Exploring the Discourse Attributes of Referential Process in Emotion Focused and Cognitive Behavioral Therapies for...

Area of Science:

• Psychology
• Psychotherapy Research
• Clinical Linguistics

Background:

• Referential Process (RP) is a framework for understanding how nonverbal experiences become verbalized in psychotherapy.
• Previous RP research focused on psychodynamic therapy and single-case studies.
• The current study extends RP research to Cognitive Behavioral Therapy (CBT) and Emotion Focused Therapy (EFT).

Purpose of the Study:

• To examine the Referential Process (RP) in CBT and EFT for depression.
• To investigate the relationship between therapist discourse, client-rated session quality, and therapeutic outcomes.
• To compare RP in different therapeutic modalities.

Main Methods:

• Analyzed 80 session transcripts from 40 depressed clients undergoing CBT or EFT using the Discourse Attributes Analysis Program (DAAP).
• Employed Generalized Estimating Equation (GEE) for data analysis.
• Assessed therapist language (affect, reflection, concreteness, clarity) and referential activity scores (WRADM, WRADHP).

Main Results:

• EFT transcripts showed more affect words; CBT transcripts showed more reflection words, aligning with theoretical orientations.
• Therapists of high-outcome clients used more concrete, imagistic, specific, and clear language.
• Higher therapist WRADM and WRADHP scores significantly predicted better client-rated sessions and outcomes.

Conclusions:

• Therapist's ability to articulate experiences clearly and use concrete language is linked to positive therapeutic outcomes.
• Therapist referential activity is a significant predictor of client-rated session quality.
• Client's own referential activity did not predict session ratings, suggesting therapist factors are more influential in this context.