Transforming core emotional pain in a course of emotion-focused therapy for depression: A case study

Objective: To investigate the pattern of change in emotional states over a course of emotion-focused therapy using the model of sequential emotional processing as an initial framework for analysis. Method: This was a single case study observational design examining 15 sessions of therapy with one client. A qualitative analysis of moment-to-moment shifts in client emotional events was conducted. This conceptualised the interplay between experienced emotions using the sequential emotional processing model as an interpretative framework. The analysis was triangulated by using existing observer-based rating scales and reliability assessed with an independent rater. Results: The sequential emotional processing model was found to be an effective means to explain the sequence of expressed emotional events, although some emotional events and emotion scheme change processes pertaining to this particular case required additional explanation than provided in the original model descriptions. Conclusions: Observed nuances in this specific case included highlighting triggers to emotional experience and avoidance processes fuelled by anticipatory fear. The observations included a process of change through accessing core feelings of shame, fear, and loneliness and their transformation through the generation of self-compassion and assertive anger. Implications for practice are discussed in terms of case conceptualisation and therapeutic strategy.