Narrative change in emotion-focused psychotherapy: A study on the evolution of reflection and protest innovative moments

Abstract

Innovative moments (IMs) are exceptions to a client's problematic self-narrative in the therapeutic dialogue. The innovative moments coding system is a tool which tracks five different types of IMs-action, reflection, protest, reconceptualization and performing change. An in-depth qualitative analysis of six therapeutic cases of emotion-focused therapy (EFT) investigated the role of two of the most common IMs-reflection and protest-in both good and poor outcome cases. Through this analysis two subtypes (I and II) of reflection and protest IMs were identified, revealing different evolution patterns. Subtype II of both reflection and protest IMs is significantly higher in the good outcome group, while subtype I of both IMs types does not present statistically significant differences between groups. The evolution from subtype I to subtype II across the therapeutic process seems to reflect a relevant developmental progression in the change process.

Innovative moments and change in client-centered therapy

“…The analysis of the process of change involved the coding of these six cases using the IMCS . Table I Matos et al (2009) and .86 in the study by Mendes et al (2011). In other case studies the values of Cohen's Kappa ranged from .76 to .90 (Ribeiro et al, 2009).…”

“…Given that CCT is the least directive of all treatments studied so far with the IMCS, we speculate that this might appear in the patterns of IMs' emergence. For instance, chair work in EFT is strongly associated with protest IMs (Mendes, Ribeiro, Angus, Greenberg, & Gonçalves, 2011) and, although we have no empirical findings on this, we suppose that in NT externalization of the problem could also elicit protest IMs. Thus, we wonder how the absence of directive therapeutic strategies will impact the pattern of IMs of the CCT sample.…”

Humanistic psychotherapy research 1990–2015: From methodological innovation to evidence-supported treatment outcomes and beyond

“…Finally, a recent series of intensive case studies (Angus & Hardtke, 2007;Angus & Kagan, 2013;Cunha et al, 2012;Gonçalves et al, 2012;Mendes et al, 2010Mendes et al, , 2011 have drawn on the York I Depression study transcript data-set (Angus, 2012) to examine emotion-focused and client-centered humanistic therapy sessions from a narrativeinformed perspective on therapy change processes (Angus & McLeod, 2004). Findings from these studies have highlighted the importance of protest moments (such as challenging the voice of selfcriticism), reclamation of own needs (for instance, by setting a boundary in an abusive relationship), working with client ambivalence and self-narrative reconstruction in good outcome therapy sessions.…”

Procesos Narrativos en Psicoterapia: diferencias entre clientes con buen y mal resultado

“…Again, as discussed by Angus (2012) our data demonstrates that changes in the narrative process are the key to clients change. Also coherently with the work of M. Gonçalves et al, 2011Gonçalves et al, , 2012Matos et al, 2009;Mendes et al, 2010Mendes et al, , 2011; therapeutic change is correlated with changes not only in narrative process but also in its content.…”

“…Research by the group led by Miguel Gonçalves and Inês Mendes (see Gonçalves et al, 2011Gonçalves et al, , 2012Mendes et al, 2010Mendes et al, , 2011Matos et al, 2009) on new emerging therapeutic meanings that they refer to as Innovative Moments (IMs) demonstrate that IMs are transtheoretical since all therapies aim to create alternative meanings in clients' self-narratives. Again, therapeutic change is correlated with changes in narrative process and content.…”