Client's immersed and distanced speech and therapist's interventions in emotion-focused therapy for depression: an intensive analysis of a case study

Previous laboratory studies have explored the importance of participants adopting an immersed or distanced perspective in the analysis of their experiences. These studies concluded that distancing allows analyzing emotions in a healthier way and immersion leads to higher vulnerability. However, in psychotherapy, the relationship between these perspectives and clinical change has been less investigated. The present study aims to contribute to understanding how these variables evolve during psychotherapy and also to explore the therapist's contributions to this process. This study analyzes a good-outcome case of emotion-focused therapy for depression through two observational measures of psychotherapy process: the measure of immersed and distanced speech - which identifies client's adoption of an immersed or distanced stance when talking about their problems - and the helping skills system - which identifies therapist's interventions focused on exploration, insight or action. Results showed a decrease of immersed speech and an increase of distanced speech along the process, with a higher frequency of exploration skills preceding both types of client's speech. Finally, the evolution of therapist's and client's speech showed a reasonable flexibility of therapeutic dialogue throughout the sessions, in particular due to the evolution of client variables (evidencing a higher diversity of behaviors).