Session-by-session client feeling and clarification processes over the course of emotion-focused therapy

Background: Emotion-Focused Therapy (EFT) is an effective form of psychotherapy for a range of psychological problems.While earlier research demonstrated the effect of in-session processes as being central for explaining the effects of EFT, it is unclear what the role of client's self-reported quality of emotional processing assessed right after each therapy session for the prediction of therapy outcome is.Specifically, we are assuming that session-by-session trajectories of clients' self-assessed clarification processes and treatment outcome are moderated by their self-reported post-session feelings.Furthermore, we assume that sessionby-session treatment outcome trajectories are additionally moderated by self-assessed clarification.Methods: A total of N = 48 clients with a variety of psychological problems and undergoing EFT within a naturalistic context have been included in the present study.Symptom change was assessed using CORE-10 after each therapy session, in addition to pre-and post-therapy.After each session, the client self-assessed a range of session feelings and the quality of clarification experienced in the session.Longitudinal trajectory analyses with moderation effects and exploratory dynamic network analyses, were conducted.Results: The post-session client experience of sadness or grief and joy moderate the trajectory of clarification depth over the course of EFT.Post-session feelings influenced the trajectory symptom levels over the coursof therapy (clarification non-significant in the model).Specific emotion-based dynamic pathways to clarification and symptom load were explored in the present study.Conclusions: The session-by-session interplay between session feelings (sadness and joy), as self-rated by the client after each session, was a moderator of self-rated clarification and symptom levels trajectories across Emotion-Focused Therapy.This study adds to the SESSION-BY-SESSION PROCESSES IN EMOTION-FOCUSED THERAPY 4 understanding of the client's self-perceived mechanisms of change in EFT as it is conducted in a naturalistic context.