Contrasting Two Clients in Emotion-Focused Therapy for Depression 1: The Case of "Tom," "Trapped in the Tunnel"

Abstract

The objective in this paper is to present a case drawn from a series of randomized clinical trials (RCT) comparing brief (16-20 sessions), emotion-focused therapy (EFT) the process experiential approach with client-centered therapy and cognitive-behavioral therapy in the treatment of depression. A case comparison method that triangulates data from clients’ histories, in-session process, post-session questionnaires, and post-therapy outcome measures was used to increase understanding of those factors that contribute to successful and unsuccessful outcomes. The case comparison method examines the role of the working alliance, clients’ emotional processing, clients’ and therapists’ interpersonal processes, and clients’ cognitive processing, as well as the specific changes that clients report immediately following their sessions that have been found to be related to therapeutic outcomes. The method is illustrated with two examples one a poor outcome case and the other a good outcome case The poor outcome case of "Tom" is presented in this article, and the good outcome case of "Eloise" is presented in the next article by Goldman, Watson, and Greenberg (2011). These two cases extend and build on the cases presented by the authors in their book Case Studies in Emotion-Focused Treatment of Depression: A Comparison of Good and Poor Outcome (Watson, Goldman, & Greenberg, 2007), in which six clients, three good outcome and three poor outcome, were compared and contrasted using the case-comparison method.