. Narrative Therapy for Adjustment Disorder
The results of a study on the application of narrative therapy in a case of a second-year junior high school student with school adjustment disorder in China showed that narrative therapy helps establish positive self-identity, extract successful patterns, and transfer these successful patterns to current challenges. This research result indicates that narrative therapy has a good effect in the treatment of adjustment disorder (Ni & Ni, 2022).
2.2.3. Art Therapy, Music Therapy, and Other Approaches for Adjustment
Disorder
Rehabilitation specialists used art therapy, music therapy, and reading therapy to help a 15-year-old patient with adjustment disorder relax their emotions, while administering psychotropic medications. After the patient adapted to the hospital environment, social workers, rehabilitation specialists, and other professionals collaborated to help improve the patient’s various social functions, and the patient finally returned to a normal life (Cui, 2023).
2.2.4. Group Biofeedback Therapy for Adjustment Disorder
The results of this study indicate that the application of group biofeedback therapy in outpatient adolescents with adjustment disorder has certain feasibility, with a low dropout rate, suggesting that this therapy can improve patient compliance. For first-visit adolescents with adjustment disorder, group biofeedback can effectively improve anxiety, depression, and sleep problems. Group biofeedback not only has good tolerability and safety but also can effectively improve the clinical symptoms of adolescents with adjustment disorder, which is worthy of extensive clinical verification, in-depth application, and promotion (Liu, 2022).
3. EFT for Treating Adolescent Adjustment Disorder
Compared with the aforementioned therapies, the goal of EFT is not only to address the immediate issue of adolescents having difficulty integrating into new environments, but also to focus more on teaching adolescents methods to understand and accept their emotions. When emotional problems arise in the future, adolescents will be able to transform maladaptive emotions on their own, making EFT more valuable in the long run.
The most common core symptom of adolescent adjustment disorder is emotional symptoms, mostly negative emotions such as anxiety and depression. Other symptoms, such as maladaptive behaviors and somatization, are mostly caused by emotions—this further highlights the core role of negative emotions in the symptoms of adolescent adjustment disorder.
At the same time, the core mechanism of EFT, which is emotion-centered, involves guiding individuals to identify, understand, and transform their emotions, ultimately achieving behavioral changes and resolving psychological distress at its root. This core mechanism matches the core symptoms of adolescent adjustment disorder; therefore, research on the intervention effect of EFT for adolescent adjustment disorder holds certain research value.
4. Limitations and Gaps in Existing Research
Based on the above summary of domestic and foreign research literature, current studies on EFT show that EFT has a significant effect in treating related psychological problems, and as a newly developed approach for some diseases, it has good prospects. However, most of the existing studies on the treatment of adolescent adjustment disorder focus on other therapeutic approaches, and the number of studies on the application of EFT in intervening in adolescent adjustment disorder is small. As reviewed earlier, current studies on EFT for adolescent adjustment disorder are characterized by small sample sizes, lack of long-term efficacy data, and insufficient comparative research with other therapies. For future research, investigators could explore the intervention effect of EFT on adolescent adjustment disorder through controlled trials or in-depth case studies. Specifically, eligible adolescents aged 13 to 19 should be selected; after obtaining consent from the adolescents themselves and their guardians, appropriate EFT interventions should be implemented. Additionally, longitudinal follow-up studies should be conducted as much as possible to verify the long-term efficacy of EFT and fill the gap of insufficient long-term efficacy data. Furthermore, future research could delve into the association between the core mechanisms of EFT and the core symptoms of adolescent adjustment disorder, clarify the differences in the intervention effects of EFT on different subtypes of adjustment disorder, or conduct comparative studies between EFT and therapies such as CBT to quantify the characteristics and advantages of EFT in terms of efficacy. The aforementioned research efforts will not only improve the theoretical system but also provide more alternative options for clinical practice, helping to address practical needs in the field of adolescent mental health.
To sum up, domestic and foreign scholars have made achievements in the research of EFT and adolescent adjustment disorder, respectively, but there are few studies on the intersection of these two fields. The reasons for the research gaps may lie in the following aspects: compared with mainstream psychotherapy methods such as CBT, EFT places greater emphasis on exploring and understanding emotions, resulting in a relatively slow, in-depth process that takes more time. Additionally, EFT has a lower level of popularization, which makes it less widely used in practical applications than methods like CBT. Therefore, the results of existing studies provide a rich theoretical basis and practical experience for research on EFT intervention in adolescent adjustment disorder, play an important role in promoting its development, and also serve as the theoretical reference for this paper.
5. Conclusion
In summary, this paper organizes the research on the intervention effect of EFT in adolescent adjustment disorder. By analyzing relevant studies by domestic and foreign scholars, this paper reviews the historical development, current status, and future development trends of research fields related to EFT in treating psychological diseases and adjustment disorder intervention methods, and provides an effective theoretical reference and framework. At the same time, there are few studies on the intersection of these two fields, and this paper provides relatively practical research directions to facilitate the provision of a practical basis, thus having certain practical significance. Most scholars have applied EFT to the treatment of other psychological problems and achieved significant effects; meanwhile, these relevant studies have also promoted the development of the field of EFT intervention in adolescent adjustment disorder. Based on this, this paper summarizes the research results in relevant fields and concludes the limitations of current research.