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Impact of the Change Triangle


Selection of quotes and PDFs of presentations from program directors, executive coaches, therapists, and communication consultants, who adapted the Change Triangle and teach it to others through groups and writing.

Impact page item #1


Heather Sanford, LMSW, MPA, PROS Program Director, Tompkins County Mental Health, Ithaca, NY


"I am the director of the PROS  (Personalized Recovery Oriented Services) program at Tompkins County Mental Health. (PROS programs are available across NY state, so you may be familiar with the model.) The program is based on a rehabilitation model - all people have the ability to move towards their goals of reclaiming or claiming life roles that are fulfilling and healthy.  This sounds great in theory, but when I arrived here two years ago, all the classes (groups) offered were about coping skills and "management" of symptoms versus a strong belief that wounds can be healed.  Or if the belief existed, it certainly didn't carry over to programming.  

I read an article you wrote that was posted on the AEDP website and preordered your book.  After reading it ( in one night), I knew I couldn't keep it to myself.  We started groups based on the change triangle right away - all learning together, as is the PROS model.  I appreciated how accessible the writing and theory was.  Many of our participants (we call clients participants) have read your book and bring their thoughts and reactions to class to talk about them together.


During classes (there are two sections- Advanced Practice which actually started first, and our new co-facilitated class that just began, Intro to Change Triangle) there is a focus on understanding the theory as experientially as possible and also a chunk of time dedicated to discussing life examples with change triangle application. 


The same people come to group week after week. This class has been wildly popular.  The participants now challenge each other when sharing difficult current experiences - "could we just thank that defense for popping up to help you and ask it to step aside for a minute?  What might be going on underneath, what's happening in your body?"  Sometimes I wonder if I need to be facilitating the class at all! 


If you would like to see the base curriculum I work off of for the Advanced Practice class, I am happy to send it to you.  Our sessions last 12 weeks.  Some of the information I reuse session to session depending on the group participants. Perhaps we should really name this class after you.  We watch YouTube clips of you at various presentations, read sections of your book and do the exercises together -  the pipe cleaner analogy is clearly the favorite.  


We are so grateful for your work and happy to see where this goes in group work.  I'd be really interested to know if others are attempting similar things.  There are no AEDP/ Change Triangle groups in the area. I have spoken with a clinician in private practice in Ithaca who is considering a group format, so maybe there will be in time!"

UpdateWe continue to do an introductory level class "Change Triangle" and an "Advanced Practice" class which has morphed into more of a processing class using the change triangle as the base. Both classes are perpetually full!"


Any results you are seeing that you can comment on?

"For me or my clients?! 😊  I think the reason that this works so well for my clients is because I am doing the work with them and am willing to share examples when they can't come up with one. One client was totally convinced that he was unable to feel anything and blamed medications.  He has been attending my Advanced Practice class for about a year.  In time he was able to recognize defenses that are getting in the way.   He is now able to recognize sadness and joy as they come and go and can tolerate experiencing sadness, knowing it will pass and that there is breathing space on the other side.  His therapist has been so impressed with his progress that she is now also interested in pursing AEDP training."  


"Using the Change Triangle in groups has been really beneficial as it creates relationships between group members.  When they are struggling outside of group they can help each other, not as a therapist really, but as a trusted other.  They can be present and not fix (a work in progress for all of us, I am sure) and encourage them to be curious and gentle with themselves.  The folks that attend my Advanced Practice class are there by my invitation and has been mostly the same group for over a year."


"The folks I work with in my day job (at Tompkins County Mental Health) have been suffering for years with significant mental health barriers.  Many are on disability for MH reasons and have felt "stuck."  I feel like the Change Triangle offers hope. Our clients are all very low income and have been led to believe that they will be "sick" forever.  They need hope!  However, in my private practice I see college students and a few professionals.  These people also have benefited.  I love hearing after one session 'this feels different.'"

"I can't imagine a time personally or professionally, that I won't be using the tool.  My kids are learning it now!"

--Heather Sanford, MA

Tompkins County PROS Program  


 Title of service: Advanced Practice Change Triangle

Number of Sessions: 12 

Duration of session: 55 mins 

PROS service: Intensive Rehabilitation Relapse Prevention 

Impact page item #2


Bobbi Blain, MA is an executive coach from Billings, Montana. 



