Narrative Processes in Emotion-Focused Therapy for Trauma

Because dropout rates and noncompliance with exposure-based procedures are notoriously high in trauma therapies, effective treatment options are crucial. Emotion-focused therapy for trauma (EFTT) is an evidence-based, short-term individual therapy that has proven highly effective in treating clients with trauma through its emphasis on both narrative and emotion processes.

A fundamental assumption underlying most trauma therapies, including EFTT, is that recovery requires the client to engage emotionally with trauma memories to achieve better affect regulation and self-understanding. EFTT draws from storytelling as a fundamental aspect of the human experience that permits this kind of engagement with trauma memories, promoting a sense of continuity and self-coherence, and bringing meaning to the client's emotional responses.

Richly illustrated with clinical examples and excerpts from therapy sessions, Narrative Processes in Emotion-Focused Therapy for Trauma integrates theory, research, practice, and training.

Acknowledgments

Introduction

I. Theory and Research

1. The Nature of Complex Trauma
2. The Unique Contributions of EFTT
3. Why Client Storytelling Matters
4. A Narrative-Informed Approach to EFTT

II. Practice

5. Assessing Narrative-Emotion Processes in EFTT
6. Principles of Intervention With Narrative-Emotion Processes
7. Cultivating the Alliance: Early-Phase EFTT
8. Two Intensive Case Analyses: Early-Phase EFTT
9. Promoting Self-Development: Middle-Phase EFTT
10. Two Intensive Case Analyses: Middle-Phase EFTT
11. Resolving Issues With Perpetrators and New Story Outcomes: Late-Phase EFTT
12. Two Intensive Case Analyses: Late-Phase EFTT

Afterword: Process-Diagnosis and Marker-Guided Intervention

Appendix: Abbreviated Degree of Resolution Scale

Glossary

References

Index

About the Authors

Sandra C. Paivio, PhD, CPsych, is currently a consultant at the York University Psychology Clinic, where she provides individual psychotherapy, graduate training, and supervision. She is professor emeritus in the psychology department at the University of Windsor, and has more than 20 years of clinical experience. She is one of the developers of emotion-focused therapy, particularly applied to complex trauma (EFTT), and has conducted clinical trials evaluating efficacy and processes of change in EFTT.

Dr. Paivio is the author of numerous publications on trauma and psychotherapy, including Working With Emotions in Psychotherapy (with Leslie S. Greenberg), Emotion-Focused Therapy for Complex Trauma: An Integrative Approach (with Antonio Pascual-Leone), and she is featured in two APA videos illustrating EFTT.

Dr. Paivio has presented numerous workshops nationally and internationally and provided intensive graduate student and professional training in EFT and EFT specifically for trauma. She also is an invited member of the APA Division 56 (Trauma Psychology) working group developing best practice guidelines for complex trauma and received a Lifetime Achievement Award from the Trauma Section of the Canadian Psychological Association (2014).

Dr. Paivio maintains a part-time private practice in Toronto, Ontario, Canada.

Lynne E. Angus, PhD, CPsych, is a professor of psychology at York University in Toronto, Ontario, Canada, and a clinical supervisor and therapist at the York University Psychology Clinic.

Dr. Angus practices, supervises, and conducts psychotherapy research addressing the contributions of narrative and emotion processes for clinically significant change, particularly in the context of emotion-focused therapy. Over the past 25 years, she has published more than 90 publications addressing the unique contributions of metaphor, narrative, emotion, and meaning-making processes to productive client change, and has conducted numerous training workshops addressing implications for effective therapy practice.

She coauthored Working With Narrative in Emotion-Focused Therapy: Changing Stories, Healing Lives (with Leslie S. Greenberg), and was featured in an APA therapy DVD with Sandra C. Paivio, Narrative Processes in Emotion-Focused Therapy for Trauma.

Dr. Angus was the senior coeditor of The Handbook of Narrative and Psychotherapy: Practice, Theory, and Research and was also coeditor of Bringing Psychotherapy Research to Life: Understanding Change Through the Work of Leading Clinical Researchers.

She is a past president of both the International Society for Psychotherapy Research and the North American Chapter, Society for Psychotherapy Research.

Definitely a must read.
—PsycCRITIQUES

This book is an excellent addition to the literature on the development of personal narrative in the treatment of all types of trauma through the use of emotion-focused experiential techniques. It provides therapists with direct guidance in using these techniques to identify and focus on the trauma narrative. In particular, the use of markers over the course of the treatment phases assists in understanding where the client is in the narrative process.
—Christine A. Courtois, PhD, ABPP
Licensed Psychologist, Independent Practice, Washington, DC (retired), editor of Spiritually Oriented Psychotherapy for Trauma and author of Treatment of Complex Trauma: A Sequenced, Relationship-Based Approach

A wonderful book that adds an understanding of narrative processes to emotional change processes. It offers explicit therapeutic strategies to enhance emotion transformation and meaning making and includes case studies. A must-read for clinicians and students who want to learn how to work in depth with complex trauma.
—Leslie S. Greenberg, PhD
Distinguished Research Professor Emeritus, Department of Psychology, York University, Toronto, Ontario, Canada

For neophyte therapists as well as seasoned clinicians wishing to improve their outcomes with complex trauma cases, this book provides a powerful, empirically derived, pragmatic, process-diagnostic map to improve case conceptualizations, guide key interventions, and facilitate trauma recovery. Paivio and Angus present an approach that is explicit and accessible, while maintaining depth and meaning. With intensive analyses of clinical cases and delineation of steps for the early, middle, and late stages of therapy, this is truly a remarkable book.
—Hanna Levenson, PhD
Professor, Wright Institute, Berkeley, CA