Responding to In-the-Moment Distress in Emotion-Focused Therapy

Emotion-focused therapy offers a setting in which clients report on their personal experiences, some of which involve intense moments of distress. This article examines video-recorded interactional sequences of client distress displays and therapist responses. Two main findings extend understanding of embodied actions clients display as both a collection of distress features and as interactional resources therapists draw upon to facilitate therapeutic intervention. First, clients drew from a number of vocal and nonvocal resources that tend to cluster on a continuum of lower or higher intensities of upset displays. Second, we identified three therapist response types that oriented explicitly to clients' in-the-moment distress: noticings, emotional immediacy questions, and modulating directives. The first two action types draw attention to or topicalize the client's emotional display; the third type, by contrast, had a regulatory function, either sustaining or abating the intensity of the upset. Data are in North American English.