What is it about?

Emotions such as joy, fear, anger and sadness are of fundamental importance for healthy human functioning. Problems dealing with such emotions are also at the core of mental disorders such as depression, PTSD and anxiety disorders. Therefore, significant efforts have been made in the field of psychotherapy during the last decades to design interventions that teach clients to deal effectively with their individual emotional problems. This meta-analysis summarizes the research that has been conducted on emotion-focused therapeutic interventions, how clients respond to these interventions, and their impacts on therapeutic improvement.

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Why is it important?

This is the first broad systematic review and meta-analysis on emotional change processes and mechanisms in psychotherapy. Changing how clients perceive emotional information appears to be a pan-theoretical change mechanism that relates to therapeutic improvement. This is done through repeated exposures to emotions that clients experience as difficult and troubling in a safe and validating environment, which improves their awareness and tolerance of these emotions. Interestingly, the effects on therapeutic improvement for improved emotional perception were stronger than what has been found for the working alliance, the most well-established change process in psychotherapy.


We all intuitively know that emotions are important for mental health. But there is a lot of confusion among both lay people and psychologists about what emotion exactly is and how to deal with emotions productively. This extends to clinical psychology, where numerous theories and perspectives on emotion exists and there is little communication between theoretical "camps". I was motivated to try to create some order in this messy state-of-affairs and I hope this meta-analysis will be useful to both clinical researchers and therapists who are interested in the role of emotion in therapeutic change.

Nils Martin Sønderland
Universitetet i Oslo

This is the most extensive review and meta-analysis of the impact of emotional processes and affective mechanisms of change on symptom improvement in the literature yet. It evaluates, systematizes and organizes findings in this complex field according to well-established criteria and identify which known components of therapeutic change the various examined emotion processes and mechanisms represent, thus delineating the state of the art in the area. Effects of the various emotional processes and mechanisms are generally robust and impressively large (outperforming most other meta-analytically examined predictors in the literature), demonstrating beyond any previous doubt the importance and impact of working with emotions in psychotherapy. I believe this to be my most important work to date.

Professor Ole André Solbakken
University of Oslo, Norway

Read the Original

This page is a summary of: Emotional changes and outcomes in psychotherapy: A systematic review and meta-analysis., Journal of Consulting and Clinical Psychology, May 2023, American Psychological Association (APA), DOI: 10.1037/ccp0000814.
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