Therapy approaches, explained

Accelerated experiential dynamic psychotherapyAEDP

People carry a drive towards healing and growth. Pain tends to need defences because feelings have to be faced alone; with someone alongside, a feeling can run its course, and the change that follows deserves to be noticed.^[7,8]

Start with the basics Meet our team

AEDP's answer: suffering often comes from facing it alone, not from the feeling being too big

Have you ever read a promotion list that didn't include your name, and when a colleague asked, said with a smile, "It doesn't matter"? At that moment it seems fine; at home, the heaviness in your chest lasts for days. Sometimes the same sadness is sayable, even cry-able, when someone stops to keep you company, and when you are alone all you can do is smile and press it down. Why is the same feeling bearable with someone alongside and unbearable alone?

1The worldview

The change triangle: three layers beneath "it doesn't matter"

Accelerated experiential dynamic psychotherapy (AEDP) was created by the American psychologist Diana Fosha, whose 2000 book The Transforming Power of Affect is its starting point. Fosha describes it as a healing-oriented, attachment-based, experiential mind–body therapy. Its roots lie in developmental psychoanalysis and short-term psychodynamic therapy, joined with attachment research, emotion theory, affective neuroscience and body-oriented ways of working with trauma. Its central picture is the triangle of conflict from the Malan and Davanloo line of short-term dynamic therapy, known in popular writing as the change triangle (see below).^{[1,3,7,19,20,21,22]}

Back to the opening question: AEDP's reading rests on two pillars. First, people are born with a drive towards healing and growth, which Fosha calls transformance: the therapist does not supply it, it is already there, and the work is to find it and amplify it. Second, the core of psychological difficulty is not "illness" but being overwhelmed by strong emotion with no one alongside, and having to cope alone; so therapy's mission is first to undo aloneness, so that two people can face together what was once too much to face. AEDP also holds that insight follows transformation, not the other way round.^[7,8]

The Chinese name is not standardised: a Taipei clinic's introduction writes 加速體驗動力心理治療, Chinese academic writing generally uses 加速經驗性動力心理治療, and Hong Kong organisations also use the short name 感動治療 (for example the Mental Health Association of Hong Kong); this page uses 加速體驗動力心理治療. And "accelerated" does not mean hurried: Fosha observed that once emotion is fully processed, change tends to come as sudden shifts rather than accumulating bit by bit, and therapy, with safety first, makes the most of these shifts.^{[3,4,23,24,25]}

To see what lies beneath "it doesn't matter", AEDP looks at a person through a triangle. It comes from short-term psychodynamic therapy's triangle of conflict (Malan's triangle, covered on our psychodynamic page, with Davanloo's short-term dynamic therapy part of the same lineage): defences and inhibitory emotions (anxiety, shame, and in popular versions guilt) hold down the core feeling beneath. What is distinctive in AEDP is that it draws two versions: when safety is lacking, the self-at-worst, with the core feeling blocked and "red-signal" affects showing; when the relationship is safe, the self-at-best, with "green-signal" affects such as hope, trust and curiosity, and the feeling within reach. Therapy works from the first minute to bring out the latter. In popular writing this triangle is also called the change triangle.

DefenceHabits for avoiding feeling: joking, reasoning, staying busy, going numb
Inhibitory emotionsAnxiety, shame, guilt: fear of ridicule, of being a burden
Core feelingThe direct emotion beneath: sadness, anger, fear, joy, with what it wants to do

2The method

Once someone is there, how does it go? Four states, three transformations, and the therapist tracks where you are

Back to that opening heaviness: someone being there is only the start, so how does it go from there? AEDP has no fixed session-by-session steps. What makes it systematic is a map: moment by moment the therapist tracks which state you are in, and offers what suits that state. The early version of AEDP (Fosha's 2006 paper) had three states; today working with the experience of transformation itself is a state of its own, the third, and core state is the fourth. Moving from one state to the next is a state transformation, three in all. The map describes the path of one emotional episode, and a single session can run it many times.^[3,7,8]

1Distress and defenceYou arrive with symptoms, anxiety, shame; build safety first and enlarge the glimmers of feeling that show through the defences.DefenceInhibitory emotions
2Core affective experienceDefences ease and the core feeling rises in the body; together you reach it, deepen it and see it through until what it wants to do is released.Core feeling
3Transformational experienceThe relief, pride or feeling moved that comes once a feeling has run its course: stop and make the change itself the thing you work with.Core feeling
4Core stateA calm, clear state close to yourself, with a sense of "this is me" and truth, consolidated into a new understanding of who you are.Core feeling

Back to the opening: your name is not on the promotion list, and how the four states go

1The company announces promotions and your name is not on the list. A few days later in therapy you say, smiling, "It doesn't matter, I never liked meetings anyway."

