ABSTRACT
Objective: The purpose of this study was to test whether changes in clients' affect regulation capacity (AR) mediated the impact of therapists' empathy on outcome and whether this relationship was stronger for more insecurely than securely attached clients. Method: The data set included 66 clients, who had participated in 16 weeks of either CBT or EFT for depression. Clients' AR was assessed using an observer and a self-report measure. Results: Changes in AR significantly mediated the relationship between therapists' empathy and outcome for depression, dysfunctional attitudes and self-esteem but not interpersonal problems, and changes in AR were moderated by clients' insecure attachment styles. Conclusions: The findings provide support for therapists' empathy as an active ingredient of change contributing to changes in clients' affect regulation capacities and emphasize the importance of assessing clients' attachment styles so that therapists can be more responsive and effectively tailor their treatments to fit the needs of individual clients.
Subject(s)
Depression/psychology , Depression/therapy , Emotional Regulation , Empathy , Object Attachment , Professional-Patient Relations , Psychotherapy , Adult , Aged , Female , Humans , Male , Middle Aged , Self Report , Treatment Outcome , Young AdultABSTRACT
Since Rogers identified empathy as an important variable in therapy, it has been found to be a consistent predictor of client change; less clear is how this occurs. The objective in this study was to test a mediation model to determine whether clients' self-reported experience of therapists' empathy contributed to changes in their attachment styles and treatment of self, after 16 weeks of psychotherapy for depression. There was a significant direct relationship between therapists' empathy and outcome and a significant indirect effect, showing that clients' perceptions of therapists' empathy was associated with significant improvement in attachment insecurity and significant decreases in negative self-treatment at the end of therapy as well as reductions on BDI, IIP, DAS and SCL-90-R, GSI, and increases on RSE. The findings suggest that clients' perception of their therapists as empathic is an important mechanism of change in psychotherapy that warrants further investigation.
Subject(s)
Empathy , Professional-Patient Relations , Psychotherapy/methods , Adult , Cognitive Behavioral Therapy/methods , Depressive Disorder, Major/psychology , Depressive Disorder, Major/therapy , Female , Humans , Male , Middle Aged , Object Attachment , Psychiatric Status Rating Scales , Psychological Tests , Surveys and Questionnaires , Treatment Outcome , Young AdultABSTRACT
The objectives were to examine the relationships among clients' affect regulation capacities, in-session emotional processing, outcome, and the working alliance in 66 clients who received either cognitive-behavioral therapy or process-experiential emotion-focused therapy for depression. Clients' initial level of affect regulation predicted their level of emotional processing during early and working phases of therapy. Clients' peak emotional processing in the working phase of therapy mediated the relationship between their initial level of affect regulation and their level of affect regulation at the end of therapy; and clients' level of affect regulation at the end of therapy mediated the relationship between their peak level of emotional processing in the working phase of therapy and outcome. Clients' affect regulation at the end of therapy predicted outcome independently of the working alliance. The findings suggest that clients' level of affect regulation early in therapy has a significant impact on the quality of their in-session processing and outcome in short-term therapy. Limitations of the study and future directions for research are discussed.
