Attachment Change in Emotionally Focused Couple Therapy and Sexual Satisfaction Outcomes in a Two-year Follow-up Study Stephanie A. Wiebe a à , Cass Elliott b , Susan M. Johnson a , Melissa Burgess Moser c , Tracy L. Dalgleish d , Marie-France Lafontaine e , and Giorgio A. Tasca e a International Centre for Excellence in Emotionally Focused Therapy, University of Ottawa, Ottawa, Ontario, Canada; b Families First, Windsor, Ontario, Canada; c Emmrys, Dawe, Parlee & Associates, Mount Alison University, Sackville, New Brunswick, Canada; d Greenbelt Family Health Team, Centre for Interpersonal Relationships, Toronto, Ontario, Canada; e University of Ottawa, Ottawa, Ontario, Canada ABSTRACT Emotionally focused couple therapy (EFT) is an empirically validated attachment based approach to couple therapy. From an EFT perspective, sexual functioning is viewed within the context of an attachment bond, but sexual satisfaction in EFT has not been empirically tested. We examined self-reported sexual satisfaction across 24months in a sample of 32 couples who received an average of 21 EFT sessions. We found that sexual satisfaction increased across six time points from pre to post therapy and across follow-up (6, 12, 18, and 24months), and that decreases in attachment avoidance from pre to post therapy predicted increases in sexual satisfaction across time. These findings provide evidence that EFT may help couples improve their sexual satisfaction by reducing attachment avoidance in therapy. KEYWORDS Emotionally focused therapy; sexual satisfaction; attachment; hierarchical linear modeling Couples in relationship distress frequently cite concerns with their sexual relationship (Boisvert, Wright, Tremblay, & McDuff, 2011). While happy couples attribute 15–20% of their happiness in the relationship to a satisfy- ing sex life, couples in distressed relationships attribute 50–70% of their distress to sexual problems (McCarthy & McCarthy, 2003). There has been a growing awareness of the interconnected nature of relationship and sexual functioning in couple relationships on the part of couple and sex therapists generally (Leiblum, 2007; McCarthy & Thestrup 2008), and in emotionally focused couple therapy (EFT) specifically (Johnson & Zuccarini, 2010). In terms of research attention to sexual functioning in CONTACT Stephanie A. Wiebe swiebe@ustpaul.ca International Centre for Excellence in Emotionally Focused Therapy, University of Ottawa, 1869 Carling Avenue, Suite 201, Ottawa, ON, K2A 1E6, Canada. à Present address: Saint Paul University, Ottawa, Canada. Supplemental data for this article can be accessed on the publisher’s website. ß 2018 Taylor & Francis Group, LLC JOURNAL OF COUPLE & RELATIONSHIP THERAPY 201 , VOL. 18, NO. 1, 1–21 https://doi.org/10.1080/15332691.2018.1481799 9