Greenberg, Leslie S.Miller, Sara2021-11-152021-11-152019-112021-11-15http://hdl.handle.net/10315/38634This psychotherapy process research study tested the predictive validity of a model of emotional processing in a sample of 23 psychotherapy clients who met criteria for a DSM-IV diagnosis of major depressive disorder and whose presentation in early sessions suggested what was termed a core maladaptive shame scheme. The model of client process examined contains five essential experiential states: i) expression of self-criticism and/or self-contempt, or narration of memories of abuse or maltreatment; ii) access to primary maladaptive shame; iii) articulation of psychological pain; iv) articulation of adaptive needs; and v) experience of primary adaptive emotions and experiential states. In the preliminary phase of the study, a truncated task analytic procedure was used to develop a psychotherapy process research measure, the Classification of Experiential States Related to Maladaptive Shame (CEMS) (Miller & Greenberg, 2013). In the second phase of the study, the measure was utilized to assign categorical and quantitative codes to each utterance in chosen segments of videotaped psychotherapy sessions of 23 psychotherapies, conducted as part of the York I & II Depression Studies. Data from the coding produced an average of 202 separate categorical codes per session, representing clients evolving experiential states across the therapy sessions. Difference scores indicating change in depressive symptoms pre- to post-therapy as measured by the Beck Depression Inventory were used as the main therapy outcome variable. A bootstrapping analysis showed that the emergence of adaptive emotion was preceded by clients experience of self-contempt and maladaptive shame, in that sequence, at a frequency higher than would be expected by chance alone. Multivariate regression analyses indicated that clients experience of three key experiential states, maladaptive shame, adaptive need, and primary adaptive emotion, was significantly predictive of pre- to post- therapy change scores, as was their experience of the model experiential states across the session in the order proscribed by the model. Finally, clients experience in the session of the primary adaptive emotions of pride, self-compassion, anger, and pride/anger (self-determination) were found to have the strongest correlation with therapy outcome. Limitations and implications for future research are discussed.Author owns copyright, except where explicitly noted. Please contact the author directly with licensing requests.PsychologyElectronic Thesis or Dissertation2021-11-15PsychotherapyDepression