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Objectives: This study examined the combined effect of therapist Facilitative Interpersonal Skills (FIS) and Training Status on experiential processes within therapy sessions. In this randomized trial of FIS and Training Status, we predicted that in-session experiential processes would be highest for the high FIS and trained therapist group and lowest for the low FIS and untrained therapists. Methods: Forty-five clients were selected from 2,713 undergraduates using a screening and clinical interview procedure. Twenty-three therapists were selected for their level of FIS (high vs. low) and Training (trainee vs. untrained) and each were assigned two clients for seven sessions each. Two different coder teams independently rated experiencing and narrative process from the third therapy session and computer analysis identified affect words from transcripts. Results: FIS×Training Status significantly interacted on the set of experiential process measures. Relative to all others, therapists who were in the low FIS / no training group had lower experiencing and reflexive content, but higher external content. Conclusions: The findings highlight the importance of therapist characteristics within therapy sessions. Therapists without training and with low interpersonal skills have sessions that are nearly devoid of content that focuses on client experiential processes and emotion.

Objective: In a secondary analysis of Friedlander et al.'s [(2018). “If those tears could talk, what would they say?” multi-method analysis of a corrective experience in brief dynamic therapy. Psyc...

According to a narrative-emotion informed psychotherapy approach, individuals enter psychotherapy when their narratives lack flexibility and emotional coherence. Effective psychotherapy helps clien...

Despite the importance of narrative, emotional and meaning-making processes in psychotherapy, there has been no review of studies using the main instruments developed to address these processes. The objective is to review the studies about client narrative and narrative-emotional processes in psychotherapy that used the Narrative Process Coding System or the Narrative-Emotion Process Coding System (1.0 and 2.0). To identify the studies, we searched The Book Collection, PsycINFO, PsycARTICLES, PsycBOOKS, PEP Archive, Psychology and Behavioral Sciences Collection, Academic Search Complete and the Web of Knowledge databases. We found 27 empirical studies using one of the three coding systems. The studies applied the Narrative Process Coding System and the Narrative-Emotion Process Coding System to different therapeutic modalities and patients with various clinical disorders. In some studies, early, middle and late phases of therapy were compared, while other studies conducted intensive case analyses of Narrative Process Coding System and Narrative-Emotion Process Coding System patterns comparing recovered vs unchanged clients. The review supports the importance to look for the contribution of narrative, emotion, meaning-making patterns or narrative-emotion markers, to treatment outcomes and encourages the application of these instruments in process-outcome research in psychotherapy.

We analyzed master theorist/therapist Hanna Levenson's six-session work with "Ann" in American Psychological Association's Theories of Psychotherapy video series to determine if and how this client had a corrective experience in Brief Dynamic Therapy. First, we identified indicators of a corrective experience in the therapist's and client's own words. Complementing this analysis, we used observational coding to identify, moment by moment, narrative-emotion markers of shifts in Ann's "same old story"; the frequency, type, and depth of immediacy; and the client's and therapist's behavioral contributions to the working alliance. Additionally, we qualitatively analyzed Levenson's session-by-session accounts of the therapy from two sources. Convergent evidence from these multi-method analyses suggested how the intertwined relational and technical change processes seemed to bring about this client's corrective experience. Through consistent attention to the alliance and increasingly deep immediacy, Levenson created a safe space for Ann to "bring down the wall"-by allowing herself to cry and be deeply understood and cared for in a way that she had never before experienced. Concurrently, Ann began seeing herself quite differently, signified by self-identity narrative change. Then, following Session 4, she took Levenson's suggestion to risk behaving more authentically with a friend and with her romantic partner.

Objective: This research explored the consolidation phase of emotion-focused therapy (EFT) for depression and studies—through a task-analysis method—how client–therapist dyads evolved from the exploration of the problem to self-narrative reconstruction. Method: Innovative moments (IMs) were used to situate the process of self-narrative reconstruction within sessions, particularly through reconceptualization and performing change IMs. We contrasted the observation of these occurrences with a rational model of self-narrative reconstruction, previously built. Results: This study presents the rational model and the revised rational-empirical model of the self-narrative reconstruction task in three EFT dyads, suggesting nine steps necessary for task resolution: (1) Explicit recognition of differences in the present and steps in the path of change; (2) Development of a meta-perspective contrast between present self and past self; (3) Amplification of contrast in the self; (4) A positive appreciation of changes is conveyed; (5) Occurrence of feelings of empowerment, competence, and mastery; (6) Reference to difficulties still present; (7) Emphasis on the loss of centrality of the problem; (8) Perception of change as a gradual, developing process; and (9) Reference to projects, experiences of change, or elaboration of new plans. Conclusions: Central aspects of therapist activity in facilitating the client's progression along these nine steps are also elaborated, tuguese Foun- dation for Science and Technology [grant PTDC/PSI-PCL/121525/2010] (Ambivalence and unsuccessful psychotherapy, 2007–2010) and by the Ph.D. grant [SFRH/BD/30880/2006]