Staying with the defenceHow AEDP goes

State 1: defence and inhibition

Staying with the defenceHumour carries it past, and the talk turns to rotas

How AEDP goesThe therapist first affirms that humour has helped you through a lot, then notices your voice dip; you say you fear being seen as making a fuss (shame), and it is received

State 2: core feeling

Staying with the defenceThe feeling never shows, only a heaviness

How AEDP goesThe heaviness sits in the chest, and beneath it is "being overlooked"; sadness rises and is seen through with company (tears, an out-breath, the body loosening)

State 3: the transformation

Staying with the defenceStraight after crying, "sorry" and a change of subject

How AEDP goesThe therapist asks you to notice what just happened: surprise ("I actually could"), a warmth in the chest, someone alongside

State 4: core state

Staying with the defenceNothing feels different

How AEDP goesCalm and clear: "I'm worth being kept company." And also knowing that back at work tomorrow, you may shrink again

Set against the map above: "It doesn't matter" is the defence, the fear of making a fuss is the inhibitory emotion, and "being overlooked" is the core feeling; the therapist uses affirmation and company in state 1 (the first dialogue below), sees the feeling through in state 2 (the second), then pauses in state 3 to work with the transformation itself (the third). A CBT (cognitive behavioural therapy) approach would more likely begin by examining the thought "I'm not good enough"; AEDP lets the feeling run its course first and then looks at the change. State 4 does not appear every time, and change is never finished in one go. Find the layer in your own chest with the emotion-awareness exercise

3The skills

Six ways of working: how you stop facing it alone, matched to the triangle's three corners

Everything the therapist does in the example above comes from these six main ways of working, not a sequence: which one is used depends on the state you are in at that moment. They are grouped by the corner they serve: defence, inhibitory emotion, core feeling. They depend on the therapist's judgement in the room and on the relationship, so this page does not offer a version to practise alone.

Defence: safety first, letting go later

Defences once protected you, so affirm them first and soften them slowly.

Undoing aloneness: affirmation and company
An AEDP therapist's stance is active, engaged and affirming. Rather than staying detached, they voice appreciation and care, share at fitting moments how they are moved, and affirm what a defence once did rather than hurry to take it apart. The engagement is not to please but to let you really feel you are not alone, since the safer the relationship, the more able you are to touch feelings that frighten you.^[4,7]
Hear it in a session
1. Client
  The promotion list came out and I'm not on it. Doesn't matter, I never liked meetings anyway, haha.
2. Therapist
  You say it with a smile. That humour has surely helped you through a lot, I can see that. But I also noticed that when you said "not on the list", your voice dropped a little. May I slow down and look at that moment? If you want to stop, tell me any time.
3. Client
  …OK.
4. Therapist
  Thank you. Where in your body do you notice something first?
5. Client
  My chest. A bit heavy.
6. Therapist
  A bit heavy in your chest. You don't have to hold it alone; I'm here. Inside the heaviness, is there a word, or a picture?
7. Client
  Something like… being overlooked.
8. Therapist
  Overlooked. …Having said it, what is it like now?
9. Client
  I feel a bit like crying, but also a bit embarrassed.
10. Therapist
  Wanting to cry and embarrassed, both can be here. What is the embarrassed part worried about?
11. Client
  That you'll think I'm making a fuss.
12. Therapist
  Thank you for telling me. What I hear is someone who tries hard and doesn't want to be a bother. That's not making a fuss at all.
13. Client
  (Lets out a breath) …When you put it that way, I feel a little looser.
14. Therapist
  A little looser. As it loosens, what is your body doing?
Notice: This is state 1 work. The person from the opening, alone and smiling "it doesn't matter", here has someone stay for the first time. The therapist doesn't expose the humour; they affirm it first, then notice a change in the voice, ask consent before slowing down and say she can stop at any time. The feeling is approached through the body, and when the shame (fear of making a fuss) is voiced, the therapist receives it directly rather than interpreting it. The client only loosens a little; nothing suddenly "clicks".
Method based on^[3,4,7]
Moment-to-moment tracking: the body and small shifts
Tracking is an AEDP therapist's basic skill: listening not only to what you say but to your tone, breathing, expression and small bodily changes, and how you react to each thing the therapist says, starting from the felt sense in the body rather than from narrative and analysis. Because of this fineness, AEDP training treats video recording as close to essential: therapists replay their own sessions to learn to catch changes that last only a few seconds.^[7]

Inhibitory emotion: anxiety and shame loosen when someone stays

Through moment-to-moment regulation between two people, not willpower, and knowing when to slow down.

Dyadic regulation: holding anxiety and shame together
AEDP sees the therapy relationship as an ongoing cycle between two people of attunement, disruption and repair: the therapist matches your emotional state (attunement), moments of mismatch inevitably occur (disruption), and the two of you bring it back together (repair). When anxiety or shame floods in, the therapist does not steer round it but names it and stays with it, using their own steady tone, pace and expression to help you regulate, so you need not cope by numbing or defending. The therapist's own emotional response is part of the process too, shared where fitting, with an invitation to say how it lands.^[2,4,10]
Working with trauma: slow, bounded, with a trained therapist
AEDP says it can work with trauma and attachment trauma, but Fosha herself names a boundary: overwhelming traumatic feeling (she calls it maladaptive affective experience) does not simply resolve when someone is accompanied through it as ordinary feelings do, and merely helping people re-experience it is not only unhelpful but can re-traumatise. So this work stresses going slowly and using methods that do not simply replay the trauma, such as intra-relational work, building a relationship with the injured parts within, or, in complex trauma and dissociation, first choosing which level is safest. Whatever the approach, the following lines hold: every step needs your consent; if you start to go numb, panic, space out or feel frozen, you stop, come back to the present and steady yourself rather than push through; you can say stop at any time, or decide not to touch it today; and until trauma is stabilised, it should not be re-run through books or self-help exercises alone.^[7,15,16]

Core feeling: see it through, then look back at the change

There is often strength at the end of a feeling; AEDP's signature is to treat that change as material for therapy too.

