Academic journal article Journal of Mental Health Counseling

An Expressive-Cognitive Approach to the Resolution of Unfinished Business

Academic journal article Journal of Mental Health Counseling

An Expressive-Cognitive Approach to the Resolution of Unfinished Business

Article excerpt

An expressive-cognitive approach to the resolution of unfinished business is proposed as an eclectic adaptation of the experiential model for resolving unfinished business (Greenberg, Rice & Elliott, 1993). The rationale for using this adaptation is presented, based on limitations of current practice. This easily implemented approach may be used as a complementary or alternative choice to the empty-chair intervention, particularly for clients who have difficulty engaging in or benefiting from experiential counseling. The case of a depressed client who was successfully treated with a brief expressive-cognitive approach to the resolution of unfinished business is presented.

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Experiential psychotherapy is one approach to mental health counseling that has been receiving increased empirical investigation (Greenberg, Elliott, & Lietaer, 1994). Experiential counseling for depression (ECD) has received empirical and theoretical support (Beutler et al., 1991; Daldrup, Beutler, Engle, & Greenberg, 1988; Greenberg et al., 1994; Greenberg et al, 1993; Greenberg & Watson, 1998; Watson & Greenberg, 1996a; Watson & Stermac, 1999), while the Gestalt concept of unfinished business (UFB) has been linked to depressive symptoms. It has also been shown that the resolution of UFB contributes to the cure of depression (Daldrup et al., 1988; Greenberg et al., 1993; Greenberg & Watson, 1998; McMain, Goldman, & Greenberg, 1996).

As major contributors to this research, Greenberg and associates have developed theoretical models describing the process of resolving UFB (Greenberg et al., 1993; McMain et al., 1996); tested these models in outcome studies using manualized, experiential interventions (Greenberg & Watson, 1998; Paivio & Greenberg, 1995; Watson & Stermac, 1999), and verified them via task analytic strategies, distinguishing between successful and unsuccessful resolution cases (Greenberg & Foerster, 1996). In these studies, it was noted that not all clients are willing to engage in ECD and that not all clients benefit from experiential techniques (Greenberg & Watson, 1998). Thus, it is important to consider alternative or modified interventions designed to match client characteristics (for reviews see Beutler, Clarkin, & Bongar, 2000; Dance & Neufeld, 1988).

The purpose of this paper is to describe a modification of experiential counseling for the resolution of depression-related unfinished business. This modification could be used with clients unwilling or unable to benefit from the traditional experiential approach. The traditional experiential model is explained first, followed by an outline of its limitations. Next, the alternative approach, based on a cognitive-type adaptation of the experiential model, is proposed. Finally, a case illustration is presented to further clarify this approach.

THE EXPERIENTIAL MODEL

According to the experiential model, UFB emerges and can be identified in the session by the presence of the following markers: (a) a lingering, unresolved feeling such as hurt or resentment, often accompanied by a complaining quality, (b) this feeling is related to a significant other who has been developmentally significant, (c) this feeling is currently experienced, but not fully expressed, and (d) the experience is currently problematic for the client (Greenberg & Foerster, 1996). The appropriate technique for the resolution of UFB in experiential counseling is the empty chair dialogue (ECD). The change mechanism (resolution model) in ECD for UFB is that the client, after expressing blame, hurt, and unresolved feelings towards a significant other, engages in a dialogue with the imagined significant other (in ECD) by recalling past events and experiences and clarifies, differentiates, and actively expresses previously unexpressed feelings and unmet needs. This results in relief, an empowered state of self, a potentially new view of the significant other (either accepting/forgiving or holding the other accountable), and letting go of the unresolved feeling and the unmet need. …

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