The Narrative-Emotion Process Coding System (NEPCS) is a behavioral coding system that identifies eight client markers: Abstract Story, Empty Story, Unstoried Emotion, Inchoate Story, Same Old Story, Competing Plotlines Story, Unexpected Outcome Story, and Discovery Story. Each marker varies in the degree to which specific narrative and emotion process indicators are represented in one-minute time segments drawn from videotaped therapy sessions. As enhanced integration of narrative and emotional expression has previously been associated with recovery from complex trauma, the purpose of the present pilot study was to examine the contribution of within session NEPCS markers to treatment outcomes for clients undergoing Emotion-Focused Therapy for Trauma (EFTT). The NEPCS was applied to two early, two middle, and two late videotaped therapy sessions selected from two recovered and two unchanged complex trauma EFTT clients. Exploratory statistical analyses established that unchanged clients expressed s...

Within emotion-focused therapy (EFT), the client’s ability to express and reflect on core emotional experiences is seen as fundamental to constructing the self and to entering into a change process. For this study, we 1) examine storytelling contexts in which clients do not disclose the emotional impact of their narrative, and 2) identify the interactional practices through which EFT therapists subsequently call attention to what the client may have felt. In doing so, we examine client stories drawn from video-taped individual psychotherapy sessions involving clinically depressed clients. Client stories and therapists’ responses to these stories were analysed using conversation analytic methods. Three different therapist response types were identified: eliciting, naming and illustrating the emotional impact of the client’s prior narrative. These responses also were found to differ in terms of how effectively they could display empathy and secure affiliation with clients. The implications of this work for therapeutic practice are discussed.

