Working with emotion predicts sudden gains during experiential therapy for depression.

Objective: This study involves the first attempt to identify sudden gains in a sample of clients undergoing experiential therapy for depression while also investigating client and therapist change processes related to sudden gains.Method: Pre- and post-session Beck Depression Inventory, short form (BDI-SF) questionnaires were used to identify sudden gains and differentiate between in-session and between-session symptom changes in thirty-six client-therapist dyads. Archival videotape data of a sub-sample were coded using the Experiencing Scale, Classification of Affective Meaning States, and the Coding System for Therapist Focus.Results: The study revealed that 63.9% of clients experienced a sudden gain and the bulk of the total mean symptom decrease (74.9%) was found to occur within the session preceding the sudden gain. During this critical session, clients were more likely to display deepened experiencing (p < .01, η2 = .34), clients were more likely to express "primary adaptive emotions" (p < .05, r = .38), and therapists were found to be more likely to focus on unmet client needs (p < .01, d = .75).Conclusion: The majority of the sudden gain change occurs within session in experiential therapy, and primary adaptive emotions as well as addressing unmet needs are possible processes of sudden gains.

Reunification, reconsidered: Presenting an integrative, single-therapist framework for resolving parent-child contact problems.

Providing therapy to families of separation and divorce can be a challenging area of practice for marriage and family therapists, particularly when a child refuses contact with a parent. Several forms of "reunification therapy" designed to overcome resist/refuse dynamics between a child and parent have been proposed, with significant variation across the conceptualization of factors contributing to parent-child contact problems and the resulting treatment models that have been described. In an effort to design an overarching integrative framework for conducting family reunification therapy that is informed by available evidence, a review of the current literature is conducted. Following this review, an integrative single-therapist framework for resolving parent-child contact problems is presented. Over the course of three successive treatment "stages," this framework permits a marriage and family therapist to conduct reunification therapy in an evidence-informed manner along general systemic therapeutic principles while permitting flexibility with respect to the specific interventions selected.