Skip to main content

Emotion-Based Interventions for Clinicians

Abstract

The primary purpose of this article is to introduce emotion-based interventions to clinicians that may not be familiar with such techniques. The article explains how emotion-based interventions could help transform the effectiveness of psychotherapy beyond that of traditional interventions alone, which are associated with cognitive behavioral or psychodynamic psychotherapy. Research suggests that techniques of emotional awareness, emotional validation, self-compassion, understanding the origin of emotions, forgiveness, grief work, and memory reconsolidation could offer novel interventions to improve therapeutic outcomes. A clinical example of panic disorder is provided to demonstrate how emotional interventions would be distinguished for traditional cognitive and behavioral interventions. Clinicians are encouraged to integrate emotional interventions in conjunction with cognitive and behavioral techniques that they may already currently be familiar with to optimize their clinical practice.

This is a preview of subscription content, access via your institution.

References

  • Agnoli, S., Mancini, G., Andrei, F., & Trombini, E. (2019). The relationship between trait emotional intelligence, cognition, and emotional awareness: An interpretative model. Frontiers in Psychology, 10, 1711

    PubMed  PubMed Central  Article  Google Scholar 

  • Ahn, H. N., & Wampold, B. E. (2001). Where oh where are the specific ingredients? A meta -analysis of component studies in counseling and psychotherapy. Journal of Counseling Psychology, 48(3), 251

    Article  Google Scholar 

  • Baer, R. A., Lykins, E. L., & Peters, J. R. (2012). Mindfulness and self-compassion as predictors of psychological wellbeing in long-term meditators and matched nonmeditators. The Journal of Positive Psychology, 7(3), 230–238

    Article  Google Scholar 

  • Baldi, E., & Bucherelli, C. (2015). Brain sites involved in fear memory reconsolidation and extinction of rodents. Neuroscience & Biobehavioral Reviews, 53, 160–190

    Article  Google Scholar 

  • Bell, E. C., Marcus, D. K., & Goodlad, J. K. (2013). Are the parts as good as the whole? A meta-analysis of component treatment studies. Journal of Consulting and Clinical Psychology, 81(4), 722

    PubMed  Article  Google Scholar 

  • Benitez, C., Southward, M. W., Altenburger, E. M., Howard, K. P., & Cheavens, J. S. (2019). The within-person effects of validation and invalidation on in-session changes in affect. Personality Disorders: Theory Research and Treatment, 10(5), 406

    Article  Google Scholar 

  • Berkowitz, L., & Harmon-Jones, E. (2004). Toward an understanding of the determinants of anger. Emotion, 4(2), 107

    PubMed  Article  Google Scholar 

  • Camoirano, A. (2017). Mentalizing makes parenting work: A review about parental reflective functioning and clinical interventions to improve it. Frontiers in Psychology, 8, 14

    PubMed  PubMed Central  Article  Google Scholar 

  • Campbell-Sills, L., Barlow, D. H., Brown, T. A., & Hofmann, S. G. (2006). Effects of suppression and acceptance on emotional responses of individuals with anxiety and mood disorders. Behaviour Research and Therapy, 44(9), 1251–1263

    PubMed  Article  Google Scholar 

  • Carryer, J. R., & Greenberg, L. S. (2010). Optimal levels of emotional arousal in experiential therapy of depression. Journal of Consulting and Clinical Psychology, 78, 190–199

    PubMed  Article  Google Scholar 

  • Conrad, R., Wegener, I., Imbierowicz, K., Liedtke, R., & Geiser, F. (2009). Alexithymia, temperament and character as predictors of psychopathology in patients with major depression. Psychiatry Research, 165(1–2), 137–144

    PubMed  Article  Google Scholar 

  • Corrigan, F. M., Fisher, J. J., & Nutt, D. J. (2011). Autonomic dysregulation and the window of tolerance model of the effects of complex emotional trauma. Journal of Psychopharmacology, 25, 17–25

    CAS  PubMed  Article  Google Scholar 

  • Cromheeke, S., & Mueller, S. C. (2014). Probing emotional influences on cognitive control: an ALE meta-analysis of cognition emotion interactions. Brain Structure and Function, 219(3), 995–1008

    PubMed  Article  Google Scholar 

  • Cuijpers, P., van Straten, A., Bohlmeijer, E., Hollon, S. D., & Andersson, G. (2010). The effects of psychotherapy for adult depression are overestimated: a meta-analysis of study quality and effect size. Psychological Medicine, 40(2), 211–223