Objective: Ambivalence can be understood as a cyclical movement between an emerging narrative novelty—an Innovative Moment (IM)—and a return to a problematically dominant self-narrative. The return implies that the IM, with its potential for change is devalued right after its emergence. Our goal is to test the hypothesis that the probability of the client expressing such form of ambivalence decreases across treatment in good-outcome cases but not in poor-outcome cases. Method: Return-to-the-Problem Markers (RPMs) signaling moments of devaluation of IMs were coded in passages containing IMs in six clients with major depression treated with emotion-focused therapy: three good-outcome cases and three poor-outcome cases. Results: The percentage of IMs with RPMs decreased across therapy in good-outcome cases, whereas it remained unchanged and high in the poor-outcome cases. Conclusions: These results were consistent with the theoretical suggestion that therapeutic failure may be associated with this form of ambivalence., Obiettivo: L'ambivalenza può essere considerata come un movimento ciclico tra un nuovo elemento narrativo emergente - Innovative Moment (IM) - e il ritorno ad una auto-narrazione problematica dominante. Il ritorno implica che il IM perde il proprio potenziale di favorire un cambiamento nel momento in cui emerge. Il nostro obiettivo è quello di verificare l'ipotesi che la probabilità che il paziente possa esprimere tale forma di ambivalenza diminuisce nel corso di un trattamento che ha un buon esito, ma non nei casi con esito negativo. Metodo: in sei pazienti affetti da depressione maggiore trattati con terapia focalizzata sulle emozioni, sono stati codificati i passaggi contenenti IM utilizzando il Return-to-the-Problem Markers (RPMs) che segnala i passaggi in cui IM vengono svalutati: tre casi con buon esito e tre con esito negativo. Risultati: La percentuale di IM con gli RPM diminuiva nel corso delle terapie dei casi con buon esito, mentre è rimasto invariato ed elevato nei casi con scarso esito. Conclusioni: Questi risultati sono coerenti con il presupposto teorico che il fallimento terapeutico possa essere associato a questa forma di ambivalenza., Objetivo: A ambivalência pode ser entendida como um movimento cíclico entre uma novidade narrativa emergente – um Momento de Inovação (MI) – e um retorno à narrativa problemática dominante. O retorno implica que o MI, com o seu potencial para a mudança, seja desvalorizado logo após a sua emergência. O nosso objetivo é testar a hipótese de que a probabilidade do cliente expressar tal forma de ambivalência diminui ao longo do tratamento em casos de sucesso mas não em casos de insucesso terapêutico. Método: Marcadores de Retorno ao Problema (MRP) que assinalam momentos de desvalorização dos MIs foram codificados em passagens contendo MIs em seis casos de clientes com depressão major tratados com terapia focada nas emoções: três casos de sucesso e três casos de insucesso. Conclusões: Estes resultados foram consistentes com as sugestões teóricas de que o insucesso terapêutico poderá estar associado a esta forma de ambivalência., Ziel: Ambivalenz kann als zyklische Bewegung zwischen einer emergenten narrativen Neuheit – einem Innovative Moment (IM) – und einer Rückkehr zu einer problematischen dominanten Selbst-Erzählung verstanden werden. Diese Rückkehr impliziert, dass der IM mit seinem Potential für Veränderung direkt nach seinem Auftauchen abgewertet wird. Unser Ziel ist die Hypothese zu testen, dass die Wahrscheinlichkeit, dass der Klient eine solche Form der Ambivalenz zeigt, bei Fällen mit gutem Therapieergebnis über die Behandlung abnimmt, aber nicht in Fällen mit schlechtem Ergebnis. Methode: Rückkehr-zu-dem-Problem Marker (RPMs), die Momente signalisieren, in denen IMs abgewertet werden, wurden in Passagen, die IMs beinhalten, von sechs Klienten mit Major Depression, die mit emotionsfokussierter Therapie behandelt wurden, kodiert: 3 Fälle mit gutem und 3 Fälle mit schlechtem Therapieergebnis. Ergebnisse: Der Prozentsatz von IMs mit RPMs verringerte sich bei Fällen mit gutem Ergebnis über die Therapie hinweg, wohingegen er in den Fällen mit schlechtem Ergebnis unverändert und hoch blieb. Schlussfolgerung: Die Ergebnisse waren mit dem theoretischen Vorschlag konsistent, dass therapeutischer Misserfolg mit dieser Form der Ambivalenz assoziiert ist., 目標：矛盾可以視為是種擺盪在新產生的新穎敘說—創意時刻(IM)—和回復到一種有問題的支配性自我敘說之間的循環動作。回復意味著潛藏改變契機的IM，其價值在出現後即被摒棄。我們的目標是檢視以下假設的可能性：「在具良好成效的案例中，案主在治療歷程中表達這種形式的矛盾會降低；而在不良成效的案例中則否」。方法：在六位具有嚴重憂鬱症患者的IM段落中，找到顯示IM價值降低時刻的故態復萌標記（RPMs）並加以編碼。這六位患者均接受情緒焦點治療，其中三位為具良好成效案例，另外三位為不良成效案例。結果：在具良好成效案例中，IM當中具有RPM的比率降低；而在不良成效的案例中，RPM的比率維持不變或更高。結論：此結果與理論假設一致，即假設治療的失敗可能與這種形式的矛盾有關。

[Excerpt] The aim of this special section is to present a review of recent advances in the assessment of changes in client narratives. An emerging trend in the psychotherapy research field suggests that narrative-based meaning reconstruction is an important foundation for the articulation of a new, more adaptive view of self (Angus & Kagan, 2013) in psychotherapy. Additionally, a range of research-informed treatment models, including psychodynamic (Luborsky, 1998), humanistic (Angus, Watson, Elliott, Schneider, & Timulak, 2015) and systemic therapy approaches (Dallos & Vetere, 2009), emphasize that client changeinpsychotherapyisfacilitatedthroughpersonal story disclosure, emotional engagement and reflection for new meaning construction and self-narrative reorganization. In fact, recent research from Angus et al. (inpress)andGonçalvesetal.(thisissue),usingdifferent methods and clinical samples, have independently established that successful psychotherapy involves client self-narrative transformation processes evidenced in late phase therapy sessions. (...)

Drawing on a Dialectical Constructivist model of therapeutic change, this paper addresses the fundamental contributions of client narrative disclosure, emotional differentiation and reflexive meaning-making processes in emotion-focused treatments of depression. An overview of the multi-methodological steps undertaken to empirically investigate the contributions of client storytelling, emotional differentiation, and meaning-making processes, using the Narrative Processes Coding System (NPCS; Angus et al., 1999) are provided, followed by a summary of key research findings that informed the development of a narrative-informed approach to emotion-focused therapy of depression (Angus & Greenberg, 2011). Finally, therapy practice implications for the adoption of a research-informed approach to working with narrative and emotion processes in emotion-focused therapy are described and future research directions discussed.

