Emotional processing in psychotherapy: A comparison between cognitive-behavioral and process-experiential approaches in the treatment of depression

Numerous theories of psychotherapy have suggested that involving clients' emotional processes is central to creating psychotherapeutic change. The goal of this study was to compare the clients' emotional processing in cognitive-behavioral therapy (CBT) and process-experiential therapy (PET). The sample consisted of a total of 50 clients with major depression, 25 clients treated by each therapy modality. Emotional processing was operationalized as depth of experiencing during in-session emotion episodes. Experiencing was rated in an early and working-phase session of therapy to assess the degree to which felt internal experience is explored, owned and used as information in solving problems. As hypothesized, PET promoted higher levels of emotional experiencing than did CBT in both phases of therapy. As well, deeper emotional processing in the working-phase of treatment predicted outcome for both modalities when the individual differences on emotional processing was controlled. This provided further evidence for emotional processing as a common factor that contributes to outcome across therapies. The findings and future directions were discussed in the light of theoretical and practical differences between these two modalities toward integration.