    CAS  PubMed  Article  Google Scholar 

  • Cunningham, W. A., Zelazo, P. D., Packer, D. J., & Van Bavel, J. J. (2007). The iterative reprocessing model: A multilevel framework for attitudes and evaluation. Social Cognition, 25(5), 736–760

    Article  Google Scholar 

  • Dimidjian, S., Arch, J. J., Schneider, R. L., Desormeau, P., Felder, J. N., & Segal, Z. V. (2016). Considering meta-analysis, meaning, and metaphor: A systematic review and critical examination of “third wave” cognitive and behavioral therapies. Behavior Therapy, 47(6), 886–905

    PubMed  Article  Google Scholar 

  • Elsey, J. W., Van Ast, V. A., & Kindt, M. (2018). Human memory reconsolidation: A guiding framework and critical review of the evidence. Psychological Bulletin, 144(8), 797

    PubMed  Article  Google Scholar 

  • Ferrari, M., Hunt, C., Harrysunker, A., Abbott, M. J., Beath, A. P., & Einstein, D. A. (2019). Self-compassion interventions and psychosocial outcomes: A meta-analysis of RCTs. Mindfulness, 10(8), 1455–1473

    Article  Google Scholar 

  • Frank, D. W., Costa, V. D., Averbeck, B. B., & Sabatinelli, D. (2019). Directional interconnectivity of the human amygdala, fusiform gyrus, and orbitofrontal cortex in emotional scene perception. Journal of Neurophysiology, 122(4), 1530–1537

    PubMed  PubMed Central  Article  Google Scholar 

  • Frewen, P. A., Dozois, D. J., Neufeld, R. W., & Lanius, R. A. (2008). Meta-analysis of alexithymia in posttraumatic stress disorder. Journal of Traumatic Stress: Official Publication of The International Society for Traumatic Stress Studies, 21(2), 243–246

    Article  Google Scholar 

  • Greenberg, L. (2006). Emotion-focused therapy: A synopsis. Journal of Contemporary Psychotherapy, 36(2), 87–93

    Article  Google Scholar 

  • Greenberg, L. S. (2008). The clinical application of emotion in psychotherapy. Handbook of emotions, 88–101. New York, NY: Guilford Press

  • Greenberg, L. S. (2010). Emotion-focused therapy: A clinical synthesis. Focus, 8(1), 32–42

    Article  Google Scholar 

  • Hayes, S. C., & Hofmann, S. G. (2017). The third wave of cognitive behavioral therapy and the rise of process based care. World Psychiatry, 16(3), 245

    PubMed  PubMed Central  Article  Google Scholar 

  • Herbert, B. M., Herbert, C., & Pollatos, O. (2011). On the relationship between interoceptive awareness and alexithymia: is interoceptive awareness related to emotional awareness? Journal of Personality, 79(5), 1149–1175

    PubMed  Article  Google Scholar 

  • Inwood, E., & Ferrari, M. (2018). Mechanisms of change in the relationship between self- compassion, emotion regulation, and mental health: A systematic review. Applied Psychology: Health and Well-Being, 10(2), 215–235

    Google Scholar 

  • Iwakabe, S., Edlin, J., Fosha, D., Gretton, H., Joseph, A. J., Nunnink, S. E. … Thoma, N. C. (2020). The effectiveness of accelerated experiential dynamic psychotherapy (AEDP) in private practice settings: A transdiagnostic study conducted within the context of a practice-research network. Psychotherapy, 57(4), 548

    PubMed  Article  Google Scholar 

  • Izard, C. E. (2010). The many meanings/aspects of emotion: Definitions, functions, activation, and regulation. Emotion Review, 2(4), 363–370

    Article  Google Scholar 

  • Jennissen, S., Huber, J., Ehrenthal, J. C., Schauenburg, H., & Dinger, U. (2018). Association between insight and outcome of psychotherapy: systematic review and meta- analysis. American Journal of Psychiatry, 175(10), 961–969

    PubMed  Article  Google Scholar 

  • John, Y. J., Bullock, D., Zikopoulos, B., & Barbas, H. (2013). Anatomy and computational modeling of networks underlying cognitive-emotional interaction. Frontiers in Human Neuroscience, 7, 101

    PubMed  PubMed Central  Google Scholar 

  • Katznelson, H. (2014). Reflective functioning: A review. Clinical Psychology Review, 34(2), 107–117

    PubMed  Article  Google Scholar 

  • Kiliç, A., Hudson, J., McCracken, L. M., Ruparelia, R., Fawson, S., & Hughes, L. D. (2021). A systematic review of the effectiveness of self-compassion-related interventions for individuals with chronic physical health conditions. Behavior Therapy, 52(3), 607–625