Personality researchers use the term self-narrative to refer to the development of an overall life story that places life events in a temporal sequence and organizes them in accordance to overarching themes. In turn, it is often the case that clients seek out psychotherapy when they can no longer make sense of their life experiences, as a coherent story. Angus and Greenberg (L. Angus and L. Greenberg, 2011, Working with narrative in emotion-focused therapy: Changing stories, healing lives. Washington, DC: American Psychological Association Press) view the articulation and consolidation of an emotionally integrated self-narrative account as an important part of the therapeutic change process that is essential for sustained change in emotion-focused therapy of depression. The purpose of the present study was to investigate client experiences of change, and self-narrative reconstruction, in the context of one good outcome emotion-focused therapy dyad drawn from the York II Depression Study. Using the Narrative Assessment Interview (NAI) method, client view of self and experiences of change were assessed at three points in time--after session one, at therapy termination, and at 6 months follow-up. Findings emerging from an intensive narrative theme analyses of the NAI transcripts--and 1 key therapy session identified by the client--are reported and evidence for the contributions of narrative and emotion processes to self-narrative change in emotion-focused therapy of depression are discussed. Finally, the implications of assessing clients' experiences of self-narrative change for psychotherapy research and practice are addressed.

Recent studies suggest that it is not simply the expression of emotion or emotional arousal in session that is important, but rather it is the reflective processing of emergent, adaptive emotions, arising in the context of personal storytelling and/or Emotion-Focused Therapy (EFT) interventions, that is associated with change.To enhance narrative-emotion integration specifically in EFT, Angus and Greenberg originally identified a set of eight clinically derived narrative-emotion integration markers were originally identified for the implementation of process-guiding therapeutic responses. Further evaluation and testing by the Angus Narrative-Emotion Marker Lab resulted in the identification of 10 empirically validated Narrative-Emotion Process (N-EP) markers that are included in the Narrative-Emotion Process Coding System Version 2.0 (NEPCS 2.0).Based on empirical research findings, individual markers are clustered into Problem (e.g., stuckness in repetitive story patterns, over-controlled or dysregulated emotion, lack of reflectivity), Transition (e.g., reflective, access to adaptive emotions and new emotional plotlines, heightened narrative and emotion integration), and Change (e.g., new story outcomes and self-narrative discovery, and co-construction and re-conceptualization) subgroups. To date, research using the NEPCS 2.0 has investigated the proportion and pattern of narrative-emotion markers in Emotion-Focused, Client-Centered, and Cognitive Therapy for Major Depression, Motivational Interviewing plus Cognitive Behavioral Therapy for Generalized Anxiety Disorder, and EFT for Complex Trauma. Results have consistently identified significantly higher proportions of N-EP Transition and Change markers, and productive shifts, in mid- and late phase sessions, for clients who achieved recovery by treatment termination.Recovery is consistently associated with client storytelling that is emotionally engaged, reflective, and evidencing new story outcomes and self-narrative change. Implications for future research, practice and training are discussed.

This study aimed to further understand how narrative flexibility contributes to therapeutic outcome in brief psychotherapy for depression utilizing the Narrative-Emotion Process Coding System (NEPCS), an observational measure that identifies specific markers of narrative and emotion integration in therapy sessions.The present study investigated narrative flexibility by examining the contribution of NEPCS shifting (i.e., movement between NEPCS markers) in early, middle, and late sessions of client-centred therapy (CCT), emotion-focused therapy (EFT), and cognitive therapy (CT) and treatment outcome (recovered versus unchanged at the therapy termination). A logistic regression, with Wald tests of parameter estimates and pairwise comparisons, was used to test the study hypotheses.Results demonstrated that for recovered clients, the probability of shifting over the course of a therapy session was constant, whereas the probability of shifting declined for unchanged clients as the session progressed. There was also evidence that longer duration of time spent in any single NEPCS marker was negatively associated with shifting for both recovered and unchanged clients, although the effect was stronger for unchanged clients.The results provided preliminary support for the contribution of narrative flexibility to treatment outcomes in EFT, CCT, and CT treatments of depression.

This paper addresses the fundamental contributions of client narrative disclosure in psychotherapy and its importance for the elaboration of new emotional meanings and self understanding in the context of Emotion-focused therapy (EFT) of depression. An overview of the multi-methodological steps undertaken to empirically investigate the contributions of client story telling, emotional differentiation and meaning-making processes (Narrative Processes Coding System; Angus et al., 1999) in EFT treatments of depression is provided, followed by a summary of key research findings that informed the development of a narrative-informed approach to Emotion-focused therapy of depression (Angus & Greenberg, 2011). Finally, the clinical practice and training implications of adopting a research-informed approach to working with narrative and emotion processes in EFT are described, and future research directions discussed.

