Journal of Psychotherapy Integration, Vol 35(1), Mar 2025, 3-20; doi:10.1037/int0000346
In this study, we identified therapist responses preceding clients’ engagement in productive narrative-emotion shifts in four successful cases of emotion-focused therapy for trauma (EFTT; Paivio & Angus, 2017). Twelve sessions were selected across three phases of EFTT from Paivio et al.’s (2010) clinical trial based on client recovery data and therapist competence ratings. Three judges used open coding and constant comparison to identify therapist behaviors preceding shifts in clients’ narrative-emotion marker sequences, as operationalized in the Narrative-Emotion Process Coding System (NEPCS; L. E. Angus et al., 2017). Change shifts were defined as movement from 1 min to the next from NEPCS problem markers (e.g., superficial storytelling) to transition (e.g., reflective storytelling) or change markers (e.g., discovery storytelling) or from transition to change markers. Problem shifts were movement from transition or change markers back to problem markers. Reasoning that clients’ narrative-emotion shifting may be a transtheoretical way in which clients achieve greater self-understanding and emotional awareness, we compared the therapist behaviors in our EFTT sample to those previously identified in a similar study (Friedlander et al., 2020) of time-limited dynamic therapy. Only one of 10 categories of behaviors was distinctive in the present sample: deepening imaginal experiencing (e.g., asking the client to respond with emotion to an imagined figure), an essential EFTT strategy. Interventions in seven categories are not theoretically specific (attending to the relationship, affirming/validating, praising, clarifying/paraphrasing/refocusing, exploring/expanding, challenging, no therapist code), whereas two other categories of behaviors (“As-If” and attaching new meaning) are more characteristic of emotion-focused and psychodynamic therapies. (PsycInfo Database Record (c) 2025 APA, all rights reserved)