Seeing the core feeling through: reach, deepen, complete
A core feeling is like a wave: it appears faintly, rises in the body, is experienced, put into words and understood, and finally recedes, bringing calm. The therapist goes with you step by step: first reaching it, then deepening it, then on to completion, when what the feeling wants to do (cry, protect yourself, voice anger) is released. One common method is the portrayal: acting out in imagination what the feeling wants to do, for instance imagining someone coming to the younger you's side. When a feeling is too strong, the therapist slows down and steadies first, rather than pushing for "depth".^[3,7,8]
Hear it in a session
1. Therapist
  That sense of being overlooked, you said it's in your chest. If you're willing, we can go a little closer to it. If it becomes too much, tell me and we'll slow down.
2. Client
  OK. …It feels very old. At parents' evenings when I was little, I was the only one nobody came for.
3. Therapist
  Nobody came for you. Saying it now, what's happening in your chest?
4. Client
  Tighter, and my throat aches a bit.
5. Therapist
  Tight, an ache in the throat. I'm right here with you. If this sadness wanted to do something, what would it want to do?
6. Client
  It wants someone to come over and hold me.
7. Therapist
  Could we try it in imagination? Picture that child on the bench in the corridor, and someone walking over to her. What do you want that person to do?
8. Client
  (Eyes reddening) Crouch down and say, "I'm here."
9. Therapist
  Crouch down and say "I'm here". Let the picture stay a moment. What does your body do?
10. Client
  (Tears, breathing slowly deepening) …My shoulders have dropped.
11. Therapist
  Let it come. I'm here. …(a pause) How is it now?
12. Client
  It's eased off a bit. Calmer than before.
Notice: This is state 2: the heaviness that could not be pressed down at the start now has someone beside it, and the feeling is reached, deepened and completed through an imagined portrayal. The therapist asks permission and says in advance that they can slow down if it becomes too much. The client's sadness rises in the body and then recedes, her breathing deepens, and she is never pushed to the point of breaking down. This is not a demonstration of work with major trauma, only a memory of being overlooked as a child.
Method based on^[3,7]
Working with the transformation itself: noticing the good so it takes root
This is what is most distinctive about AEDP, called metatherapeutic processing (metaprocessing for short). In most therapy, a feeling being completed is an end point; AEDP holds that it is exactly the start of another round of work: the therapist pauses and asks you to notice the change that just happened and what comes with it, such as pride, being moved, gratitude, even a little fear and excitement, and works with these as carefully as with painful feelings. Fosha groups them into four kinds: mastery (pride, joy), mourning the self, being moved at being seen, and facing the strangeness that change brings. The aim is that progress is remembered by the body and that positive feeling becomes a new resource. In popular writing this is sometimes called "tracking the good".^[3,5,6,9]
Hear it in a session
1. Therapist
  Just now you let yourself cry, and let me stay with you. I'd like to ask you to look back at this moment: what do you notice now?
2. Client
  Lighter. And a bit… surprised. I actually could.
3. Therapist
  Surprised, "I actually could". Where is that surprise in your body?
4. Client
  My shoulders have come down, and my eyes are a bit hot, but it's a warm kind of hot.
5. Therapist
  Warm. Stay in that warmth a little longer. What is it warm towards?
6. Client
  Towards myself, I think. …And that you were here the whole time.
7. Therapist
  You say "you were here the whole time", and I'm moved by your openness too. You let me see this part of you, and thank you. Hearing me say that, what do you feel?
8. Client
  A bit shy, but… the good kind.
9. Therapist
  Shy, and good. If this warmth had something to say, what would it say?
10. Client
  It says I'm worth being kept company. …But I know that when I'm back at work tomorrow, I'll shrink again.
11. Therapist
  That is true too, and there's no need to rush to erase it. Shall we keep this warmth in mind together and see, next time you're back at work, whether it's still there?
Notice: This is state 3, following on from the previous exchange. The therapist doesn't ask "do you feel better?" but invites the client to notice the change itself: the body, the feelings, the relationship with the therapist. The client names mixed feelings (surprise, warmth, also unease), the therapist welcomes all of them and honestly shares being moved too. It does not end by announcing "you're better": she knows she may shrink again tomorrow, and that is treated as part of what is real.
Method based on^[3,6,9]

The dialogues are illustrative composites, not real clients; skills that stir strong emotion or touch on trauma should be done with a trained therapist.

Company is built session by session: what does a course of AEDP look like?

Now you know how it sees a person and how it works. The next questions: what is it actually like, does it work, and what is it not for?

Being alongside is not done in one go. In research AEDP is usually weekly for 16 sessions; real length varies, from a dozen or so sessions on one specific event to a year or more on a long-standing pattern. The first session varies too: some are 50 minutes, while in a case Fosha published there was first a detailed evaluation of about three and a half hours. AEDP sessions are often video-recorded for supervision and self-review, and in a case Fosha published the client received copies of every session; some therapists also work by video call.^{[3,7,11,17,18,26]}

1Welcome and safetyFrom the first minute the therapist actively offers welcome and care, and invites you to say what you hope for and worry about. The aim is for you to feel seen and not alone before the more painful material is touched.
2Find the stuck pattern and a trace of strengthTogether you look at the difficulty, what sets it off and your usual defences, while noticing strengths you already have and signs of movement towards growth, as the starting point.
3Reach the feeling and see it throughWhen a feeling rises in the body, the therapist goes with you in reaching and deepening it, and completing it through portrayals and the like. If it is too strong, slow down and steady first.
4Pause and look at the changeAfter a feeling has run its course, turn to the change itself: what is different in the body, in feeling and in the relationship with the therapist, letting the positive feeling be felt and remembered.
5Take the new understanding into lifeNotice how the changes show up day to day, and face honestly any return of the old pattern.
6Saying goodbye wellEnding is part of therapy too: reviewing the road travelled, acknowledging what is hard to leave, and saying what each takes away.