Angus and her colleagues have examined the importance of metaphor and narratives in their patients' lives, particularly the expression of emotion-laden metaphors by patients who have received serious psychological or physical illness diagnoses. What seems to be particularly important in these emotion-laden metaphors is that they allow patients to express emotions that are felt somatically or are otherwise trapped within. Building on Angus and Greenberg's metaphor, broken stories, to describe the interference to patients' expectations for their future caused by devastating illness diagnoses, this article provides clinical examples of how metaphors have helped patients express their painful feelings and how patients and therapists co-create particularly helpful metaphors. The co-creation of healing metaphors draws patients and therapists and doctors together. Within the context of such empathy, healing narratives can develop from co-created metaphors.

In this article, we examine the use of motivational interviewing (MI) to treat generalized anxiety disorder (GAD) by means of case illustration that focuses on four categories drawn from the client's experience of the key ingredients in MI therapy. The case illustration, drawn from the York study on combining MI and cognitive behavior therapy in the treatment of GAD (uses the client's pre- and post-therapy narrative interviews) to arrive at categories representative of the client's experience of MI therapy. The results of the qualitative analysis highlight the key contributions to positive client outcomes and readiness for change in brief MI therapy for GAD.

This article is concerned with the relationships which hold between the clinical practice and the theory of family therapy; and between these and academic research. These relationships are seen as tenuous and thin because, in the first place, there is a lack of rigorous theoretical underpinning; and second, the research methods employed do not fit in with current family therapy practice, and with the theory that underlies this practice. The role of the concept of narrative process modes is proposed as a bridging and mediating one. The external, internal and reflective narrative process modes are seen as relevant from the point of view of family therapy process research, and the clinical practice of marital and family therapy.

The aim of this study is to investigate whether the method (Narrative Processes Coding System) for studying the narrative sequences of individual psychotherapy developed by Angus and Hardtke (1994) can be applied in a family therapeutic process. According to the results narrative process coding system adds new dimensions and gives new depth in the narrative understanding of family therapeutic process. In micro-analytic interactional level it shows the complicated interactions between narration, plot, and narrative process type.

This paper examines the use of ‘burden' metaphors relating to the experience of depression in one good and one poor outcome process-experiential short-term psychotherapy dyad. Burden-metaphors are meaningful as they appear to characterize the way these clients experience the course of their depressions (e.g. Korman & Angus, 1995). Understanding how these experiences are dealt with in productive therapies, as compared to less-productive treatments, can aid in therapist training and in developing therapeutic programmes for depressed clients. The Experiencing Scale (Klein et al., 1970) and the Narrative Process Coding System (Angus et al., 1996) are used to examine the processes at play when burden-metaphors are used in the good and the poor therapy. Results indicate that, in the good outcome dyad, metaphors of ‘being burdened' were transformed into metaphors of ‘unloading the burden' over the course of the therapy, while there was no transformation evident in the poor-outcome dyad. The good outcome therapy ...

The Narrative Processes model is focused on the strategies and processes by which a client and therapist transform the events of everyday life into a meaningful story that both organizes and represents the client's sense of self and others in the world. Some investigators have elected to use clients' within session descriptions of relationship events or micronarratives as their unit of narrative analysis. In contrast, we are centrally interested in the development of the macronarrative framework in which the singular events described in a therapy relationship-micronarratives-come to be articulated, experienced, and linked together in such a way that the client's sense of his or her life story-in essence, the sense of self-may be transformed at the conclusion of the therapeutic relationship. The following paper details the Narrative Processes theory of therapy and the coding system that has been developed to identify and evaluate empirically key components of the model. Findings emerging from the analyses of successful psychotherapy dyads are described and the implications for future research and practice are discussed.

This article discusses the need for a systematic method that enables researchers to evaluate integrative therapy approaches using a range of therapy process measures. The Narrative System Process Coding (NPCS; Angus, Hardtke, & Levitt, 1996) is proposed as such a method, and is applied with the Experiencing Scale (Klein, Mathieu, Gendlin, & Keisler, 1970) and the Levels of Client Perceptual Processing (LCPP; Toukmanian, 1986) to three brief good outcome integrative therapy modalities to illustrate this need. The study found higher Experiencing Scale scores to be most strongly related to an experiential approach to therapy and to the NPCS internal narrative processes. Higher LCPP scores were most strongly related to the NPCS reflexive narrative process and to a perceptual-processing approach. The discussion initiates a discourse on the importance of explicating process measures' origins when comparing different therapy approaches in order to allow for the meaningful consolidation of process research findings.

