Exploring the Discourse Attributes of Referential Process in Emotion Focused and Cognitive Behavioural Therapies for Depression

The referential process (RP) refers to the way one’s nonverbal experiences are translated into verbal forms (Bucci, 1993; Bucci, Maskit, & Murphy, 2015). In the context of psychotherapy, three stages of the RP – activation of emotions, symbolization, and reflection – have been presented as a general framework for understanding change (Bucci, 2013). However, most of the studies on RP has been conducted in the context of psychodynamic treatment and in single case designs. Thus, the current study examined the discourse attributes of RP using session transcripts of 40 clients who underwent 16 sessions of cognitive behavioural therapy (CBT) or emotion focused therapy (EFT) for depression.The Discourse Attributes Analysis Program (DAAP; Maskit, Bucci, & Murphy, 2012), a computerized text analysis program that measures the discourse attributes RP, were applied to 80 session transcripts. Given that some therapists had worked with multiple clients and two sessions belonged to each client, Generalized Estimating Equation (GEE) was used to account for the nested structure of the data. The DAAP measures differed between EFT and CBT in the expected ways based on the theories of change that are rooted in each modality: there were more affect words in the EFT transcripts and more reflection words in the CBT transcripts. Overall, the two modalities did not differ in terms of the major measures of RP applied to clients’ and therapists’ speech. This substantiated Bucci (2013)’s theory that RP is an atheoretical framework for understanding change. The study unveiled novel information about specific in-session therapist processes that contribute to clients’ session ratings, as well as their overall treatment outcome. Therapists whose clients belonged to the good outcome group used more concrete, imagistic, specific, and clear language in the highest client rated sessions Additionally, the more that therapists used this style of language and spent more of the sessions doing so, the greater changes their clients perceived from their sessions. These findings imply that it is important for therapists to effectively connect to their experiences and communicate themselves clearly to their clients. Theoretical, clinical, and measurement implications, limitations, and directions for future research are discussed.

Department dc:contributor.department

Applied Psychology and Human Development

Year dc:date.issued

2023

Author dc:creator

• Hong, Jinny

Advisor dc:contributor.advisor

• Watson, Jeanne C

• Cognitive behavioural therapy
• Discourse attributes
• Emotion focused therapy
• Referential process

Handle dc:identifier.uri

http://hdl.handle.net/1807/129816

OAI identifier oai:identifier

oai:utoronto.scholaris.ca:1807/129816