Therapist Interventions Associated with Productive Emotional Processing in the Context of Attachment-Based Family Therapy for Depressed and Suicidal Adolescents.

Productive emotional processing is considered a key change mechanism in attachment-based family therapy (ABFT). This study examined the impact of attachment-based family therapy therapist interventions aimed to promote productive emotional processing of primary adaptive emotions in a sample of 30 depressed and suicidal adolescents who had participated in a larger randomized clinical trial. Results of sequential analyses revealed that relational reframes and therapists' focus on primary adaptive emotions were associated with the subsequent initiation of adolescents' productive emotional processing of primary adaptive emotions. In contrast, interpretations, reassurances, and therapists' focus on adolescents' rejecting anger toward their parents were all followed by the discontinuation of adolescents' emotional processing that had already begun. Finally, therapists' general encouragement of affect and focus on adolescents' unmet attachment/identity needs were associated with both the initiation of adolescents' productive emotional processing, and with the discontinuation of such processing once it had already begun. Theoretical and clinical implications are discussed.

El procesamiento emocional productivo (Greenberg, Auszra y Hermann, 2007) se considera un mecanismo de cambio clave en la terapia familiar centrada en apego (ABFT en inglés; Diamond, Diamond, & Levy, 2014). Este estudio examinó el impacto de intervenciones terapéuticas ABFT dirigidas a promover el procesamiento emocional productiva de emociones adaptativas primarias en una muestra de 30 estudiantes deprimidos y suicidas que participaron en un ensayo clínico aleatorio de mayor escala. Los resultados de los análisis secuenciales revelaron que los reencuadres relacionales y el enfoque de los terapistas en las emociones adaptativas primarias se asociaron al inicio subsiguiente del procesamiento emocional productivo de emociones adaptativas primarias por parte de los adolescentes. En cambio, las interpretaciones, afirmaciones y el enfoque de los terapistas en el enojo rechazador de los adolescentes hacia sus padres fueron seguidas por la suspensión del procesamiento emocional que había ya comenzado. Por último, la motivación general por parte de los terapistas del afecto y enfoque en las necesidades insatisfechas de apego/identidad de los adolescentes se asociaron tanto al inicio del procesamiento emocional productivo de los adolescentes como a la suspensión de dicho procesamiento cuando había ya comenzado. Se discuten las implicaciones teóricas y clínicas.

Attachment-based family therapy and individual emotion-focused therapy for unresolved anger: Qualitative analysis of treatment outcomes and change processes.

Twenty-six clients who received 10 sessions of either attachment-based family therapy (ABFT) or individual emotion-focused therapy (EFT) for unresolved anger toward a parent were interviewed 6 months after completing treatment. Interviews were analyzed using the consensual qualitative research approach. Clients in both conditions reported improved relationships with parents, gaining a new perspective of their parent, increased compassion toward parent, less reactivity to anger, feeling cleaned-out, and acquiring new coping strategies. Whereas ABFT clients more often reported improved relationships with parents, EFT clients more often reported feeling cleaned-out. Clients in both groups attributed change to productive emotional processing. Also, clients in both groups attributed change to saying difficult things that had never been said before directly to parents, though more so in ABFT. Whereas ABFT clients noted the importance of their parents participating in treatment and mutual vulnerability, EFT clients noted the importance of remembering previously avoided memories and feelings, and getting their anger of their chest. While some EFT clients reported that therapy had a negative impact on their relationship with their parents and increased their anger, some ABFT clients reported that the positive impact of therapy during the active phase of treatment did not last, though there were no meaningful between-groups differences regarding these negative treatment outcomes and processes. Results are discussed in the context of previous quantitative findings from the same sample, and in the context of prior research on experiential and emotion-focused therapies. Implications for future research are noted. (PsycINFO Database Record