| This study examined the patterns of narrative processing within self-related topic segments of cognitive-behavioural (CBT) and emotion-focused (EFT) therapies for depression. The Narrative Processes Coding System (NPCS: Angus & Hardtke, 1994) was applied to two early and two working phase sessions from a sample (N = 57) of depressed clients from two large scale psychotherapy research projects. The EFT sample was comprised of28 clients from the National Institute of Mental Health and the Ontario Mental Health Foundation studies at York University (NIMH; York I Depression Study: Greenberg & Watson, 1998, and OMHF; York II Depression Study: Goldman, Greenberg, & Angus, 2000). The CBT sample was comprised of29 clients from the National Institute of Mental Health Treatment of Depression Collaborative Research Program (NIMH TDCRP: Elkin et al., 1989). Using Jacobson and Truax's (1991) method for determining clinically significant change, clients were categorized according to the degree of change in pre- to post-treatment scores on the Beck Depression Inventory (BDI: Beck, 1972). This statistical method resulted in the two outcome groups used in this study: Recovered and Unchanged. Differences in narrative process patterns were assessed in relation to treatment group, phase of therapy, and treatment outcome. The additional influence of client in-session processing variables, as measured by the Experiencing Scale (EXP: Klein, Mathieu-Coughlan, & Kiesler, 1986) and the Levels of Client Perceptual Processing measure (LCPP: Toukmanian, 2004), was also examined with the rationale that they each provide a measure of the depth of engagement with the narrative material. Finally, treatment differences in therapists' initiation of each type of NPCS sequence subtype were also investigated. Hierarchical linear modeling (HLM) was used to examine the hypothesized relationships. Results demonstrated that sessions of EFT were characterized by a pattern of consecutive Internal and Reflexive narrative sequences, whereas sessions of CBT were characterized by a pattern of External and Reflexive sequences. Additionally, EFT therapists initiated a relatively higher proportion of Internal sequences, and CBT therapists initiated a higher proportion of External and Reflexive sequences. Findings are discussed in relation to methodological considerations and future directions for research. |