Whom can this company help, and with what?

AEDP's research covers a wide range of difficulties rather than a single diagnosis: participants' depression, avoidance of feeling, difficulty regulating emotion and main problems all improved. It also looks especially at attachment trauma and relational hurt, and aims, beyond easing distress, to build self-acceptance and vitality.^[7,11]

Depression and general emotional distress
Habitually avoiding feeling through joking, reasoning or busyness
Difficulty regulating emotion
Shame, loneliness and insecurity left by early relationships
Trauma (only with a trained therapist, at a safe pace)
People wanting more self-acceptance and vitality

Everyone is different. If you are thinking of hurting yourself or ending your life, please don't face it alone: call The Samaritans' 24-hour line on 2896 0000, or 999 in an emergency. If you have a history of severe trauma, or are often flooded or dissociate, talk with a therapist first about how to go slowly and stay safe.

Someone alongside, the feeling run its course: how much evidence stands behind it?

This way of going sounds reasonable, but reasonable is not the same as effective. AEDP is young: Fosha's first book appeared in 2000 and the first effectiveness study was published in 2020. So far the research has mostly been done by the teams promoting the approach, and there is no randomised controlled trial. All five items below sit at "more evidence needed": the early results are encouraging, but not enough to conclude.

Overall: most people improved after 16 sessions
A study run in private practices in the United States, Canada, Israel, Japan and Sweden followed about 60 self-referred adults, each given 16 sessions of AEDP. After treatment, depression, avoidance of feeling, overall distress, difficulty regulating emotion and the main problem they came with all improved clearly, and most people's progress was larger than the scales' own margin of error; self-compassion and self-esteem rose too. The limits: there was no comparison group, so we cannot tell how much was time or what other therapies would also bring; every result is self-report; and the research team is closely tied to the approach's founder.^[7,11]
Does it last? Gains mostly held at six and twelve months
Of the same people, 40 answered at six months and 52 at twelve; the gains made in treatment mostly held. Those with more severe problems gained more, and more of them reached clinically meaningful change. The limits: still no comparison group, and not everyone responded, so how the non-responders fared is hard to know.^[12]
Positive emotion: tied to better sessions, but not clearly at six months
AEDP stresses working with positive emotion, and two studies followed this across the 16-session course. In one, with 46 participants, more positive emotion in a session went with a better session and better functioning the week after; positive emotion across the whole course predicted improvement in depression and interpersonal functioning after treatment, but at six months the link was no longer significant. In the other, with 58 participants, more positive emotion at the end of one session went with a better working alliance (collaboration and trust) in the next, though not the other way round. The limit: these are associations, and do not show that working with positive emotion caused the gains.^[13,14]
The signature technique, metaprocessing: described, not yet tested
Research on metatherapeutic processing has so far mainly described how it unfolds: in 2016 a preliminary process model built with task analysis (analysing therapy segments in detail to derive steps) was the first empirical study of it. It shows how the technique goes, but does not compare therapy with and without it.^[7,9]
Better than other therapies, or for complex trauma? No evidence yet
In PubMed we found no randomised trial comparing AEDP with another therapy, and no clinical trial of AEDP for post-traumatic stress disorder. A 2008 paper by authors from the AEDP founder's team compared it with prolonged exposure for complex post-traumatic stress disorder: the latter has strong research support, while evidence for experiential therapy is "sparser, but also positive". That is an argument, not a trial result.^[11,15]

So the honest summary is that AEDP has a clear, fine-grained theory, and early studies show people in the course generally improving, but it has not yet been fairly compared with other therapies. Neighbouring approaches such as emotion-focused therapy have more research behind them; a reason to choose AEDP is more likely a fit with its theory, your therapist's experience and your relationship with them, not that it has been shown to work better than others.^[7,11,12]

To be honest: this kind of company has limits too

Beyond the still-thin evidence, a few things are worth knowing:^[7,11]

1Research from the founder's team, small samples, no comparison

The effectiveness studies so far come from AEDP's own practice-research network, with the founder, Fosha, among the authors; there are about 60 participants, no comparison group, and the results are self-report. That doesn't make them untrue, but until other researchers repeat them with comparison groups they should be read cautiously.

2Overlap with neighbouring approaches, so it is hard to say what works

AEDP's own sources include attachment theory, short-term psychodynamic therapy (for example Davanloo's intensive short-term dynamic psychotherapy), other emotion-focused experiential therapies and body-oriented methods. What is distinctive is mainly treating transformation itself as the object of therapy, and the therapist's active, engaged stance; but no research yet shows whether these add anything beyond the neighbouring approaches.

3Recording and an active, affirming style do not suit everyone

AEDP treats recording as an important tool for training and supervision, and the sessions in its research were all recorded. Some people feel uncomfortable on camera, and some find a therapist's direct expression of feeling and affirmation too close, or prefer more distance. It is worth asking before you start whether sessions will be recorded, how recordings are stored, and whether you have a choice.

4Samples from elsewhere; no research in Hong Kong that we found

The research was done in the United States, Canada, Israel, Japan and Sweden, and we found none in Hong Kong or other Chinese-speaking communities. AEDP encourages directly expressing feelings and needs; whether it suits people used to more reserved expression just as well remains to be studied.

