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The goal of this paper is to show (i) how the moment-to-moment tracking and processing of emotion to completion —in an emotionally engaged patient–therapist dyad where the individual feels safe and known—constitutes a powerful mechanism of therapeutic transformation, and (ii) how positive emotions are sensitive affective markers of that transformational process. Evidence from transformational studies is used to elaborate the vital role of positive emotions in the process of change in general, and, more specifically, in the course of therapeutic work with painful and overwhelming emotional experience. It is proposed that these emergent positive emotions are affective markers which signal the operation of healing transformational processes in psychotherapy. Several types of positive emotion that arise spontaneously during moment-to-moment experiential therapeutic work will be described and their role as markers of different transformational processes will be elucidated. The paper begins with examples of clinical work with emotion in AEDP (Accelerated Experiential–Dynamic Psychotherapy), an emotion-focused and attachment-based model of therapy that places the dyadic regulation of affect at the centre of both theory and practice. Copyright © 2004 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Emotion-focused therapy (EFT) is an integrative and experiential treatment approach that views emotions as fundamentally adaptive and privileges attention to, and exploration of, emotional experiences. EFT has been demonstrated to be efficacious with depression, interpersonal trauma and marital discord, but application to anxiety disorders is in its initial stages. The purpose of this paper is to present the main principles of using EFT with socially anxious patients and to make the case that EFT is particularly well suited for working with this patient group. The primary change processes in EFT for social anxiety include improving emotion awareness, reducing experiential avoidance and the activation and transformation of shame that underlies the symptomatic anxiety. Such processes lead to less self-criticism, to more self-compassion and self-soothing and to a more favourable perception of the self. A case example is used to illustrate how these principles were applied with a socially anxious patient. Copyright © 2013 John Wiley & Sons, Ltd. Key Practitioner Message Although cognitive-behavioral therapies (CBT) are effective for social anxiety disorder (SAD), a substantial number of patients do not respond to CBT or remain considerably symptomatic at the end of treatment. Therefore, more treatment options for SAD are necessary in order to improve patient care., Emotion-focused therapy (EFT), which is an efficacious treatment for depression, complex trauma, and couples' distress may also be efficacious for SAD., EFT offers an emotion-based case formulation of SAD, in which social anxiety is conceptualized as secondary to primary maladaptive shame. A primary goal in EFT for SAD is to access and evoke shame in order to transform it. [ABSTRACT FROM AUTHOR]

This paper presents a series of cases to explore the development and value of a form of relating therapy for people who hear voices. The therapy is theoretically underpinned by Birtchnell's Relating Theory and offers a therapeutic space where hearers can explore and seek to change the relationship with their predominant voice. Five cases are presented to illustrate the processes of: (1) exploring similarities between relating to the voice and relating socially; (2) enhancing awareness of reciprocity with the voice–hearer relationship; and (3) using assertiveness training and empty chair work to facilitate change. Results were encouraging as change in control and/or distress was apparent for four of the cases. Changes in patterns of relating to voices were also apparent. Copyright © 2009 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Despite the proven efficacy of exposure techniques for the treatment of Post-Traumatic Stress Disorder, some obstacles can arise that interfere with successful implementation of exposure-based therapy. In this paper, the theory behind exposure therapy for PTSD is reviewed and basic implementation procedures are detailed. The ways in which three obstacles to treatment (extreme anger, emotional numbing, and overwhelming anxiety) can impede progress in therapy are discussed in terms of theory and case examples. Specific suggestions for circumventing these obstacles are offered, including modifying the exposure techniques and augmenting exposure by using stress inoculation techniques or cognitive therapy. [ABSTRACT FROM AUTHOR]

Introduces a series of articles on emotions and psychotherapy.

Emotion regulation (ER) difficulties have been identified as an important target for clinical intervention in the treatment of post‐traumatic stress disorder (PTSD) symptoms in survivors of childhood sexual abuse (CSA). However, there is limited research regarding the use of specific strategies to regulate specific emotions following exposure to traumatic events. The aim of the current study was to investigate the indirect effects of four trauma‐related emotions (anger, sadness, disgust, and fear) on PTSD severity via two mediators: derealization and self‐harm. In particular, we tested that if the two hypothetical mediators operate sequentially, derealization precedes self‐harm and/or self‐harm precedes derealization. A predominate female clinical sample (N = 109) of CSA survivors completed measures of experience of emotions, ER, and post‐traumatic stress. Bivariate and serial mediation analyses were conducted to test the direct and indirect effects of trauma‐related emotions on PTSD severity. Serial mediation analyses indicated that there were significant total effects of all trauma‐related emotions on PTSD severity. Three trauma‐related emotions (sadness, disgust, and fear) were indirectly associated to PTSD severity via derealization and self‐harm and via self‐harm and derealization. Results indicate that difficulties in regulating the emotions of sadness, disgust, and fear may result in more severe derealization and self‐harm as coping strategies, which in turn lead to greater PTSD severity. The sequence of mediators does not hold great importance in these pathways. Overall, our findings suggest that therapeutically targeting derealization and self‐harm might enable the reduction of PTSD among CSA survivors. [ABSTRACT FROM AUTHOR]