"Recognizing from experience, both personally and professionally, and the compelling nature of the literature on the power of working with emotion, I boldly left a successful leadership coaching business recently to start the Accelerated Relational Performance Group.  This group (ARPG) is designed for leaders who want to take their relational and business performance to the next level. We meet once a month for a full day over the course of six months. Hilary's Change Triangle is one of the cornerstone's on which the program has been developed. It has been pure gold. Leaders in the ARPG program are experiencing more meaningful interactions, not only in the group as they learn about their emotions and the Change Triangle, but they are taking their new skills to their business, families, and other important relationships including their intimate relationships with their spouses and partners.  I am seeing businesses, families and relationships  growing and being transformed.  I am grateful for Hilary's vision to develop the Change Triangle for everyone to use. Learning about emotions benefits everyone."

-Bobbi Blain, MS, LCPC, Billings, Montana

Impact page item #3


Jacob Munhoz, MA from San Diego is teaching workshops in his community and more...







"My final year of graduate school I began to integrate AEDP’s triangles (particularly Conflict and Comparison) explicitly into my work with students at San Diego City College.  I found them to be useful but some times a bit difficult to explain.  Right after finishing my degree, I attended the AEDP Immersion where Diana Fosha recommended Its Not Always Depression.  I bought the book, loved it and started integrating the Change Triangle into my work with both individuals and couples.   It is exciting to see my patients using it and explicitly referring to it during session.  I asked a patient what was coming up for him the other day as we began to wade in to a difficult topic.  He literally said, “Anxiety which I know is an inhibitory emotion.  If I move it aside, what’s under it is fear.”  Another patient who has a difficult time accessing or even believing he has emotions finally started reading your book after a couple of months of stuckness in our work.  He sat down and said, “That book is great!”  I had forgotten which book I recommended to him because it was so long ago and replied “Oh good!” as I searched my memory for previous references.  He saved me:  “When she writes about the woman who saw the little girl’s dog get hit by a bicycle right before her session, I burst into tears.”  The patient who previous showed only glimmers of State 2 in months of work together burst into tears right in front of me and our work was transformed and has never been the same. I have a couple that pulls out the diagrams I did with them during our second session when they start to argue at home.  I explained to them that part of what was going wrong in their conversations at home is that they were having difficult conversations “at the tops of their triangles”.  I always tell my couples that its difficult, if not impossible to make real connections when we’re reacting from a place of anxiety or defense rather than responding from a place of core affect.  Part of their time out routine when things start to get heated is to work their Change Triangle before reengaging with one another.

The book is almost always my first or second recommendation for reading to my patients (depending on their presenting issues) because it lays a really clear foundation for how we are going to talk about emotions during our work together.  Almost invariably, I teach the Change Triangle in the second or third session and make reference to it frequently during psychotherapy both with couples and individuals.  I use EFT in addition to AEDPfC in my work with couples and have found that making a connection between where each individual is on their Change Triangle (AEDP) when their cycle (EFT) starts has been a really useful way of helping the understand and break their cycle.  


At the beginning of March, I presented a full day workshop to 80 participants on contemplative spirituality and healing from trauma.  I based my workshop on The Seven Steps of Spiritual Healing by James Finley.  His first step is about being grounded in ego consciousness.  I argued that an essential part of becoming grounded in ego consciousness is being aware of and engaging with our emotions and that our emotions are doorways into spiritual experience (Core State) where healing takes place.  I presented the Change Triangle as a tool to facilitate this engagement and awareness.  I’ve attached the flyer and the relevant slides along with my notes.  I’ll be adapting my presentation in to a three day retreat that I’ve been asked to give in December.  I also included in my handouts for the workshop some of the PDFs from your website. Four patients came into my practice as a result of the workshop.  Three of them specifically asked for more information about the Change Triangle."

-Jacob Munhoz, MA, San Diego, CA 


Impact page item #4


The Change Triangle is in books on communication and conflict resolution:


Persuasion: Convincing Others When Facts No Longer Seem to Matter By Lee Hartley Carter (Penguin Random House, Fall 2019) (This is confidential material, please do not duplicate.)

See section in PDF beginning on book page 67-71:

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