Emotional arousal, client perceptual processing, and the working alliance in experiential psychotherapy for depression.

Abstract

Early-, middle-, and late-phase client emotional arousal, perceptual processing strategies, and working alliance were examined in relation to treatment outcome on 4 measures in 32 clients who previously underwent experiential therapy for depression. Hierarchical regression analyses relating these variables to outcome indicated that results varied depending on the therapeutic process, phase of treatment, and outcome measure involved in the analyses. Mid-therapy arousal predicted improvements in self-esteem, whereas mid- and late treatment perceptual processing predicted reductions in client interpersonal dysfunction. Emotional arousal in conjunction with perceptual processing during mid-therapy predicted reductions in depressive and psychopathological symptomatology better than either of these variables alone. The implications of these findings for psychotherapy research and practice are discussed.

Does the two-chair dialogue intervention facilitate processing of emotions more efficiently than basic Rogerian conditions?

“…Level 4 is assumed to be a clinically productive level of arousal, while level 7 is assumed to be too intense. Emotional arousal, as measured by The Client Emotional Arousal Scale III, has been associated with good outcome in prior research (Missirlian et al, 2005;Pos et al, 2017;Pos et al, 2009). …”

“…The association between the above mentioned assumption that various elements of emotional processing are beneficial for emotional well-being has gained some 16 empirical support. First, the arousal or activation of emotions has been demonstrated to be associated with a corresponding reduction in symptoms of depression, anxiety, and trauma McLean, Asnaani, & Foa, 2015;Missirlian, Toukmanian, Warwar, & Greenberg, 2005;Pos, Paolone, Smith, & Warwar, 2017;. This suggests that the activation of emotions can facilitate therapeutic change.…”

“…The notion that EFT increases emotional arousal throughout therapy has empirical support (Pos et al, 2017). It also seems that this increase in arousal is related to better outcome (Missirlian et al, 2005;Pos et al, 2017). Furthermore, it seems that too high or too low levels of arousal are less productive with regard to treatment outcome (Carryer & Greenberg, 2010); further, it seems that emotional arousal is more productive under a good working alliance (Iwakabe et al, 2000;Pos et al, 2009).…”

“…The therapeutic alliance is given particular attention in EFT as a necessary condition for the client to engage in more active emotional processing . Research on EFT also suggests that a good therapeutic alliance is associated with better emotional processing Iwakabe, Rogan, & Stalikas, 2000;Missirlian et al, 2005;. In the first phase of an EFTtreatment, the therapist is instructed to concentrate on building a safe and trusting relationship by complying to basic Rogerian conditions, that is, being empathic, congruent, and to show unconditional positive regard for the client (Rogers, 1957).…”

Narrative Processes Coding System: A Dialectical Constructivist Approach to Assessing Client Change Processes in Emotion-Focused Therapy of Depression

“…As such, results from our Narrative Process Coding System research program suggest that depressed clients' reflection on emotional experiences evoked in the context of specific personal story disclosures may provide a unique opportunity to (a) identify specific factors, events or actions that evoked an emotional response and (b) understand more fully the meaning of those emotions, in the context of their own personal stories (Missirlian, Toukmanian, Warwar, & Greenberg, 2005;Toukmanian, 1992) that in turn increases emotional selfregulation and self-understanding.…”