The study aim was to test whether a 12-week publically rebated group programme, based upon Steketee and Frost's Cognitive Behavioural Therapy-based hoarding treatment, would be efficacious in a community-based setting. Over a 3-year period, 77 participants with clinically significant hoarding were recruited into 12 group programmes. All completed treatment; however, as this was a community-based naturalistic study, only 41 completed the post-treatment assessment. Treatment included psychoeducation about hoarding, skills training for organization and decision making, direct in-session exposure to sorting and discarding, and cognitive and behavioural techniques to support out-of-session sorting and discarding, and nonacquiring. Self-report measures used to assess treatment effect were the Savings Inventory-Revised (SI-R), Savings Cognition Inventory, and the Depression, Anxiety and Stress Scales. Pre-post analyses indicated that after 12 weeks of treatment, hoarding symptoms as measured on the SI-R had reduced significantly, with large effect sizes reported in total and across all subscales. Moderate effect sizes were also reported for hoarding-related beliefs (emotional attachment and responsibility) and depressive symptoms. Of the 41 participants who completed post-treatment questionnaires, 14 (34%) were conservatively calculated to have clinically significant change, which is considerable given the brevity of the programme judged against the typical length of the disorder. The main limitation of the study was the moderate assessment completion rate, given its naturalistic setting. This study demonstrated that a 12-week group treatment for hoarding disorders was effective in reducing hoarding and depressive symptoms in an Australian clinical cohort and provides evidence for use of this treatment approach in a community setting. Copyright © 2016 John Wiley & Sons, Ltd. Key Practitioner Message A 12-week group programme delivered in a community setting was effective for helping with hoarding symptoms with a large effect size., Hoarding beliefs (emotional attachment and responsibility) and depression were reduced, with moderate effect sizes., A third of all participants who completed post-treatment questionnaires experienced clinically significant change., Suggests that hoarding CBT treatment can be effectively translated into real-world settings and into a brief 12-session format, albeit the study had a moderate assessment completion rate. [ABSTRACT FROM AUTHOR]

This narrative review draws upon a broad range of literature, including theory and empirical research, to argue that positive emotions are a useful adjunct to therapy when working with individuals who self-harm. The review highlights how self-harm is often employed as a method of emotion regulation and may be both negatively and positively reinforced. It is suggested that individuals who self-harm have potential difficulty in experiencing positive and negative emotions. The compatibility of an emotion focused approach to therapy for individuals who self-harm is therefore deemed an appropriate one. However, current therapeutic models predominantly focus on unpleasant or negative emotions and largely tend to neglect positive emotions, such as happiness. Broaden and build theory indicates that positive emotions can reduce the effects of negative emotions and aid recovery from intolerable negative emotions that may underpin self-harming behaviours. Therefore, the incorporation of positive emotions into therapy is likely to be helpful. In addition, if cultivated over time, positive emotions can build resilience that may enable individuals to cope better with events that precipitate self-injurious behaviours. The review emphasizes how positive emotions represent a valuable addition to therapeutic work but also highlights that the negatively valenced and painful emotions often experienced by those who self-injure must still be addressed. Copyright © 2013 John Wiley & Sons, Ltd. Key Practitioner Message When working with individuals who self-harm it may be beneficial for practitioners to consider clients' experiences of positive emotions, and how to cultivate these, in addition to targeting the negative emotions which tend to underpin self-harming behaviours. [ABSTRACT FROM AUTHOR]

In an Emotion-focused approach emotion is seen as foundational in the construction of the self and is a key determinant of self-organization. As well as having emotion people also live in a constant process of making sense of our emotions. Personal meaning is seen as emerging by the self-organization and explication of one's own emotional experience and optimal adaptation involves an integration of reason and emotion. In this framework therapists are viewed as Emotion coaches who work to enhance emotion-focused coping by helping people become aware of, accept and make sense of their emotional experience. Emotion coaching in therapy is based on two phases: Arriving and Leaving. A major premise is that one cannot leave a place until one has arrived at it. Three major empirically-supported principles of Emotion Awareness, Emotion Regulation and Emotion Transformation that guide emotion coaching are discussed. Copyright © 2004 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]