The purpose of this qualitative study was to explore the experiences of three women breast-cancer survivors and the associated experiences of their partners. Individual in-depth interviews were conducted using a narrative approach, and the six accounts were analysed using the grounded theory method. The results describe the marked variation in the meaning of the experience among the participants, and the perceived change in each woman’s identity from prior to her cancer diagnosis to the time of the interview. The findings are presented in three sections: (1) Three Narrative Themes, the themes, Back to ‘Normal’, Rebirth and Turning Point, that represent the perceived change in each woman’s identity; (2) The Construction of Meaning, the shared characteristics that relate to meaning construction and identity; (3) Integration, the integration in each self-narrative of past and present self-understandings. The findings are compared with the existing literature, and the implications of different interpretations of self and change in the cancer experience are discussed. The limitations of the study are discussed with recommendations for future research.

While the individual contributions of narrative and emotion processes to psychotherapy outcome have been the focus of recent interest in psychotherapy research literature, the empirical analysis of narrative and emotion integration has rarely been addressed. The Narrative-Emotion Processes Coding System (NEPCS) was developed to provide researchers with a systematic method for identifying specific narrative and emotion process markers, for application to therapy session videos.The present study examined the relationship between NEPCS-derived problem markers (same old storytelling, empty storytelling, unstoried emotion, abstract storytelling) and change markers (competing plotlines storytelling, inchoate storytelling, unexpected outcome storytelling, and discovery storytelling), and treatment outcome (recovered versus unchanged at therapy termination) and stage of therapy (early, middle, late) in brief emotion-focused (EFT), client-centred (CCT), and cognitive (CT) therapies for depression.Hierarchical linear modelling analyses demonstrated a significant Outcome effect for inchoate storytelling (p = .037) and discovery storytelling (p = .002), a Stage × Outcome effect for abstract storytelling (p = .05), and a Stage × Outcome × Treatment effect for competing plotlines storytelling (p = .001). There was also a significant Stage × Outcome effect for NEPCS problem markers (p = .007) and change markers (p = .03).The results provide preliminary support for the importance of assessing the contribution of narrative-emotion processes to efficacious treatment outcomes in EFT, CCT, and CT treatments of depression.

According to the narrative approach, change in self-narratives is an important part of successful psychotherapy. In this view, several authors have highlighted the usefulness of narrating new experiences (like actions, thoughts, and stories) during therapy in contrast with maladaptive client self-narratives. These new experiences are termed here innovative moments (IMs), and different types can be specified: action, reflection, protest, reconceptualization, and performing change. With the aim of understanding which therapist skills are related to client IMs, we analyzed the association between exploration, insight, and action skills and IMs in two initial, two middle, and two final sessions of three good outcome (GO) and three poor outcome (PO) cases of emotion-focused therapy (EFT) for depression. IMs occurred more often in GO than PO cases. Furthermore, in GO more than PO cases, exploration and insight skills more often preceded action, reflection, and protest IMs in the initial and middle phases of EFT, but more often preceded reconceptualization and performing change IMs in the final phase. Action skills were more often associated with action, reflection, and protest IMs across all phases, especially in the final phase, of GO EFT.

Previous studies have used the Innovative Moments Coding System (IMCS) to describe the process of change in Narrative Therapy (NT) and in Emotion-Focused Therapy (EFT). This study aims to extend this research program to a sample of Client-Centered Therapy (CCT). The IMCS was applied to six cases of CCT for depression to track the Innovative Moments (IMs) which are exceptions to the problematic self-narrative in therapeutic conversation. Results suggest that IMCS can be applied to CCT, allowing the tracking of IMs' emergence. The analysis based on a generalized linear model revealed that the overall amount of IMs is significantly associated with symptom improvement, which is congruent with former studies done with the IMCS.

