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Does CBT Facilitate Emotional Processing?

Published online by Cambridge University Press:  11 March 2011

Roger Baker ,
Matthew Owens ,
Sarah Thomas ,
Anna Whittlesea ,
Gareth Abbey ,
Phil Gower ,
Lara Tosunlar ,
Eimear Corrigan  and
Peter W. Thomas
Roger Baker*
Affiliation:
Dorset Research and Development Support Unit, Bournemouth University, UK
Matthew Owens
Affiliation:
St Ann's Hospital, Dorset Healthcare University NHS Foundation Trust, Poole, UK
Sarah Thomas
Affiliation:
Dorset Research and Development Support Unit, Bournemouth University, UK
Anna Whittlesea
Affiliation:
St Ann's Hospital, Dorset Healthcare University NHS Foundation Trust, Poole, UK
Gareth Abbey
Affiliation:
St Ann's Hospital, Dorset Healthcare University NHS Foundation Trust, Poole, UK
Phil Gower
Affiliation:
St Ann's Hospital, Dorset Healthcare University NHS Foundation Trust, Poole, UK
Lara Tosunlar
Affiliation:
St Ann's Hospital, Dorset Healthcare University NHS Foundation Trust, Poole, UK
Eimear Corrigan
Affiliation:
St Ann's Hospital, Dorset Healthcare University NHS Foundation Trust, Poole, UK
Peter W. Thomas
Affiliation:
Dorset Research and Development Support Unit, Bournemouth University, UK
*
Reprint requests to Roger Baker, Consultant Clinical Psychologist, Research and Development Support Unit, Royal London House, Bournemouth University, Christchurch Road, Bournemouth BH1 3LT, UK E-mail: [email protected]
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Abstract

Background: Cognitive Behavioural Therapy (CBT) is not primarily conceptualized as operating via affective processes. However, there is growing recognition that emotional processing plays an important role during the course of therapy. Aims: The Emotional Processing Scale was developed as a clinical and research tool to measure emotional processing deficits and the process of emotional change during therapy. Method: Fifty-five patients receiving CBT were given measures of emotional functioning (Toronto Alexithymia Scale [TAS-20]; Emotional Processing Scale [EPS-38]) and psychological symptoms (Brief Symptom Inventory [BSI]) pre- and post-therapy. In addition, the EPS-38 was administered to a sample of 173 healthy individuals. Results: Initially, the patient group exhibited elevated emotional processing scores compared to the healthy group, but after therapy, these scores decreased and approached those of the healthy group. Conclusions: This suggests that therapy ostensibly designed to reduce psychiatric symptoms via cognitive processes may also facilitate emotional processing. The Emotional Processing Scale demonstrated sensitivity to changes in alexithymia and psychiatric symptom severity, and may provide a valid and reliable means of assessing change during therapy.

Keywords

Emotional processingcognitive behavioural therapy (CBT)emotiondepressionanxietyscale
Type
Research Article
Information
Behavioural and Cognitive Psychotherapy , Volume 40 , Issue 1 , January 2012 , pp. 19 - 37
Copyright
Copyright © British Association for Behavioural and Cognitive Psychotherapies 2011

