Internet-Delivered Affect-Focused Psychodynamic Therapy for Adolescent Depression: Treatment Principles and Clinical Application in the ERiCA Project

Figures & data

Figure 1. Malan’s triangles.

Table 1. Treatment modules.

Module 1: Introducing theory on the interplay between basic emotions and attachment. Emphasis lies on how attachment needs are given priority over our emotions, thus leading to affect phobias (illustrated using the “triangle of conflict”).

Module 2: Super-ego, shame and self-compassion. Focus on building the capacity for self-observation and differentiating between old habits of self-neglect and self-criticizing versus more healthy parts of the ego.

Module 3: Differentiation between optimal and too high levels of anxiety. Anxiety regulation through an increased capacity for self-observation and breathing exercises.

Module 4: Identifying and understanding defensive patterns. Identifying different defensive maneuvers and the long-term negative consequences connected to them.

Module 5: Affect theory and the visceral experience of affect. How to notice, accept, and experience them viscerally.

Module 6: Especially problematic feelings: anger, sadness, and guilt. Mixed and complex emotions. Exposure to warded off feelings through an expressive writing exercise.

Module 7: Interpersonal patterns of relatedness and self-definition. Identifying one’s predominant relationship patterns according to Sidney Blatt’s theory on anaclitic and introjective polarities of personality. Participants are also taught how this is connected to avoidance of our emotions and how to break these patterns by going against them.

Module 8: Communicating and expressing affects appropriately and identifying and repairing relationship ruptures. Moving forward and maintaining gains.

Figure 2. Weekly ratings of depression (QIDS-A17-SR) including post- and follow-up measurements.

Figure 3. Assessments of anxiety (GAD-7) pre-, post and follow-up measurements.