5Looking at the good is no substitute for going through the pain

In AEDP's model it is the painful feeling that is seen through first, and only then the transformation and positive feeling that are worked with. If anyone uses "look on the bright side" to skip the pain, that is a misuse, not AEDP. If you feel pushed to feel better, tell your therapist directly.

So for the heaviness pressed down alone at the start, AEDP offers a way of going with someone alongside, not a guarantee. It is an attractive, finely worked-out road, especially for people who value relationship and bodily feeling; but its evidence is only beginning, and a good therapist adjusts to you and is frank about what remains unknown.

Take this with you

Some sadness is not too big; it has simply never had anyone beside it. With the research still young, this is a view worth carrying, not a promise: once a feeling has run its course, look back and see what you now have that you didn't before.

A self-guided AEDP path

Not ready to see a therapist? Start by learning about attachment and noticing your feelings. Trauma and deeper emotional work are best left to a trained therapist.

Courses

Beyond AEDP: which other approaches work with feeling and relationship

AEDP stands where several approaches meet: the psychodynamic triangle, attachment and object relations, the experiential and humanistic present, and the approaches that work with emotion.

Psychodynamic therapyAEDP's root. The change triangle comes from Malan's triangle of conflict; AEDP keeps it, but works more actively to let the core feeling run its course and gives weight to positive transformation.^[7,19]
Emotion-focused therapy (EFT)Also centred on emotion and present experience, and one of AEDP's sources. EFT, developed by Greenberg, has more research; AEDP puts more weight on dyadic regulation within attachment, and works with transformation itself.^[4]
Person-centred therapyAEDP's affirming, accompanying stance echoes person-centred acceptance and empathy; the difference is that an AEDP therapist is more active and proposes specific experiential methods.^[4]
Object-relations therapyAlso concerned with how early relationships become internalised as the way we see ourselves and others; AEDP turns this into a new relational experience, lived through with the therapist in the present.^[7]
Compassion-focused therapy (CFT)Also works with shame, centred on building compassion for oneself. AEDP's research also measured self-compassion, and it rose.^[7,11]
Emotionally focused couple therapyDeveloped by Sue Johnson around attachment theory, also abbreviated EFT, and aimed at the cycles between partners. Like AEDP it treats attachment as the ground of change, but its subject is the couple's relationship rather than the individual.^[7]

Other therapy approaches

FAQ

What is AEDP called in Chinese? Is 感動治療 the same thing?

Yes, the same therapy under different translations. 加速體驗動力心理治療 (used by a Taipei clinic's introduction), 加速經驗性動力心理治療 (generally used in Chinese academic writing) and 感動治療 (the short name used by Hong Kong organisations such as the Mental Health Association of Hong Kong) all refer to accelerated experiential dynamic psychotherapy. This page uses 加速體驗動力心理治療.^[23,24,25]

Does "accelerated" mean you get better quickly?

No. "Accelerated" means that when therapy lets emotion fully run its course within a safe relationship, change often arrives as sudden shifts, so it can come sooner than expected. But AEDP equally stresses safety, since the safer the relationship, the more able you are to face frightening feelings; it promises no particular speed, and real length varies from a dozen sessions to over a year.^[3,4,7,26]

Will AEDP make me relive trauma?

It shouldn't. Fosha herself says that merely accompanying someone through re-experiencing overwhelming traumatic feeling does not help and can re-traumatise. A trained AEDP therapist working with trauma puts your safety and stability first, goes slowly, and uses methods that do not simply replay the trauma. In any approach you have the right to say stop at any time, or to decide not to touch it this time.^[7,15]

Are there randomised controlled trials?

We found none in the PubMed database. The main research so far is a study of about 60 people over 16 sessions with no comparison group, plus its six- and twelve-month follow-up. That is preliminary evidence, not a conclusion.^[11,12]

How is AEDP different from EFT?

Both stress emotion and present experience, and the names are easily confused (EFT can mean Greenberg's emotion-focused therapy or Johnson's emotionally focused couple therapy). AEDP is distinguished by its basis in the attachment relationship and dyadic regulation, and by treating transformation itself as something to work with; EFT has developed marker-guided tasks such as chair dialogues, and has more research. They overlap a good deal, and no study compares them directly.^[4,7]

Does it have to be recorded?

AEDP training and certification treat recording as an important tool, and the research sessions were all recorded, but that is the therapist's training need, not necessarily yours. You are entitled to ask beforehand whether sessions will be recorded, why, how recordings are kept and who sees them, and you can decline.^[7,11]

How do I find an AEDP therapist in Hong Kong?

