Resolution of Self-Interruption in Emotion-Focused Therapy: A Model of Client Processes

The aim of this study was to develop and preliminarily validate a transdiagnostic model of how clients overcome Aversion to Emotion/ Self-Interruption (AESI) over the course of a session of emotion-focused therapy. The study employed task analytic methodology and consisted of two phases: a Discovery Phase and a Validation Phase. In the Discovery Phase of the study, a model of the resolution of AESI was developed through the intensive analysis of 5 cases (3 Resolved, 2 Unresolved). The model identified 7 component processes involved in this task: Marker of AESI, Awareness of How Interrupting, Awareness of Purpose of Interruption, Realization of Negative Impact of Interruption, Reduction of Fear of Emotion, Desire to Allow Emotion, and Resolution of AESI. Rating scales were developed to measure each component, so that they could be used to verify the model in the Validation Phase of the study. These rating scales consisted of the Marker of AESI Rating Scale (MARS), the Components of Resolution of AESI Rating Scale (CRARS), and the Resolution of AESI Rating Scale (RARS).

In the Validation Phase of the study, segments of therapy sessions from a sample of 24 clients (13 Resolved, 11 Unresolved) were rated for the presence of model components, using the MARS, CRARS and RARS. Significant inter-rater reliability was obtained on each scale. Preliminary support for the validity of the model of resolution was established. The two early mid-model components (Awareness of How Interrupting and Awareness of Purpose of Interruption) were present among all clients, while the three late mid-model components (Realization of Negative Impact of Interruption, Reduction of Fear of Emotion, and Desire to Allow Emotion) occurred more frequently among Resolved clients, compared to Unresolved clients. Resolution of AESI had a perfect positive relationship with Reduction of Fear of Emotion, a fairly strong positive relationship with Desire to Allow Emotion, and a moderate positive relationship with Realization of Negative Impact of Interruption. Support for the structure of the model was mixed. Clinical and theoretical implications of these findings are discussed and contextualized within current psychotherapy research literature.