ABSTRACT
Objective
This exploratory multi-case process study described within-session emotional sequencing in Emotion-Focused Therapy (EFT) with a Korean clinical research sample using the Classification of Affective-Meaning States (CAMS) mapped onto the Sequential Model of Emotional Processing (SMEP). We focused on clinically interpretable nonlinearity patterns and the timing of first adaptive-state emergence.
Method
Ten adults completed 12–19 sessions (148 sessions total). All sessions were observationally CAMS coded and mapped onto SMEP. We summarised fixation and recurrent return patterns and described time to first adaptive state as temporal context, defined as the session number from treatment onset in which Grief/Hurt, Assertive Anger, Self-Compassion or Acceptance and Agency first appeared.
Results
Canonical SMEP dialectical cycles were observed but were commonly embedded within broader recurrent return patterns among early distress and evaluative states. The first adaptive state appeared at a median of Session 8.5. Chair work occurred in all cases and was first introduced between Sessions 3 and 11. Depressive symptoms and perceived stress decreased from pre-treatment to post-treatment on the CES-D and K-PSS-11.
Conclusions
Findings are hypothesis-generating and provide descriptive process markers for locating stalls and tracking adaptive-state emergence in clinical practice, without implying causal effects of specific tasks or timing.