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References

Anderson, T., Bein, E., Pinnell, B. J. and Strupp, H. H. (1999). Linguistic analysis of affective speech in psychotherapy: a case grammar approach. Psychotherapy Research, 9, 88–99.CrossRefGoogle Scholar
Bagby, R. M., Parker, J. D. A. and Taylor, G. J. (1994). The Twenty-Item Toronto Alexithymia Scale-I: item selection and cross-validation of the factor structure. Journal of Psychosomatic Research, 38, 23–32.CrossRefGoogle ScholarPubMed
Bagby, R. M., Taylor, G. J. and Parker, J. D. A. (1994). The Twenty-Item Toronto Alexithymia Scale-II: convergent, discriminant, and concurrent validity. Journal of Psychosomatic Research, 38, 33–40.CrossRefGoogle ScholarPubMed
Baker, R. (2001). An emotional processing model for counselling and psychotherapy: a way forward? Counselling in Practice, 7, 8–11.Google Scholar
Baker, R. (2007). Emotional Processing: healing through feeling. Oxford: Lion Hudson.Google Scholar
Baker, R. (2010). Understanding Trauma: how to overcome post-traumatic stress. Oxford: Lion Hudson.Google Scholar
Baker, R., Allen, H., Gibson, S., Newth, J. and Baker, E. (1998). Evaluation of primary care counselling service in Dorset. British Journal of General Practice, 48, 1049–1053.Google ScholarPubMed
Baker, R., Baker, E., Allen, H., Thomas, P., Newth, J., Hollingbery, T., et al. (2002). A naturalistic longitudinal evaluation of counselling in Primary Care. Counselling Psychology Quarterly, 15, 359–373.CrossRefGoogle Scholar
Baker, R., Holloway, J., Thomas, P. W., Thomas, S. and Owens, M. (2004). Emotional processing and panic. Behaviour Research and Therapy, 42, 1271–1287.CrossRefGoogle ScholarPubMed
Baker, R., Owens, M., Tosunlar, L., Thomas, P. W. and Thomas, S. (2004). Emotional Processing. Website: www.emotionalprocessing.org.uk, date accessed: October 2007.Google Scholar
Baker, R., Thomas, S., Thomas, P. W. and Owens, M. (2007). Development of an emotional processing scale. Journal of Psychosomatic Research, 62, 167–178.CrossRefGoogle ScholarPubMed
Berthoz, S., Consoli, S., Perez, D. F. and Jouvent, R. (1999). Alexithymia and anxiety: compounded relationships? A psychometric study. European Psychiatry, 14, 372–378.CrossRefGoogle ScholarPubMed
Campbell-Sills, L. and Barlow, D. H. (2007). Incorporating emotion regulation into conceptualizations and treatments of anxiety and mood disorders. In Gross, J. J. (Eds.), Handbook of Emotion Regulation. New York: The Guilford Press.Google Scholar
Castonguay, L. G., Goldfried, M. R., Wiser, S., Raue, P. J. and Hayes, A. M. (1996). Predicting the effect of cognitive therapy for depression: a study of unique and common factors. Journal of Consulting and Clinical Psychology, 64, 497–504.CrossRefGoogle ScholarPubMed
Coombs, M. M., Coleman, D. and Jones, E. E. (2002). Working with feelings: the importance of emotion in both cognitive-behavioural and interpersonal therapy in the NIMH Treatment of Depression Collaborative Research Program. Psychotherapy: Theory, Research, Practice, Training, 39, 233–244.CrossRefGoogle Scholar
Crane, R. (2008). Mindfulness-Based Cognitive Therapy (CBT Distinctive Features). London: Routledge.CrossRefGoogle Scholar
Derogatis, L. R. and Cleary, P. A. (1977). Confirmation of the dimensional structure of the SCL-90: a study in construct validation. Journal of Clinical Psychology, 33, 981–989.3.0.CO;2-0>CrossRefGoogle Scholar
Derogatis, L. R. and Melisaratos, N. (1983). The Brief Symptom Inventory: an introductory report. Psychological Medicine, 13, 595–605.CrossRefGoogle ScholarPubMed
Feeny, N. C., Zoellner, L. A. and Foa, E. B. (2002). Treatment outcome for chronic PTSD among female assault victims with borderline personality characteristics: a preliminary examination. Journal of Personality Disorders, 16, 30–40.CrossRefGoogle ScholarPubMed
Foa, E. B. (2006). Psychosocial therapy for posttraumatic stress disorder. Journal of Clinical Psychiatry, 67, 40–45.Google ScholarPubMed
Foa, E. B., Hembree, E. A. and Rothbaum, B. O. (2007). Prolonged Exposure Therapy for PTSD. New York: Oxford University Press.Google Scholar
Foa, E. B. and Kozak, M. J. (1986). Emotional processing of fear: exposure to corrective information. Psychological Bulletin, 99, 20–35.CrossRefGoogle ScholarPubMed
Gendlin, E. T. (1978). Focusing. New York: Everest House.Google Scholar
Gendlin, E. T. (1996). Focusing-Oriented Psychotherapy: a manual of the experiential method. New York: The Guilford Press.Google Scholar
