Imaginal Confrontation for Resolving Child Abuse Issues

Abstract

This process-outcome study is a follow-up to an outcome study evaluating emotion-focused therapy for adult survivors of childhood abuse. The contributions of the therapeutic alliance, initial engagement in the primary imaginal confrontation intervention (IC), overall dosage of IC (Quality Ú Frequency), and client predisposing variables were examined. The Levels of Engagement Scale (LES) was developed to measure the quality of client engagement in IC. LES ratings were stable across therapy, but early engagement was only marginally related to subsequent dosage of IC. A strong alliance predicted improvements in self-esteem and resolution of abuse issues; early engagement in IC predicted abuse resolution; dosage additionally contributed to reduced global and trauma-specific symptomatology and interpersonal problems. Finally, severity of childhood trauma and current trauma symptoms were unrelated to therapy processes but were linked with poorer outcome on some dimensions.

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