Shared or different pathways to change? Clients' experiences of change in cognitive behavioral therapy and emotion-focused therapy for depression.

Objective: Cognitive behavioral therapy (CBT) and Emotion-focused therapy (EFT) are empirically supported models for treating depression. Comparisons of the models regarding outcome exist, but no comparison of the clients' experiences of change. This study explored and compared experiences of change in CBT and EFT for major depression.

Method: We conducted a comparative thematic analysis of the experiences of 28 clients after 12-18 sessions of either CBT (n = 14) or EFT (n = 14).

Results: The analysis resulted in five themes reported across treatments: (1) Changing the understanding of my problems; (2) Finding a new way to relate to inner experiences; (3) Changing how I see myself; (4) Challenging problematic ways of being with others; (5) Bringing changes into everyday life. Across treatment modalities, the clients experienced the same types of changes. Compared to EFT clients, more CBT clients emphasized the importance of practicing new strategies when facing adversity in their change process. Reversely, more EFT clients emphasized getting in touch with, tolerating, and listening to their inner experiences.

Conclusion: Our findings suggest that clients undergoing CBT and EFT describe changes in the same domains but show differences in how they emphasize various pathways leading to their change.