Gilboa-Schechtmann, E., Avnon, L., Zubery, E. and Jeczmien, P. (2006). Emotional processing in eating disorders: specific impairment or general distress related deficiency? Depression and Anxiety, 23, 331–339.CrossRefGoogle Scholar
Goldfried, M. R. (2003). Cognitive-behaviour therapy: reflections on the evolution of a therapeutic orientation. Cognitive Therapy and Research, 27, 53–69.CrossRefGoogle Scholar
Greenberg, L. (2008). Emotion and cognition in psychotherapy: the transforming power of affect. Canadian Psychology, 49, 49–59.CrossRefGoogle Scholar
Greenberg, L. S., Rice, L. N. and Elliott, R. (1993). Facilitating Emotional Change: the moment-by-moment process. New York: The Guilford Press.Google Scholar
Greenberg, L. S. and Safran, J. D. (1987). Emotion in Psychotherapy. London: The Guilford Press.Google Scholar
Gross, J. J. (1998). The emerging field of emotion regulation: an integrative review. Review of General Psychology, 2, 271–291.CrossRefGoogle Scholar
Gross, J. J. and Muñoz, R. F. (1995). Emotion regulation and mental health. Clinical Psychology: Science and Practice, 2, 151–164.Google Scholar
Hayes, S. C. (2004). Acceptance and commitment therapy and the new behaviour therapies: mindfulness, acceptance, and relationship. In Hayes, S. C., Follette, V. M. and Linehan, M. M. (Eds.), Mindfulness and Acceptance: expanding the cognitive-behavioural tradition. New York: The Guilford Press.Google Scholar
Hendryx, M. S., Haviland, M. G. and Shaw, D. G. (1991). Dimensions of alexithymia and their relationships to anxiety and depression. Journal of Personality Assessment, 56, 227–237.CrossRefGoogle ScholarPubMed
Hunt, M. G. (1998). The only way out is through: emotional processing and recovery after a depressing life event. Behaviour Research and Therapy, 36, 361–384.CrossRefGoogle ScholarPubMed
Jones, E. E. and Pulos, S. M. (1993). Comparing the process in psychodynamic and cognitive-behavioural therapies. Journal of Consulting and Clinical Psychology, 61, 306–316.CrossRefGoogle Scholar
Lane, R. D., Quinlan, D. M., Schwartz, G. E., Walker, P. A. and Zeitlin, S. B. (1990). The levels of emotional awareness scale: a cognitive-developmental measure of emotion. Journal of Personality Assessment, 55, 124–134.CrossRefGoogle Scholar
Luminet, O., Bagby, R. M. and Taylor, G. J. (2001). An evaluation of the absolute and relative stability of alexithymia in patients with major depression. Psychotherapy and Psychosomatics, 70, 254–260.CrossRefGoogle ScholarPubMed
Lundh, L. G., Johnsson, A., Sundqvist, K. and Olsson, H. (2002). Alexithymia, memory of emotion, emotional awareness and perfectionism. Emotion, 2, 361–379.CrossRefGoogle ScholarPubMed
Mackay, H. C., Barkham, M., Stiles, W. B. and Goldfried, M. R. (2002). Patterns of client emotion in helpful sessions of cognitive-behavioral and psychodynamic-interpersonal therapy. Journal of Counselling Psychology, 49, 376–380.CrossRefGoogle Scholar
Marchesi, C., Brusamonti, E. and Maggini, C. (2000). Are alexithymia, depression, and anxiety distinct constructs in affective disorders? Journal of Psychosomatic Research, 49, 43–49.CrossRefGoogle ScholarPubMed
Mennin, D. S., Heimberg, R. G., Turk, C. L. and Fresco, D. M. (2002). Applying an emotion regulation framework to integrative approaches to generalized anxiety disorder. Clinical Psychology: Science and Practice, 9, 85–90.Google Scholar
Mischel, W. (2004). Toward an integrative model for CBT: encompassing behaviour, cognition, affect, and process. Behavior Therapy, 35, 185–203.CrossRefGoogle Scholar
Morrow, J. and Nolen-Hoeksema, S. (1990). Effects of responses to depression on the remediation of depressive affect. Journal of Personality and Social Psychology, 58, 519–527.CrossRefGoogle ScholarPubMed
Nolen-Hoeksema, S. (1991). Responses to depression and their effects on the duration of depressive episodes. Journal of Abnormal Psychology, 100, 569–582.CrossRefGoogle ScholarPubMed
Nolen-Hoeksema, S. and Morrow, J. (1993). Effects of rumination and distraction on naturally occurring depressed mood. Cognition and Emotion, 7, 561–570.CrossRefGoogle Scholar
Orlinsky, D. E. and Howard, K. I. (1986). The relation of process to outcome in psychotherapy. In Garfield, S. L. and Bergin, A. E. (Eds.), Handbook of Psychotherapy and Behaviour Change (3rd ed.). New York: Wiley.Google Scholar