Look for specific AEDP training and certification (AEDP certification involves submitting recorded sessions), and membership of a professional body. Further down are TreeholeHK's therapists who use AEDP; read their backgrounds before you book.^[7]

References

1.Fosha, D. (2000). The transforming power of affect: A model for accelerated change. Basic Books.
2.Fosha, D. (2001). The dyadic regulation of affect. Journal of Clinical Psychology, 57(2), 227–242. doi.org/10.1002/1097-4679(200102)57:2%3C227::AID-JCLP8%3E3.0.CO;2-1
3.Fosha, D. (2006). Quantum transformation in trauma and treatment: Traversing the crisis of healing change. Journal of Clinical Psychology, 62(5), 569–583. doi.org/10.1002/jclp.20249
4.Fosha, D., & Yeung, D. (2006). Accelerated experiential-dynamic psychotherapy: The seamless integration of emotional transformation and dyadic relatedness at work. In A casebook of psychotherapy integration (pp. 165–184). American Psychological Association. doi.org/10.1037/11436-013
5.Fosha, D. (2009). Positive affects and the transformation of suffering into flourishing. Annals of the New York Academy of Sciences, 1172, 252–262. doi.org/10.1111/j.1749-6632.2009.04501.x
6.Fosha, D., & Thoma, N. C. (2020). Metatherapeutic processing supports the emergence of flourishing in psychotherapy. Psychotherapy, 57(3), 323–339. doi.org/10.1037/pst0000289
7.Fosha, D. (2021). Introduction: AEDP after 20 years. In D. Fosha (Ed.), Undoing aloneness and the transformation of suffering into flourishing: AEDP 2.0 (pp. 3–23). American Psychological Association. doi.org/10.1037/0000232-001
8.AEDP Institute. (n.d.). Transformance and the phenomenology of transformation. aedpinstitute.org
9.Iwakabe, S., & Conceição, N. (2016). Metatherapeutic processing as a change-based therapeutic immediacy task: Building an initial process model using a task-analytic research strategy. Journal of Psychotherapy Integration, 26(3), 230–247. doi.org/10.1037/int0000016
10.Lipton, B., & Fosha, D. (2011). Attachment as a transformative process in AEDP: Operationalizing the intersection of attachment theory and affective neuroscience. Journal of Psychotherapy Integration, 21(3), 253–279. doi.org/10.1037/a0025421
11.Iwakabe, S., Edlin, J., Fosha, D., Gretton, H., Joseph, A. J., Nunnink, S. E., Nakamura, K., & Thoma, N. C. (2020). The effectiveness of accelerated experiential dynamic psychotherapy (AEDP) in private practice settings: A transdiagnostic study conducted within the context of a practice-research network. Psychotherapy, 57(4), 548–561. doi.org/10.1037/pst0000344
12.Iwakabe, S., Edlin, J., Fosha, D., Thoma, N. C., Gretton, H., Joseph, A. J., & Nakamura, K. (2022). The long-term outcome of accelerated experiential dynamic psychotherapy: 6- and 12-month follow-up results. Psychotherapy, 59(3), 431–446. doi.org/10.1037/pst0000441
13.Gross, N., Bar-Kalifa, E., & Shahar, B. (2026). The role of positive emotions in accelerated experiential dynamic psychotherapy. Psychotherapy Research, 36(5), 959–970. doi.org/10.1080/10503307.2025.2534972
14.Notsu, H., Iwakabe, S., & Thoma, N. C. (2023). Enhancing working alliance through positive emotional experience: A cross-lag analysis. Psychotherapy Research, 33(3), 328–341. doi.org/10.1080/10503307.2022.2124893
15.Gleiser, K., Ford, J. D., & Fosha, D. (2008). Contrasting exposure and experiential therapies for complex posttraumatic stress disorder. Psychotherapy, 45(3), 340–360. doi.org/10.1037/a0013323
16.Lamagna, J., & Gleiser, K. A. (2007). Building a secure internal attachment: An intra-relational approach to ego strengthening and emotional processing with chronically traumatized clients. Journal of Trauma & Dissociation, 8(1), 25–52. doi.org/10.1300/J229v08n01_03
17.Ronen-Setter, I. H., & Cohen, E. (2020). Becoming "teletherapeutic": Harnessing accelerated experiential dynamic psychotherapy (AEDP) for challenges of the COVID-19 era. Journal of Contemporary Psychotherapy, 50(4), 265–273. doi.org/10.1007/s10879-020-09462-8
18.Harrison, R. L. (2020). Termination in 16-session accelerated experiential dynamic psychotherapy (AEDP): Together in how we say goodbye. Psychotherapy, 57(4), 531–547. doi.org/10.1037/pst0000343
19.Malan, D. H. (1979). Individual psychotherapy and the science of psychodynamics. Butterworths.
20.Davanloo, H. (1990). Unlocking the unconscious: Selected papers of Habib Davanloo. Wiley.
21.Hendel, H. J. (2018). It's not always depression: Working the change triangle to listen to the body, discover your core emotions, and connect to your authentic self. Spiegel & Grau.
22.Hendel, H. J. (n.d.). What is the change triangle? hilaryjacobshendel.com. hilaryjacobshendel.com
23.香港心理衛生會. (n.d.). 感動治療 (AEDP). tnfc.mhahk.org.hk
24.李政洋身心診所. (2026, July 9). 如何化解孤獨、轉化痛苦、邁向繁盛？AEDP 介紹. leepsyclinic.com
25.Peace Academia. (n.d.). AEDP感動治療簡介. peace-academia.com
26.Solacare 心亮閣. (n.d.). About accelerated experiential dynamic psychotherapy (AEDP). solacare.hk

Want someone alongside you?

You can do the exercises on your own. When you're stuck, a trained therapist can take you further.

