Mapping patterns of change in emotion-focused psychotherapy: Implications for theory, research, practice, and training

Abstract

An important objective in humanistic-experiential psychotherapies and particularly emotion-focused psychotherapy (EFT) is to map patterns of change. Effective mapping of the processes and pathways of change requires that in-session processes be linked to in-session resolutions, immediate post-session changes, intermediate outcome, final therapy outcome, and longer-term change. This is a challenging and long-term endeavour. Fine-grained descriptions of in-session processes that lead to resolution of specific interpersonal and intrapersonal issues linked with longer-term outcomes are the foundation of EFT, the process-experiential approach. In this paper, evidence in support of EFT as a treatment approach will be reviewed along with research on two mechanisms of change, viewed as central to EFT, clients’ emotional processing and the therapeutic relationship conditions. The implications for psychotherapy research are discussed. Given the methodological constraints, there is a need for more innovative methodologies and strategies to investigate specific psychotherapy processes within and across different approaches to map patterns and mechanisms of change to enhance theory, research, practice, and training.Clinical or methodological significance of this article: This paper was first presented at the International Society for Psychotherapy Research’ Annual Conference in Philadelphia in June 2015 as a Presidential Address. The manuscript reviews research that has contributed to the evolution and development of Emotion-Focused Psychotherapy, beginning with the work of Rogers and Gendlin in the 1950s. Evidence supporting the efficacy of the approach as well as research relevant to the process of change linking in-session processes with distal outcomes is reviewed. Two important issues that have dominated the field of psychotherapy research, the differential effectiveness of various psychotherapy approaches and the impact of the therapeutic relationship conditions in facilitating change are discussed. It is argued that progress in these two lines of research has been constrained by methodological issues and that novel and innovative ways to explore the mechanisms and processes of change need to be developed to enhance theory, research, and practice.