    PubMed  Article  Google Scholar 

  • Kolovos, S., Kleiboer, A., & Cuijpers, P. (2016). Effect of psychotherapy for depression on quality of life: meta-analysis. The British Journal of Psychiatry, 209(6), 460–468

    PubMed  Article  Google Scholar 

  • Krause, E. D., Mendelson, T., & Lynch, T. R. (2003). Childhood emotional invalidation and adult psychological distress: The mediating role of emotional inhibition. Child Abuse & Neglect, 27(2), 199–213

    Article  Google Scholar 

  • Lane, R. D., Ryan, L., Nadel, L., & Greenberg, L. (2015). Memory reconsolidation, emotional arousal, and the process of change in psychotherapy: New insights from brain science. Behavioral and Brain Sciences, 38

  • Lane, R. D., & Nadel, L. (Eds.). (2020). Neuroscience of enduring change: Implications for psychotherapy. USA: Oxford University Press

    Google Scholar 

  • Levenson, H., Angus, L., & Pool, E. (2020). Viewing psychodynamic/interpersonal theory and practice through the lens of memory reconsolidation. Neuroscience of Enduring Change (pp. 300–359). Oxford University Press

  • Lilliengren, P., Johansson, R., Lindqvist, K., Mechler, J., & Andersson, G. (2016). Efficacy of experiential dynamic therapy for psychiatric conditions: A meta-analysis of randomized controlled trials. Psychotherapy, 53(1), 90

    PubMed  Article  Google Scholar 

  • Longmore, R. J., & Worrell, M. (2007). Do we need to challenge thoughts in cognitive behavior therapy? Clinical Psychology Review, 27(2), 173–187

    PubMed  Article  Google Scholar 

  • MacBeth, A., & Gumley, A. (2012). Exploring compassion: A meta-analysis of the association between self-compassion and psychopathology. Clinical Psychology Review, 32(6), 545–552

    PubMed  Article  Google Scholar 

  • Markin, R. D., & Zilcha-Mano, S. (2018). Cultural processes in psychotherapy for perinatal loss: Breaking the cultural taboo against perinatal grief. Psychotherapy, 55(1), 20

    PubMed  Article  Google Scholar 

  • Monfils, M. H., Cowansage, K. K., Klann, E., & LeDoux, J. E. (2009). Extinction- reconsolidation boundaries: key to persistent attenuation of fear memories. Science, 324(5929), 951–955

    CAS  PubMed  PubMed Central  Article  Google Scholar 

  • Neff, K. D. (2003). The development and validation of a scale to measure self-compassion. Self and Identity, 2(3), 223–250

    Article  Google Scholar 

  • Neff, K. D., & Germer, C. K. (2013). A pilot study and randomized controlled trial of the mindful self-compassion program. Journal of Clinical Psychology, 69(1), 28–44

    PubMed  Article  Google Scholar 

  • Neff, K. D., Long, P., Knox, M. C., Davidson, O., Kuchar, A., Costigan, A. … Breines, J. G. (2018). The forest and the trees: Examining the association of self-compassion and its positive and negative components with psychological functioning. Self and Identity, 17(6), 627–645

    Article  Google Scholar 

  • Nielsen, L., & Kaszniak, A. W. (2006). Awareness of subtle emotional feelings: a comparison of long-term meditators and nonmeditators. Emotion, 6(3), 392

    PubMed  Article  Google Scholar 

  • Öst, L. G. (2014). The efficacy of acceptance and commitment therapy: an updated systematic review and meta-analysis. Behaviour Research and Therapy, 61, 105–121

    PubMed  Article  Google Scholar 

  • Pascual-Leone, A., & Greenberg, L. S. (2007). Emotional processing in experiential therapy: Why” the only way out is through.“. Journal of Consulting and Clinical Psychology, 75(6), 875

    PubMed  Article  Google Scholar 

  • Pessoa, L. (2013). The cognitive-emotional brain: From interactions to integration. Cambridge, MA: MIT press

    Book  Google Scholar 

  • Pessoa, L. (2019). Embracing integration and complexity: placing emotion within a science of brain and behaviour. Cognition and Emotion, 33(1), 55–60

    PubMed  Article  Google Scholar 

  • Renner, F., Cuijpers, P., & Huibers, M. J. H. (2014). The effect of psychotherapy for depression on improvements in social functioning: a meta-analysis. Psychological Medicine, 44(14), 2913–2926