The concept of narrative, its various definitions and its role in the process of meaning construction in psychotherapy is reviewed. Despite the current theoretical interest in this area, we lack a shared understanding of what the term narrative refers to in the context of the therapy session. To address this problem, the term narrative processes is coined to incorporate the conceptual and experiential strategies which lead to the construction and reconstruction of stories. The Narrative Processes Coding System (NPCS), a systematic method of unitizing therapy text is described. The NPCS is a two step process which enables raters to a) reliably subdivide therapy session transcripts into topic segments according to thematic content shifts, and b) further subdivide and characterize these topic segments in terms of three narrative process codes i) external description of events (actual or imagined), ii) subjective/experiential description, and iii) reflexive analysis of current, past and/or future events. The findings from a pilot study using the NPCS are reported and implications and future applications of the NPCS as a generic method for unitizing and characterizing therapy text are discussed.Representing a wide range of specialty areas within psychology clinicians and researchers alike have increasingly drawn on the concept of narrative to conceptualize the processes entailed in generating explanations of everyday events and organizing these experiences into a coherent self - identity or life - story (Bruner, 1990; Howard, 1991; Mitchell,1980; Polkinghorne, 1988; Russell & Van den Broek, 1992; Sarbin, 1986). While a wide ranging theoretical debate is taking place about the roles that narrative plays in the process of meaning construction in psychotherapy (Howard, 1991; Polkinghorne, 1988; Russell, Van den Broek et al., 1991; Schafer, 1980; Spence, 1982; White & Epston, 1990), only a few empirical studies (Angus, Hardtke & Levitt, 1992; Nye, 1990) have attempted to address these concerns within the context of the psychotherapy discourse itself. A major stumbling block for psychotherapy researchers has been the absence of a shared understanding of what the term narrative means in the context of the dialogical interchange of the therapy session.The aim of this paper is twofold. First, it will be argued that along with the stories told to therapists by clients, the conceptual and experiential strategies which lead to the construction and reconstruction of stories about self and others should be included in a comprehensive definition of narrative in psychotherapy. Second, we describe the rationale for and development of the Narrative Processes Coding System (Angus, Hardtke, & Levitt, 1992) - a rating system which allows researchers to segment sessions according to narrative type, irrespective of therapeutic modality. Process research applications for the Narrative Processes Coding System (NPCS) will be discussed and preliminary results from a pilot project using the coding method reported.Definitions of Narrative in PsychotherapyBased on a critical review of the relevant clinical research literature, it appears that there are three primary ways in which narrative has been conceptualized as being central to the psychotherapeutic enterprise. Each perspective adopts a different unit of analysis as representative of narrative in psychotherapy. In order to clarify the meaning of narrative in psychotherapy, the following definition of terms will be adopted: a) the term "narratives" will refer to the individual stories clients tell therapists during therapy sessions, b) the thematic story - line which weaves together the many different stories or narratives into a cohesive, coherent whole, will be referred to as "the narrative" (Polkinghorne, 1988) and c) the term "narrative processes" will be used to describe the modes of inquiry or cognitive/affective processes which help clients to understand themselves and their relationships with others in a more comprehensive, differentiated manner. …

While Motivational Interviewing (MI) has demonstrated efficacy, little is known about the mechanisms through which MI achieves beneficial effects or how clients perceive the process of MI. The present study addressed this gap through a qualitative analysis of client accounts following four sessions of MI for generalized anxiety disorder. Clients identified increased motivation for treatment and change, experiencing the therapist as empathic and MI as a safe place to explore their feelings regarding change. MI was also described as deviant from client initial expectations. Overall, the emergent understanding of MI derived from clients’ post-treatment narratives was consistent with MI principles and processes.

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.

Clinically depressed individuals have consistently been shown to demonstrate a bias for overgeneral autobiographical memory (ABM) disclosure, a strategy used to protect against the access of intense, primary emotions that may accompany specific memories. The present study examined how ABM specificity in client narratives was related to expressed emotional arousal in brief emotion-focused and client-centred psychotherapy for depression. Emotion episodes identified in two early-, two middle-, and two late-therapy transcripts drawn from 34 clients from the York I Depression Study were rated for degree of ABM specificity and expressed emotional arousal. A hierarchical linear modelling analysis demonstrated that greater ABM specificity was associated with higher expressed emotional arousal for clients who were no longer depressed at therapy termination.

