Therapist interventions and emotional processing in attachment-based family therapy for unresolved anger

A growing body of research suggests that emotional processing is a central and common change mechanism across various types of therapies (Diener & Hilsenroth, 2009; Foa, Huppert, & Cahill, 2006; Greenberg, 2010), including attachment-based family therapy (Diamond, Shahar, Sabo, & Tsvieli, 2016). The purpose of this study was to examine which therapist interventions facilitated productive emotional processing in a sample of 15 young adults receiving attachment-based family therapy (Diamond, Diamond, & Levy, 2014) for unresolved anger toward a parent, and which therapist interventions led to a discontinuation of productive emotional processing once it had begun. Therapist interventions and productive emotional processing were measured during the course of individual, alliance-building sessions with the young adult. Results indicate that young adults’ productive emotional processing occurred at a rate significantly greater than chance following therapists’ focus on vulnerable emotions, focus on attachment needs, and empty-chair interventions. In contrast, therapists’ focus on clients’ rejecting anger preceded the discontinuation of such processing at rates significantly greater than chance. Theoretical and clinical implications are discussed.