Emotion processing

The two articles I describe here relate to emotion processing. Their focus is quite different but equally important. First, Hubbard, Moore, Zajac, Bookhout & Dozier (2023) published “Emotion Transmission in Peer Dyads in Middle Childhood” in Child Development. Here’s the edited abstract:

This study investigated emotion transmission among peers during middle childhood. Participants included 202 children (111 males; race: 58% African American, 20% European American, 16% Mixed race, 1% Asian American, and 5% Other; ethnicity: 23% Latino(a) and 77% Not Latino(a); Mincome = $42,183, SDincome = $43,889; Mage = 9.49; English-speaking; from urban and suburban areas of a mid-Atlantic state in the United States). Groups of four same-sex children interacted in round-robin dyads in 5-min tasks during 2015–2017. Emotions (happy, sad, angry, anxious, and neutral) were coded and represented as percentages of 30-s intervals. Analyses assessed whether children's emotion expression in one interval predicted change in partners' emotion expression in the next interval. Findings suggested: (a) escalation of positive and negative emotion [children's positive (negative) emotion predicts an increase in partners' positive (negative) emotion], and (b) de-escalation of positive and negative emotion (children's neutral emotion predicts a decrease in partners' positive or negative emotion). Importantly, de-escalation involved children's display of neutral emotion and not oppositely valenced emotion.

I like this study because it makes intuitive sense. We know that emotion tends to be contagious. However, what I find most helpful is the last sentence. While escalation relates to matching emotions, de-escalation benefits from a neutral emotional stance, not doing the opposite. I think most parents learn this pretty quickly, but I find it fascinating that 9-10-year-old children know this. And, while I said the focus of the two articles is different, I think this study is relevant to training of mental health professionals. Yamin et al. (2023) published “Experiential Training of Mental Health Graduate Students in Emotional Processing Skills: A randomized, controlled trial” in Psychotherapy. Here’s the edited abstract and impact statement:

Emotional processing interventions for trauma and psychological conflicts are underutilized. Lack of adequate training in emotional processing techniques and therapists’ lack of confidence in utilizing such interventions are barriers to implementation. We developed and tested an experiential training to improve trainees’ performance in a set of transtheoretical emotional processing skills: eliciting patient disclosure of difficult experiences, responding to defenses against disclosure, and eliciting adaptive emotions. Mental health trainees (N = 102) were randomized to experiential or standard training, both of which presented a 1-hr individual session administered remotely. Before and after training and at 5-week follow-up, trainees were videorecorded as they responded to videos of challenging therapy situations, and responses were coded for demonstrated skill. Trainees also completed measures of therapeutic self-efficacy, anxiety, and depression at baseline and follow-up. Repeated-measures analysis of variance indicated all three skills increased from pre- to posttraining for both conditions, which were maintained at follow-up. Importantly, experiential training led to greater improvements than standard training in the skills of eliciting disclosure, responding to defenses, and encouraging adaptive emotions at posttraining, and the training benefits for eliciting disclosure were maintained at follow-up. Both conditions led to improved self-efficacy. Trainees’ anxiety decreased in the standard training, but not in the experiential. One session of experiential training improved trainees’ emotional processing therapy skills more than didactic training, although more training and practice likely are needed to yield longer lasting skills. 

An experiential approach, such as utilizing observation, repetitive practice, and personalized feedback during clinical skills training, leads to more improvement in trainees’ emotional processing skills compared to a lecture-based training. Experiential training should be consistently incorporated into training of mental health clinicians, especially for challenging therapeutic skills. Future research is needed on the maintenance of the training effects over time, and on the impact of experiential training on real-life therapy practice and patient outcomes. 

I think this is an important study for several reasons. First, if you’ve been reading the blog for a while, you know I have deep reservations about cognitive behavioral strategies because they too often neglect emotion processing. These strategies are easy to train, especially when compared with emotion processing strategies. Second, I am not at all surprised that experiential training works much better than didactic training – it always has. Third, the finding about anxiety is fascinating. The experiential training is better in terms of important therapeutic outcomes and equally beneficial in enhancing self-efficacy, but it doesn’t help with trainees’ anxiety. Dealing with emotion is hard work and will always be. I hope this team follows up with research on maintenance of skills over time and the pace and timing of experiential training that are most beneficial.