A growing body of research suggests that emotional processing is a central and common change mechanism across various types of therapies (Diener & Hilsenroth, 2009; Foa, Huppert, & Cahill, 2006; Greenberg, 2011). This study examined whether 10 weeks of attachment-based family therapy (ABFT), characterized by the use of in-session young adult-parent dialogues, were more effective than 10 weeks of individual emotion-focused therapy (EFT), characterized by the use of imaginal dialogues, in terms of facilitating productive emotional processing among a sample of 32 young adults presenting with unresolved anger toward a parent. This study also examined whether greater amounts of productive emotional processing predicted more favorable treatment outcomes. In contrast to our expectations, we found significantly more productive emotional processing in individual EFT than in conjoint ABFT. Results also showed that while both treatments led to significant and equivalent decreases in unresolved anger, state anger, attachment anxiety, and psychological symptoms, only ABFT was associated with decreases in attachment avoidance. Although amount of emotional processing did not explain the unique decrease in attachment avoidance in ABFT, greater amounts of productive emotional processing predicted greater decreases in psychological symptoms (but not other outcome measures) across both treatments.
A growing body of research suggests that emotional processing is a central and common change mechanism across various types of therapies (Diener & Hilsenroth, 2009; Foa, Huppert, & Cahill, 2006; Greenberg, 2010), including attachment-based family therapy (Diamond, Shahar, Sabo, & Tsvieli, 2016). The purpose of this study was to examine which therapist interventions facilitated productive emotional processing in a sample of 15 young adults receiving attachment-based family therapy (Diamond, Diamond, & Levy, 2014) for unresolved anger toward a parent, and which therapist interventions led to a discontinuation of productive emotional processing once it had begun. Therapist interventions and productive emotional processing were measured during the course of individual, alliance-building sessions with the young adult. Results indicate that young adults' productive emotional processing occurred at a rate significantly greater than chance following therapists' focus on vulnerable emotions, focus on attachment needs, and empty-chair interventions. In contrast, therapists' focus on clients' rejecting anger preceded the discontinuation of such processing at rates significantly greater than chance. Theoretical and clinical implications are discussed. (PsycINFO Database Record
Productive emotional processing is considered a key change mechanism in attachmentbased family therapy (ABFT). This study examined the impact of attachment-based family therapy therapist interventions aimed to promote productive emotional processing of primary adaptive emotions in a sample of 30 depressed and suicidal adolescents who had participated in a larger randomized clinical trial. Results of sequential analyses revealed that relational reframes and therapists' focus on primary adaptive emotions were associated with the subsequent initiation of adolescents' productive emotional processing of primary adaptive emotions. In contrast, interpretations, reassurances, and therapists' focus on adolescents' rejecting anger toward their parents were all followed by the discontinuation of adolescents' emotional processing that had already begun. Finally, therapists' general encouragement of affect and focus on adolescents' unmet attachment/identity needs were associated with both the initiation of adolescents' productive emotional processing, and with the discontinuation of such processing once it had already begun. Theoretical and clinical implications are discussed.
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