Therapist interventions and client innovative moments in emotion-focused therapy for depression.

Abstract

According to the narrative approach, change in self-narratives is an important part of successful psychotherapy. In this view, several authors have highlighted the usefulness of narrating new experiences (like actions, thoughts, and stories) during therapy in contrast with maladaptive client self-narratives. These new experiences are termed here innovative moments (IMs), and different types can be specified: action, reflection, protest, reconceptualization, and performing change. With the aim of understanding which therapist skills are related to client IMs, we analyzed the association between exploration, insight, and action skills and IMs in two initial, two middle, and two final sessions of three good outcome (GO) and three poor outcome (PO) cases of emotion-focused therapy (EFT) for depression. IMs occurred more often in GO than PO cases. Furthermore, in GO more than PO cases, exploration and insight skills more often preceded action, reflection, and protest IMs in the initial and middle phases of EFT, but more often preceded reconceptualization and performing change IMs in the final phase. Action skills were more often associated with action, reflection, and protest IMs across all phases, especially in the final phase, of GO EFT.

Client's immersed and distanced speech and therapist's interventions in emotion-focused therapy for depression: an intensive analysis of a case study

“…Also in this phase of EFT, through the use of therapist exploration skills like reflection of feelings, the therapist may have facilitated client's distanced speech during the process of reflecting and transforming emotional responses: for example, when the therapist followed client reflections about the way she felt before and the differences regarding the way she feels now (closure statement of distancing speech). The predominance of exploration skills in this case is consistent with previous studies on EFT that show a high prevalence of this type of therapist interventions, congruently to the development of goodoutcome process of EFT (Cunha et al, 2012;GoatesJones, 2004;Goates-Jones et al, 2009).…”

“…Results indicated that exploration skills were more frequent than other skills across all different therapy phases of good and poor-outcome cases. Action and insight skills, although they were less frequent, occurred more often in poor-outcome cases than in good-outcome cases (Cunha et al, 2012). Yet, whereas Cunha and collaborators (2012), focused on client narrative change (through the presence of innovative moments in client speech), the present study looks specifically to the perspectives adopted in client speechi.e.…”

“…A special focus has been given to the therapist's role and the relationship between therapeutic process and clinical outcome (Nuovo, 2011), as well as conversation patterns between therapists and clients (Bucci, 2013;Dagnino, Krause, Pérez, Valdés, & Tomicic, 2012). We consider that this line of research has important implications, namely to the training of undergraduate students (Nuovo, 2011) in the use of these techniques Hill et al, 2015;Jackson et al, 2014;Meystre et al, 2014;Spangler et al, 2014) due to the effectiveness of these on therapeutic outcome across different modalities of psychotherapy (Cunha et al, 2012;Goates-Jones, 2004;Goates-Jones, Hill, Stahl, & Doscheck, 2009;Hill et al, 2015).…”

“…To code therapist's interventions we used the HSS (Hill, 2002), which remains one of the most well-known and widely used until now Cunha et al, 2012;Goates-Jones, 2004;Goates-Jones et al, 2009;Hill, 2005;Hill et al, 2015;Jackson et al, 2014;Meystre et al, 2014;Spangler et al, 2014). The HSS is a revision of the hill counselor verbal response category system (Hill, 1978) and consists in 12 nominal and mutually exclusive categories of therapist's interventions, organized around three major categories, namely exploration, insight and action skills.…”

Depressive Symptoms and Relationship Between Genders: Differences in Young Adults in a Randomized Clinical Trial

“…This approach indicates that auto-narrative changes are an important part of psychotherapeutic success. Moreover, authors have highlighted the usefulness of narrating new experiences (like actions, thoughts and stories) during therapy, contrasting with the customer's inadequate auto-narratives (Cunha et al, 2012). Therefore, along with possible influence of biological aspects, it is also possible that the more humanistic experience during the constructivist process of NCT is more suitable to female depression representations (Gonçalves & Machado, 1999).…”