Attachment-based family therapy and emotion-focused therapy for unresolved anger: The role of productive emotional processing.

Abstract

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.

Attachment‐Based Family Therapy: A Review of the Empirical Support

“…These kinds of barriers and our solutions are described in the article by Israel and Diamond (). Similar implementation challenges were explored in three recent papers on implementing ABFT in Australia (Diamond, Wagner, & Levy, ), Belgium (Santens, Devacht, Dewulk, Hermans, & Bosmans, ), and Sweden (Ringborg, ). They describe both nation‐specific and universal challenges and solutions that stem from implementing manualized therapies in new settings.…”

“…One very interesting study compared ABFT with EFT for helping young adults work through unresolved anger toward their parents (Diamond et al., ). The study explored whether EFT's two‐chair, imagined conversation with one's parents (Greenberg, ) had any greater or less effect in facilitating productive processing of primary adaptive emotions and attachment needs than the ABFT in vivo actual conversation with one's parents.…”

“…Regardless of the content focus, the framework of negotiating or finding the right balance of attachment and autonomy guides the treatment plan. Two specific populations that we have given some empirical attention to are adults with unresolved anger toward a parent (Diamond, Shahar, Sabo, & Tsvieli, 2016) and suicidal gay, lesbian, and bisexual youth . Finally, we did some initial pilot work to adapt ABFT to work with anxious youths in collaboration with our good colleague, Lynne Siqueland, Ph.D. (Siqueland, Rynn, & Diamond, 2005 Young adults with unresolved anger One very interesting study compared ABFT with EFT for helping young adults work through unresolved anger toward their parents .…”

Parent‐therapist alliance and parent attachment‐promoting behaviour in attachment‐based family therapy for suicidal and depressed adolescents

“…More specifically, ABFT has been shown to lead to greater decreases in both suicidal ideation and depressive symptoms – differential gains which are maintained at 6 month follow‐up (Diamond et al , ). In addition, there is preliminary evidence ABFT also leads to decreases in perceived parental control, attachment avoidance and attachment anxiety among adolescents (Shpigel et al ., ; Diamond et al ., ) and young adults (Diamond, G. M. et al ., ). ABFT has recently been designated a proven programme by RAND'S promising practices network and appears on US Department of Health and Human Services’ Substance Abuse and Mental Health Services Administration's National Registry of Evidenced‐Based Programs and Practices.…”

Evaluating the Utility of MFT Models in the Treatment of Trauma: Implications for Affect Regulation

“…Consequently, attachment security is akin to Porges' (2011) delineation of an advanced regulatory strategy engaging the myelinated vagus nerve and using little metabolic activity. Thus, the tenets of attachment theory support Porges' notion that physiological affect regulation can be significantly influenced by relationship quality and relational events centering around connection (Diamond et al 2016;Johnson 2004;Mikulincer et al 2003). …”