The Effect of PTSD Symptom Severity in EFTT on In-Session Therapy Processes

The present study tested the hypothesis that heightened post-traumatic stress disorder (PTSD) symptom severity at pre-treatment would negatively affect therapy processes in emotion-focused therapy for complex trauma (EFTT). Archival data were utilized from an outcome study (Paivio, Jarry, Chagigioris, Hall, & Ralston, 2010). Clients (women n = 26, men n = 21) were adult childhood abuse survivors. The PTSD Symptom Severity Interview (Foa, Riggs, Dancu, & Rothbaum, 1993) measured pre-treatment PTSD symptom severity. Therapy process variables - measured in early, middle, and late sessions containing re-experiencing procedures - included experiencing, emotional arousal, engagement with trauma material, and distress which were respectively measured by the Patient Experiencing Scale (Klein, Mathieu-Coughlan, & Kiesler, 1989), Emotional Arousal Scale-Revised (Machado, Beutler, & Greenberg, 1999), client Post-Session Questionnaire (Paivio et al., 2010), and Subjective Units of Distress (Wolpe, 1969). Heightened pre-treatment PTSD symptom severity was associated with increased peak distress (supported hypothesis) and increased emotional arousal (contrary to expectations)