Does emotional processing predict 18-month post-therapy outcomes in the experiential treatment of major depression?

Objective: This study tested whether emotion-focused therapy's (EFT) emotion processing theory serves as a predictor of 18-month post-therapy outcomes for major depressive disorder (MDD), independent of experiential therapy received. Method: We examined sequences of emotion episodes using the THEME™ sequential analysis of emotional processing in 55 clients who provided 18-month post-therapy Beck Depression Inventory reports after receiving experiential treatment in the York I and II trials, either emotion-focused or client-centered therapy. Archival Classification of Affective Meaning States (CAMS) ratings of emotion episodes of clients' working-phase sessions were analyzed using THEME™ sequential analyses of emotions coded during emotion episodes. Results: According to THEME™, poor outcome clients (Beck Depression Inventory at 18 months ≥ 10) expressed more emotion episode sequences containing secondary, or self-protective emotions, than good outcome clients. Good outcome clients expressed more emotion sequences with needs, hurt/grief, and assertive anger than poor outcome clients. Conclusions: EFT sequential emotional processing theory appears to offer good basic assumptions for experiential long-term therapy outcomes after receiving therapy for MDD. Generalization of the theory for other treatments is desired.