Parker, J. D. A., Taylor, G. J. and Bagby, R. M. (2003). The 20-item Toronto Alexithymia Scale III: reliability and factorial validity in a community population. Journal of Psychosomatic Research, 55, 269–275.CrossRefGoogle Scholar
Pos, A. E., Greenberg, L. S., Goldman, R. and Korman, L. (2003). Emotional processing during experiential treatment of depression. Journal of Consulting and Clinical Psychology, 71, 1007–1016.CrossRefGoogle ScholarPubMed
Rachman, S. (1980). Emotional processing. Behaviour Research and Therapy, 18, 51–60.CrossRefGoogle ScholarPubMed
Rachman, S. (2001). Emotional processing, with special reference to post-traumatic stress disorder. International Review of Psychiatry, 13, 164–171.CrossRefGoogle Scholar
Rauch, S. and Foa, E. B. (2006). Emotional processing theory (EPT) and exposure therapy for PTSD. Journal of Contemporary Psychotherapy, 36, 61–65.CrossRefGoogle Scholar
Rudkin, A., Llewelyn, S., Hardy, G., Stiles, W. B. and Barkham, M. (2007). Therapist and client processes affecting assimilation and outcome in brief psychotherapy. Psychotherapy Research, 17, 613–621.CrossRefGoogle Scholar
Rude, S. S. and McCarthy, C. T. (2003). Emotional functioning in depressed and depression-vulnerable college students. Cognition and Emotion, 17, 799–806.CrossRefGoogle Scholar
Samoilov, A. and Goldfried, M. R. (2000). Role of emotion in cognitive behaviour therapy. Clinical Psychology: Science and Practice, 7, 373–385.Google Scholar
Sayar, K., Kose, S., Grabe, H. J. and Topbas, M. (2005). Alexithymia and dissociative tendencies in an adolescent sample from Eastern Turkey. Psychiatry and Clinical Neurosciences, 59, 127–134.CrossRefGoogle Scholar
Santonastaso, M., Gremigni, , Baker, P., Thomas, R., Thomas, P., , S. (2008). EPS: cross cultural validation between Italy and England. In VIII National Congress of Health Psychology: Health and Shared Social Responsibility [Conference]. Rovigo, Italy.Google Scholar
Strongman, K. T. (1993). Emotion theory and cognitive-behaviour therapy. Behaviour Change (Special Issue: the relevance of basic research to cognitive-behaviour therapy), 10, 141–153.CrossRefGoogle Scholar
Tallis, F. (1999). Unintended thoughts and images. In Dalgleish, T. and Power, M. (Eds.), Handbook of Cognition and Emotion (chap. 15). West Sussex, England: John Wiley and Sons.Google Scholar
Taylor, G. J., Bagby, R. R. and Parker, J. D. A. (1997). Disorders of Affect Regulation: alexithymia in medical and psychiatric illness. Cambridge: Cambridge University Press.CrossRefGoogle Scholar
Veale, D. (2008). Behavioural activation for depression. Advances in Psychiatric Treatment, 14, 29–36.CrossRefGoogle Scholar
Watson, J. C. and Bedard, D. L. (2006). Clients' emotional processing in psychotherapy: a comparison between cognitive-behavioural and process-experiential therapies. Journal of Consulting and Clinical Psychology 74, 152–159.CrossRefGoogle Scholar
Watson, M. and Greer, S. (1983). Development of a questionnaire measure of emotional control. Journal of Psychosomatic Research, 27, 299–305.CrossRefGoogle ScholarPubMed
Wegner, D. M. and Erber, R. (1992). The hyperaccessibility of suppressed thoughts. Journal of Personality and Social Psychology, 63, 1–10.CrossRefGoogle Scholar
Whelton, J. W. (2004). Emotional processes in psychotherapy: evidence across therapeutic modalities. Clinical Psychology and Psychotherapy, 11, 58–71.CrossRefGoogle Scholar
Wilkins, C., Baker, R., Bick, D. and Thomas, P. (2009). Emotional processing in childbirth: a predictor of postnatal depression? British Journal of Midwifery, 17, 154–159.CrossRefGoogle Scholar
Wiser, S. and Goldfried, , , M. R. (1993). Comparative study of emotional experiencing in psychodynamic-interpersonal and cognitive-behavioural therapies. Journal of Consulting and Clinical Psychology, 61, 892–895.CrossRefGoogle Scholar
Wiser, S. and Goldfried, , , M. R. (1998). Therapist interventions and client emotional experiencing in expert psychodynamic-interpersonal and cognitive-behavioural therapies. Journal of Consulting and Clinical Psychology, 66, 634–640.CrossRefGoogle Scholar
Zonnevylle-Bender, M. J. S., Van Goozen, S. H. M., Cohen-Kettenis, P. T., Van Elburg, A., De Wildt, M., Stevelmans, E. and Van England, H. (2004). Emotional functioning in anorexia nervosa patients: adolescents compared to adults. Depression and Anxiety, 19, 35–42.CrossRefGoogle ScholarPubMed
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