Book therapy

Working with the transformation itself: noticing the good so it takes root

This is what is most distinctive about AEDP, called metatherapeutic processing (metaprocessing for short). In most therapy, a feeling being completed is an end point; AEDP holds that it is exactly the start of another round of work: the therapist pauses and asks you to notice the change that just happened and what comes with it, such as pride, being moved, gratitude, even a little fear and excitement, and works with these as carefully as with painful feelings. Fosha groups them into four kinds: mastery (pride, joy), mourning the self, being moved at being seen, and facing the strangeness that change brings. The aim is that progress is remembered by the body and that positive feeling becomes a new resource. In popular writing this is sometimes called "tracking the good".^[3,5,6,9]

Hear it in a session

Therapist
Just now you let yourself cry, and let me stay with you. I'd like to ask you to look back at this moment: what do you notice now?
Client
Lighter. And a bit… surprised. I actually could.
Therapist
Surprised, "I actually could". Where is that surprise in your body?
Client
My shoulders have come down, and my eyes are a bit hot, but it's a warm kind of hot.
Therapist
Warm. Stay in that warmth a little longer. What is it warm towards?
Client
Towards myself, I think. …And that you were here the whole time.
Therapist
You say "you were here the whole time", and I'm moved by your openness too. You let me see this part of you, and thank you. Hearing me say that, what do you feel?
Client
A bit shy, but… the good kind.
Therapist
Shy, and good. If this warmth had something to say, what would it say?
Client
It says I'm worth being kept company. …But I know that when I'm back at work tomorrow, I'll shrink again.
Therapist
That is true too, and there's no need to rush to erase it. Shall we keep this warmth in mind together and see, next time you're back at work, whether it's still there?

Notice: This is state 3, following on from the previous exchange. The therapist doesn't ask "do you feel better?" but invites the client to notice the change itself: the body, the feelings, the relationship with the therapist. The client names mixed feelings (surprise, warmth, also unease), the therapist welcomes all of them and honestly shares being moved too. It does not end by announcing "you're better": she knows she may shrink again tomorrow, and that is treated as part of what is real.

Method based on^[3,6,9]

FAQ

What is AEDP called in Chinese? Is 感動治療 the same thing?

Does "accelerated" mean you get better quickly?

Will AEDP make me relive trauma?

Are there randomised controlled trials?

How is AEDP different from EFT?

Does it have to be recorded?

How do I find an AEDP therapist in Hong Kong?

References

1.Fosha, D. (2000). The transforming power of affect: A model for accelerated change. Basic Books.
2.Fosha, D. (2001). The dyadic regulation of affect. Journal of Clinical Psychology, 57(2), 227–242. doi.org/10.1002/1097-4679(200102)57:2%3C227::AID-JCLP8%3E3.0.CO;2-1
3.Fosha, D. (2006). Quantum transformation in trauma and treatment: Traversing the crisis of healing change. Journal of Clinical Psychology, 62(5), 569–583. doi.org/10.1002/jclp.20249
4.Fosha, D., & Yeung, D. (2006). Accelerated experiential-dynamic psychotherapy: The seamless integration of emotional transformation and dyadic relatedness at work. In A casebook of psychotherapy integration (pp. 165–184). American Psychological Association. doi.org/10.1037/11436-013
5.Fosha, D. (2009). Positive affects and the transformation of suffering into flourishing. Annals of the New York Academy of Sciences, 1172, 252–262. doi.org/10.1111/j.1749-6632.2009.04501.x
6.Fosha, D., & Thoma, N. C. (2020). Metatherapeutic processing supports the emergence of flourishing in psychotherapy. Psychotherapy, 57(3), 323–339. doi.org/10.1037/pst0000289
7.Fosha, D. (2021). Introduction: AEDP after 20 years. In D. Fosha (Ed.), Undoing aloneness and the transformation of suffering into flourishing: AEDP 2.0 (pp. 3–23). American Psychological Association. doi.org/10.1037/0000232-001
8.AEDP Institute. (n.d.). Transformance and the phenomenology of transformation. aedpinstitute.org
9.Iwakabe, S., & Conceição, N. (2016). Metatherapeutic processing as a change-based therapeutic immediacy task: Building an initial process model using a task-analytic research strategy. Journal of Psychotherapy Integration, 26(3), 230–247. doi.org/10.1037/int0000016
10.Lipton, B., & Fosha, D. (2011). Attachment as a transformative process in AEDP: Operationalizing the intersection of attachment theory and affective neuroscience. Journal of Psychotherapy Integration, 21(3), 253–279. doi.org/10.1037/a0025421
11.Iwakabe, S., Edlin, J., Fosha, D., Gretton, H., Joseph, A. J., Nunnink, S. E., Nakamura, K., & Thoma, N. C. (2020). The effectiveness of accelerated experiential dynamic psychotherapy (AEDP) in private practice settings: A transdiagnostic study conducted within the context of a practice-research network. Psychotherapy, 57(4), 548–561. doi.org/10.1037/pst0000344
12.Iwakabe, S., Edlin, J., Fosha, D., Thoma, N. C., Gretton, H., Joseph, A. J., & Nakamura, K. (2022). The long-term outcome of accelerated experiential dynamic psychotherapy: 6- and 12-month follow-up results. Psychotherapy, 59(3), 431–446. doi.org/10.1037/pst0000441
13.Gross, N., Bar-Kalifa, E., & Shahar, B. (2026). The role of positive emotions in accelerated experiential dynamic psychotherapy. Psychotherapy Research, 36(5), 959–970. doi.org/10.1080/10503307.2025.2534972
14.Notsu, H., Iwakabe, S., & Thoma, N. C. (2023). Enhancing working alliance through positive emotional experience: A cross-lag analysis. Psychotherapy Research, 33(3), 328–341. doi.org/10.1080/10503307.2022.2124893
15.Gleiser, K., Ford, J. D., & Fosha, D. (2008). Contrasting exposure and experiential therapies for complex posttraumatic stress disorder. Psychotherapy, 45(3), 340–360. doi.org/10.1037/a0013323
16.Lamagna, J., & Gleiser, K. A. (2007). Building a secure internal attachment: An intra-relational approach to ego strengthening and emotional processing with chronically traumatized clients. Journal of Trauma & Dissociation, 8(1), 25–52. doi.org/10.1300/J229v08n01_03
17.Ronen-Setter, I. H., & Cohen, E. (2020). Becoming "teletherapeutic": Harnessing accelerated experiential dynamic psychotherapy (AEDP) for challenges of the COVID-19 era. Journal of Contemporary Psychotherapy, 50(4), 265–273. doi.org/10.1007/s10879-020-09462-8
18.Harrison, R. L. (2020). Termination in 16-session accelerated experiential dynamic psychotherapy (AEDP): Together in how we say goodbye. Psychotherapy, 57(4), 531–547. doi.org/10.1037/pst0000343
19.Malan, D. H. (1979). Individual psychotherapy and the science of psychodynamics. Butterworths.
20.Davanloo, H. (1990). Unlocking the unconscious: Selected papers of Habib Davanloo. Wiley.
21.Hendel, H. J. (2018). It's not always depression: Working the change triangle to listen to the body, discover your core emotions, and connect to your authentic self. Spiegel & Grau.
22.Hendel, H. J. (n.d.). What is the change triangle? hilaryjacobshendel.com. hilaryjacobshendel.com
23.香港心理衛生會. (n.d.). 感動治療 (AEDP). tnfc.mhahk.org.hk
24.李政洋身心診所. (2026, July 9). 如何化解孤獨、轉化痛苦、邁向繁盛？AEDP 介紹. leepsyclinic.com
25.Peace Academia. (n.d.). AEDP感動治療簡介. peace-academia.com
26.Solacare 心亮閣. (n.d.). About accelerated experiential dynamic psychotherapy (AEDP). solacare.hk

