Changes in Quality of Emotional Processing in Trauma Narratives as a Predictor of Outcome in Emotion Focused Therapy for Complex Trauma

摘要

The present study tested a model of change in emotional processes over thecourse of Emotion Focused Therapy for Trauma (EFTT). The Classification of AffectiveMeaning States (CAMS; Pascual-Leone u26 Greenberg, 2005) specifies a sequential shiftfrom maladaptive and unproductive affective processes (i.e. global distress, fear andshame, and rejecting anger), through negative self-evaluation and expressing unmetneeds, to productive affective processes (i.e. hurt and grief, self-compassion, assertiveanger, and acceptance and agency) that aid in adaptive functioning. This study used theCAMS to examine changes in the quality of emotional processes during trauma narrativesin early and late sessions of EFTT. It was expected that a shift from unproductive toproductive affective processes over the course of therapy would be associated withresolution of abuse issues and reduction in trauma symptomology at therapy termination.It was also anticipated that the shift in affective processes would follow the sequence aspresented in the CAMS. Results indicated a greater frequency of productive affectiveprocesses in late narratives; a greater frequency of productive processes was morepredictive of treatment outcome compared to unproductive processes; and greaterincrease in the frequency of productive processes from early to late narrativessignificantly contributed to good treatment outcome. Findings also revealed a significantinteraction between unproductive and productive affective processes in predictingtreatment outcome. These findings are consistent with the proposed hypotheses of thepresent study. Finally, results indicated that clients were significantly more likely tofollow the proposed sequence for lower level processes, which supports the hypothesis.However, results did not produce similarly significant results for higher levels. Rather clients expressed higher levels of productive affective processes in late sessions that werenot preceded by lower levels of processes in the proposed model. The findings haveimplications for guiding the therapeutic process in a productive manner that leads totrauma recovery.