    CAS  PubMed  Article  Google Scholar 

  • Schultheis, A. M., Mayes, L. C., & Rutherford, H. J. (2019). Associations between emotion regulation and parental reflective functioning. Journal of Child and Family Studies, 28(4), 1094–1104

    PubMed  PubMed Central  Article  Google Scholar 

  • Shenk, C. E., & Fruzzetti, A. E. (2011). The impact of validating and invalidating responses on emotional reactivity. Journal of Social and Clinical Psychology, 30(2), 163–183

    Article  Google Scholar 

  • Song, S., Zilverstand, A., Song, H., Uquillas, F. D. O., Wang, Y., Xie, C. … Zou, Z. (2017). The influence of emotional interference on cognitive control: A meta-analysis of neuroimaging studies using the emotional Stroop task. Scientific Reports, 7(1), 1–9

    Article  CAS  Google Scholar 

  • Stevens, F. L. (2019). Affect regulation and affect reconsolidation as organizing principles in psychotherapy. Journal of Psychotherapy Integration, 29(3), 277

    Article  Google Scholar 

  • Stevens, F. L. (2021). Affective Neuroscience in Psychotherapy: A Clinician’s Guide for Working with Emotions. London, UK: Routledge

    Book  Google Scholar 

  • Suzuki, A., Josselyn, S. A., Frankland, P. W., Masushige, S., Silva, A. J., & Kida, S. (2004). Memory reconsolidation and extinction have distinct temporal and biochemical signatures. Journal of Neuroscience, 24(20), 4787–4795

    CAS  PubMed  Article  Google Scholar 

  • Teper, R., & Inzlicht, M. (2013). Meditation, mindfulness and executive control: the importance of emotional acceptance and brain-based performance monitoring. Social Cognitive and Affective Neuroscience, 8(1), 85–92

    PubMed  Article  Google Scholar 

  • Twohig, M. P., & Levin, M. E. (2017). Acceptance and commitment therapy as a treatment for anxiety and depression: a review. Psychiatric Clinics, 40(4), 751–770

    PubMed  Google Scholar 

  • Van Dam, N. T., Sheppard, S. C., Forsyth, J. P., & Earleywine, M. (2011). Self-compassion is a better predictor than mindfulness of symptom severity and quality of life in mixed anxiety and depression. Journal of Anxiety Disorders, 25(1), 123–130

    PubMed  Article  Google Scholar 

  • Vervliet, B., Craske, M. G., & Hermans, D. (2013). Fear extinction and relapse: state of the art. Annual Review of Clinical Psychology, 9, 215–248

    PubMed  Article  Google Scholar 

  • Wager, T. D., Barrett, L. F., Bliss-Moreau, E., Lindquist, K., Duncan, S., Kober, H. … Mize, J. (2008). The neuroimaging of emotion. In M. Lewis, J. M. Haviland- Jones, & L. F. Barrett (Eds.), Handbook of Emotions (3rd ed., pp. 249–271). New York: Guilford Press

    Google Scholar 

  • Wampold, B. E. (2015). How important are the common factors in psychotherapy? An update. World Psychiatry, 14(3), 270–277

    PubMed  PubMed Central  Article  Google Scholar 

  • Welling, H. (2012). Transformative emotional sequence: Towards a common principle of change. Journal of Psychotherapy Integration, 22(2), 109

    Article  Google Scholar 

  • Werner, K., & Gross, J. J. (2010). Emotion regulation and psychopathology: A conceptual framework. In A. M. Kring, & D. M. Sloan (Eds.), Emotion regulation and psychopathology: A transdiagnostic approach to etiology and treatment (pp. 13–37). New York, NY: The Guilford Press

    Google Scholar 

  • Zessin, U., Dickhäuser, O., & Garbade, S. (2015). The relationship between self-compassion and well-being: A meta-analysis. Applied Psychology: Health and Well-Being, 7(3), 340–364

    Google Scholar 

Download references

Funding

The authors declare that no funds, grants, or other support were received during the preparation of this manuscript.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Francis L. Stevens.

Ethics declarations

Conflict of Interest

Authors have no financial or non-financial interests to disclose.

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Stevens, F.L. Emotion-Based Interventions for Clinicians. J Contemp Psychother (2022). https://doi.org/10.1007/s10879-022-09546-7

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • DOI: https://doi.org/10.1007/s10879-022-09546-7

Keywords

  • Emotion
  • Psychotherapy interventions
  • Memory reconsolidation
  • Emotional awareness
  • Emotional validation
  • Self-Compassion