Accelerated experiential dynamic psychotherapyAEDP

AEDP's answer: suffering often comes from facing it alone, not from the feeling being too big

The change triangle: three layers beneath "it doesn't matter"

Once someone is there, how does it go? Four states, three transformations, and the therapist tracks where you are

Back to the opening: your name is not on the promotion list, and how the four states go

Six ways of working: how you stop facing it alone, matched to the triangle's three corners

Defence: safety first, letting go later

Undoing aloneness: affirmation and company

Moment-to-moment tracking: the body and small shifts

Inhibitory emotion: anxiety and shame loosen when someone stays

Dyadic regulation: holding anxiety and shame together

Working with trauma: slow, bounded, with a trained therapist

Core feeling: see it through, then look back at the change

Seeing the core feeling through: reach, deepen, complete

Working with the transformation itself: noticing the good so it takes root

Company is built session by session: what does a course of AEDP look like?

Whom can this company help, and with what?

Someone alongside, the feeling run its course: how much evidence stands behind it?

Overall: most people improved after 16 sessions

Does it last? Gains mostly held at six and twelve months

Positive emotion: tied to better sessions, but not clearly at six months

The signature technique, metaprocessing: described, not yet tested

Better than other therapies, or for complex trauma? No evidence yet

To be honest: this kind of company has limits too

1Research from the founder's team, small samples, no comparison

2Overlap with neighbouring approaches, so it is hard to say what works

3Recording and an active, affirming style do not suit everyone

4Samples from elsewhere; no research in Hong Kong that we found

5Looking at the good is no substitute for going through the pain

A self-guided AEDP path

Courses

Beyond AEDP: which other approaches work with feeling and relationship

Other therapy approaches

FAQ

References

Want someone alongside you?

Accelerated experiential dynamic psychotherapyAEDP

AEDP's answer: suffering often comes from facing it alone, not from the feeling being too big

The change triangle: three layers beneath "it doesn't matter"

Once someone is there, how does it go? Four states, three transformations, and the therapist tracks where you are

Back to the opening: your name is not on the promotion list, and how the four states go

Six ways of working: how you stop facing it alone, matched to the triangle's three corners

Defence: safety first, letting go later

Undoing aloneness: affirmation and company

Moment-to-moment tracking: the body and small shifts

Inhibitory emotion: anxiety and shame loosen when someone stays

Dyadic regulation: holding anxiety and shame together

Working with trauma: slow, bounded, with a trained therapist

Core feeling: see it through, then look back at the change

Seeing the core feeling through: reach, deepen, complete

Working with the transformation itself: noticing the good so it takes root

Company is built session by session: what does a course of AEDP look like?

Whom can this company help, and with what?

Someone alongside, the feeling run its course: how much evidence stands behind it?

Overall: most people improved after 16 sessions

Does it last? Gains mostly held at six and twelve months

Positive emotion: tied to better sessions, but not clearly at six months

The signature technique, metaprocessing: described, not yet tested

Better than other therapies, or for complex trauma? No evidence yet

To be honest: this kind of company has limits too

1Research from the founder's team, small samples, no comparison

2Overlap with neighbouring approaches, so it is hard to say what works

3Recording and an active, affirming style do not suit everyone

4Samples from elsewhere; no research in Hong Kong that we found

5Looking at the good is no substitute for going through the pain

A self-guided AEDP path

Courses

Beyond AEDP: which other approaches work with feeling and relationship

Other therapy approaches

FAQ

References

Want someone alongside you?