Identifying and developing therapeutic principles for trauma focused work in person-centred and emotion focused therapies

Background: The aim of this research was to identify facilitative therapeutic principles in person-centred and emotion-focused therapy for working with traumatised clients in the early stages of therapy. Methods: Four cases were selected from the Strathclyde Experiential Therapy for Social Anxiety archive: one good and one poor outcome case from each therapeutic approach. Outcomes were considered good and poor based on quantitative outcome measures. Each case met DSM-IV-TR diagnostic criteria for both PTSD and social anxiety. We developed a new method for the identification of therapeutic principles that offers an alternative to current approaches to competency identification. Our method uses a qualitative, bottom-up inductive process analysis. The first three sessions from each case were transcribed and independently analysed by two researchers (one blinded to the outcomes); the third researcher acted as consultant. The transcripts were analysed by focusing on session episode structure and treatment principles. Findings: Four trauma-focused therapist principles were identified: (a) support early relationship building/alliance formation; (b) facilitate client identification and recognition of past events as trauma experiences; (c) facilitate work on traumatic sources of current experiential and interpersonal difficulties; and (d) offer self-agency focused empathy. Conclusions: We conclude that our approach identifies and provides a new method for establishing person-centred experiential therapy principles for early trauma-focused work. Further research is recommended, and limitations are discussed.