Client experiencing is a small to medium predictor of treatment outcomes and a probable common factor.

Different psychotherapy theories describe process patterns of emotional arousal in contradictory ways. To control both treatment and therapist responsivity, this study sought to test dynamic patterns in the arousal of negative affect using a controlled experimental study of expressive writing. There were 261 participants (78% women; M = 21 years old; 56% White) who suffered unresolved traumas who were randomly assigned to an expressive writing task and asked to write about their deepest thoughts and feelings, or to a writing control. Participants wrote for 15 min on three consecutive days, completing the Positive Affect and Negative Affect Scale before and after each visit. Data across 6 time points were subjected to hierarchical linear modeling (HLM) and pattern analyses. Session-by-session (24 hr periods), the expressive writing group showed an overall linear decrease in negative affect (β = −2.273, p < .001). However, in pre- to post-session ratings (15 min periods), the expressive writing group also demonstrated increases in negative affect (β = 6.467, p < .001). Neither of these patterns were observed in the control group. Pattern analysis demonstrated 69.8% of cases in the expressive writing group perfectly or almost perfectly followed a predicted zig-zag pattern ( p < .01). No control cases showed this pattern. Findings demonstrate how the habituation/inhibition hypothesis (“it gets easier as one gets over it”) and the meaning-making hypothesis (“it gets worse before it gets better”) can both be supported, each at different scopes of analysis. Implications clarify the role of emotional arousal in change.

Examining successful treatment cases showed several theoretically coherent kinds of temporal patterns, although not always in the same case. Clinical or methodological significance of this article: This is the first paper to demonstrate systematic temporal patterns of emotion over the course of an entire treatment. (1) The study offers a proof of concept that longitudinal patterns in the micro-processes of emotion can be objectively derived and quantified. (2) It also shows that patterns in emotion may be identified on the within-session level, as well as the session-by-session level of analysis. (3) Finally, observed processes over time support the ordered pattern of emotional states hypothesized in Pascual-Leone and Greenberg's ( 2007 ) model of emotional processing.

Aim: This paper describes and contrasts the impact of two 13-week counsellor training programmes in integrative-experiential psychotherapy; one with 24 undergraduate psychology students presented in this paper, and the other with archival data from Pascual-Leone and Andreescu's study of 22 clinical psychology graduate students. Method: The programmes taught psychotherapy to trainees who conducted single sessions with eight volunteers. Outcomes of these sessions were measured at four time points using both trainee and client reports. Findings: Undergraduate trainees significantly improved in fostering a therapeutic alliance, helping skills, and in their confidence (partial eta Sq. = .628). Most of this effect seemed to occur in the first nine weeks. When baseline scores were compared across the two training groups, undergraduate trainees were not performing as well as graduate trainees at fostering alliance and helping skills and this difference held throughout training (p's < .007). Implications: Despite differences, training was effective for both groups and undergraduates did seem to be closing the gap. Implications for further research and clinical practice are discussed.

No abstract