Setbacks in the process of assimilation of problematic experiences in two cases of emotion-focused therapy for depression

Abstract

As in previously studied therapies, setbacks in EFT, usually represent productive work on relatively less advanced strands of the client's major problems. Results point to the importance of the therapist attending to the limits of the client's therapeutic ZPD.

Therapeutic collaboration and the assimilation of problematic experiences in emotion-focused therapy for depression: Comparison of two cases

“…BDI-II, OQ-45) in the cases of Julia and Afonso is also consistent with results of previous assimilation studies (e.g., Mendes et al, 2015;see Stiles, 2002). Like other unimproved cases, reported in the assimilation literature, (e.g.…”

“…Consistently with previous assimilation model studies of therapist interventions (Caro-Gabalda, et al, 2015;Meystre, et al, 2013;Meystre, et al, 2015), this study showed how the therapist interventions seemed to be responsive to these two client's emergent needs and capacities, facilitating the assimilation of their problematic experiences, by taking into account their current TZPD. The therapists' choices of whether to support or challenge seem to reflect each client's emergent needs.…”

“…Caro-Gabalda, 2006; Caro-Gabalda, Stiles, & Pérez Ruiz, 2015;Osatuke et al, 2005). However, most setbacks represent task-appropriate switches to a related but less-assimilated strand of the problem, a normal and potentially productive part of the therapeutic process (Caro-Gabalda & Stiles 2009, 2013Caro-Gabalda, Stiles, & Pérez Ruiz, 2015;Mendes et al, 2015).…”

“…As always, longer sequences, more cases, and a wider sample of diagnoses and treatment approaches are to be encouraged (cf. Ferreira et al, 2015;Mendes et al, 2015; Table 3 -Evolution of APES scores across therapy phases for the two cases Table 4 -Therapeutic exchanges across therapy phases for two cases Table 5 -Therapist-client exchanges preceding assimilation advances and setbacks in the different phases of the two cases The client is not aware of the problem; the problematic "voice" is silent or dissociated. Affect may be minimal, reflecting an effective avoidance.…”

Does assimilation of problematic experiences predict a decrease in symptom intensity?

“…A series of intensive case studies of assimilation progress in different therapeutic models has shown that good outcome clients, as assessed by standard symptom intensity measures, progress toward high APES levels across their sessions (e.g., Brinegar, Salvi, & Stiles, 2008;Caro Gabalda, 2011;Caro Gabalda, Stiles, & Pérez Ruiz, 2016;Gray & Stiles, 2011;Honos-Webb, Stiles, & Greenberg, 2003;Knobloch, Endres, Stiles, & Silberschatz, 2001;Mendes et al, 2016;Osatuke et al, 2007;Ribeiro, Braga et al, 2016a;Ribeiro, Cunha et al, 2016b). For example, in a study of one good outcome client, Basto et al (2016) found a strong negative correlation across 16 sessions of CBT between APES level and symptom intensity.…”