The aim of this study was to advance understanding of how clients construct their own process of change in effective therapy sessions. Toward this end, the authors applied a narrative methodological tool for the study of the change process in emotion-focused therapy (EFT), replicating a previous study done with narrative therapy (NT). The Innovative Moments Coding System (IMCS) was applied to three good-outcome and three poor-outcome cases in EFT for depression to track the innovative moments (IMs), or exceptions to the problematic self-narrative, in the therapeutic conversation. IMCS allows tracking of five types of IMs events: action, reflection, protest, reconceptualization, and performing change. The analysis revealed significant differences between the good-outcome and poor-outcome groups regarding reconceptualization and performing change IMs, replicating the findings from a previous study. Reconceptualization and performing change IMs seem to be vital in the change process., This article was supported by Portuguese Foundation for Science and Technology Research Grant PTDC/PSI/72846/2006 (Narrative Processes in Psychotherapy, 2007 2010) and PhD Grants SFRH/ BD/29804/2006 and SFRH/BD/46189/2008., info:eu-repo/semantics/publishedVersion

This article presents an intensive analysis of a good-outcome case of emotion-focused therapythe case of Lisausing the Innovative Moments Coding System (IMCS). IMCS, influenced by narrative therapy, conceptualizes narrative change as resulting from the elaboration and expansion of narrative exceptions or unique outcomes to a client's core problematic self-narrative. IMCS identifies and tracks the occurrence of five different types of narrative change: action, reflection, protest, reconceptualization, and performing change. This is the first attempt to use the IMCS with cases outside the narrative tradition. We discuss the results, emphasizing the commonalities and major differences between this case and other good-outcome cases., This article was supported by the Portuguese Foundation for Science and Technology (FCT), by Grant PTDC/PSI/72846/2006 (Narrative Processes in Psychotherapy, 2007–2010). We are grateful to Bill Stiles for convincing us to write this article., info:eu-repo/semantics/publishedVersion

Preface, by Lynne Angus & John McLeod PART ONE. THE 'NARRATIVE TURN': WHY STORIES MATTER IN PSYCHOTHERAPY 1. The Narrative Creation of Self, by Jerome Bruner 2. Folk Psychology & Narrative Practices, by Michael White 3. Narrative Therapy & Postmodernism, by Donald Polkinghorne PART TWO. WORKING WITH NARRATIVE IN PSYCHOTHERAPY 4. The CCRT Approach to Working with Patient Narratives in Psychodynamic Psychotherapy, by Howard Book 5. "What's the Story?" Working with Narrative in Experimental Psychotherapy, by Lynne Angus, Jennifer Lewin, Beverly Bowes-Bouffard, & Debra Rotondi-Trevisan 6. Nurturing Nature: Cognitive Narrative Strategies, by Oscar Goncalves, Margarida Henriques, & Paulo Machado 7. Working with Narrative in Psychotherapy: A Relational Constructivist Approach, by Luis Botella, Olga Herrero, Meritxell Pacheco, & Sergei Corbella 8. A Poststructuralist Approach to Narrative Work, by Gene Combs & Jill Freedman PART THREE. NARRATIVE IDENTITY & SELF-MULTIPLICITY: IMPLICATIONS FOR PSYCHOTHERAPY 9. Narrative Identity & Narrative Therapy, by Dan McAdams 10. The Innovation of Self-Narrative: A Dialogical Approach, by Hubert Hermans 11. Assimilation & Narrative: Stories as Meaning Bridges, by Katerine Osatuke, Meredith Glick, Michael Gray, D'Arcy Reynolds, Jr., Carol Humphreys, Lisa Salvi, & William Stiles 12. Minding Our Therapeutic Tales: Treatments in Perspectivism, by Robert Russell & Fred B. Bryant PART FOUR. NARRATIVE ASSESSMENT STRATEGIES IN PSYCHOTHERAPY 13. Self-defining Memories, Narrative Identity & Psychotherapy: A Conceptual Model, Empirical Investigation & Case Report, by Jefferson Singer & Pavel Blagov 14. The Narrative Assessment Interview: Assessing Self-change in Psychotherapy, by Karen Hardtke & Lynne Angus 15. Disorganized Narratives: The Psychological Condition & Its Treatment, by Giancarlo Dimaggio & Antonio Semerari 16. Story Dramaturgy & Personal Conflict: JAKOB - A Tool for Narrative Understanding & Psychotherapeutic Pratice, by Brigitte Boothe & Agnes von Wyl PART FIVE. EMERGING TRENDS & FUTURE DIRECTIONS 17. Narrative Activity: Clients' & Therapists' Intentions in the Process of Narration in Psychotherapy, by Heidi M. Levitt & David L. Rennie 18. "To Tell My Story": Configuring Interpersonal Relations with Narrative Processes, by Timothy Anderson 19. The Contributions of Emotion Processes to Narrative Change in Psychotherapy: A Dialectical Constructivist Approach, by Leslie Greenberg & Lynne Angus 20. Social Constuctionism, Narrative, & Psychotherapy, by John McLeod 21. Towards an Integrative Framework for Understanding the Role of Narrative in the Psychotherapy Process, by Lynne Angus & John McLeod