The effect of therapists’ enactment interventions in promoting vulnerability sharing in emotion focused couple therapy

Figures & data

Table I. Frequencies of therapist preparatory intervention ratings.

Intervention	0 Not present	1 Slightly present	2 Clearly present
TPI #1: Setting a meaningful systemic context	28.5%	29.5%	41.9%
TPI #2: Promoting the revealing partner’s emotional engagement	29.5%	25.7%	44.7%
TPI #3: Promoting the listening partner’s emotional engagement	26.6%	28.5%	44.7%
TPI #4: Preparing the revealing partner for enactment	3.8%	26.6%	69.5%

Table II. Means and correlations of therapists’ preparatory interventions and expressed vulnerability.

	Expressed vulnerability	TPI #1	TPI #2	TPI #3	TPI #4
Expressed vulnerability	1.00 (.52)	r = .33**	r = .26*	r = −.03	r = .30*
TPI #1: Setting a meaningful systemic context		1.13 (0.83)	r = .67***	r = .01	r = .16
TPI #2: Promoting the revealing partner’s emotional engagement			1.15 (0.83)	r = .07	r = .19
TPI #3: Promoting the listening partner’s emotional engagement				1.18(0.83)	r = .09
TPI #4: Preparing the revealing partner for enactment					1.66 (0.5)

*p ≤ 0.05. **p ≤ 0.01. ***p ≤ 0.001.

Table III. Results of the multilevel model analysis.

	Estimates (SE)	95% CI	Stand. Est.^a	p
Intercept	0.439 (0.17)	0.098−0.780		.012
TPI #1: Setting a meaningful systemic context	0.222 (0.085)	0.052−0.391	.357	.011
TPI #2: Promoting the revealing partner’s emotional engagement	−0.063 (0.091)	−0.244−0.118	−.104	.490
TPI #3: Promoting the listening partner’s emotional engagement	−0.028 (0.057)	−0.141−0.086	−.044	.630
TPI #4: Preparing the revealing partner for enactment	0.260 (0.091)	0.078−0.442	.277	.006

Note: ^a Standardized effects were obtained by standardizing the outcome and the continuous predictors and rerunning the model (see Baldwin et al., 2014).

Table

TPIs	Therapist Interventions	Description	Examples
TPI- 1	Setting a meaningful systemic context	Therapist explores and links the vulnerable content to the revealing partner’s attachment or identity needs Or/ and to his or her cycle Therapist emphasizes what is first exposed in the vulnerable content.	“it is scary to need her so much and to feel alone without her”
			“it’s hard to feel bad inside, as if you’re not good enough, and you just have to distance yourself from her” “I feel small and voiceless in that place. I can’t stand it so I shout things at her. Is that how it is?”
TPI-2	Promoting revealing partner’s emotional engagement	Therapist deepens the emotional experience using empathy-based interventions, validation, conjectures, heightening, repetition, focusing on body experience, “I language”. Therapist differentiates and intensifies the vulnerable core experience, and it becomes present and crystalized in the room, implicitly or explicitly.	“Can you tell me about how scared you are”?
			“What is it like in your body? This heavy weight on your chest”? “This is painful. So so painful … ”
			“This younger child inside you feeling so unseen and small”.
			“Can you tell me about how scared you are”? “Can we slow this down”? “Can we stay here for a minute”?
			“This heaviness in my body … weight on my chest. This pain of feeling like nothing”
TPI-3	Promoting listening partner’s emotional engagement	Therapist checks that the listening partner is attentive, open, and curious Therapist invites receptivity in the listening partner and leans in with anticipatory questions.	“What would it be like for you to hear her tell you how much she needs you”
			“Can you listen with an open heart to what he will share with you now? This vulnerable new place he revealed?”

Table

TPI-4	Preparing the revealing partner for enactment	Therapist asks the partner to share focusing and organizing the vulnerable content that was exposed Therapist explains the purpose of the enactment and explicitly highlights the opportunity of taking a new move of sharing vulnerability. Therapist validates the risk in sharing vulnerability. If the fear is overwhelming, therapist slices it thinner, or encourages revealing the fear Therapist specifies the vulnerable aspect that was exposed and will now be shared	“Can you look into her eyes and tell her this” …
			“What would it be like for you to share with your wife how scared you are to be” …
			“Being able to share this new vulnerable place with each other is so meaningful. It enables you to connect with each other from a new place”
			“Can you tell him you want to share it with him but you don’t know how”.
			“Can you tell her how you want to be close to her and also how much it scares you.”

Baldwin, S. A., Imel, Z. E., Braithwaite, S. R., & Atkins, D. C. (2014). Analyzing multiple outcomes in clinical research using multivariate multilevel models. Journal of Consulting and Clinical Psychology, 82(5), 920–930. https://doi.org/10.1037/a0035628

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