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Resolving "unfinished business": Efficacy of experiential therapy using empty-chair dialogue.
Abstract
In this study, 34 clients with unresolved feelings related to a significant other were randomly assigned to either experiential therapy using a Gestalt empty-chair dialogue intervention or an attention-placebo condition. The latter was a psychoeducational group offering information about "unfinished business." Treatment outcomes were evaluated before and after the treatment period in each condition and at 4 months and 1 year after the experiential therapy. Outcome instruments targeted general symptomotology, interpersonal distress, target complaints, unfinished business resolution, and perceptions of self and other in the unfinished business relationship. Results indicated that experiential therapy achieved clinically meaningful gains for most clients and significantly greater improvement than the psychoeducational group on all outcome measures. Treatment gains for the experiential therapy group were maintained at follow-up.
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“In this method clients in a therapy session typically argue with an imaginary significant other sitting across from them in an empty chair. This may also involve clients eventually sitting in that chair and then experiencing and arguing about the problem from the perspective of the significant other.”
From Conversations between self and self as Sigmund Freud—A virtual body ownership paradigm for self counselling (2015) · cites this paper as [38]
In the citing paper
“A practical application of perspective taking is the ‘empty chair technique’ of Gestalt Therapy3738.”
From Conversations between self and self as Sigmund Freud—A virtual body ownership paradigm for self counselling (2015) · cites this paper as [38]
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BackgroundMethodInfluentialSelf-citationThe Use of Structural Analysis of Social Behavior (SASB) as an Assessment Tool
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BackgroundNarkiss-Guez, T., Enav Zichor, Y., Guez, J., & Diamond, G. M. (2015) · Counselling Psychology Quarterly · doi:10.1080/09515070.2014.924480 · Cited by 22
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BackgroundHalvorsen, M. S., & Monsen, J. T. (2007) · Psychotherapy Research · doi:10.1080/10503300600608363 · Cited by 21
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Humanistic‐Experiential Psychotherapy
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Self-citationLetter Writing as a Clinical Tool in Grief Psychotherapy
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“Although the task of speaking to a camera as if another person may seem unnatural, and so not ecologically valid, it is actually modeled on the ‘empty chair’ technique developed in the Gestalt therapy that has been empirically proven to be of therapeutic value despite its artificiality, because it evokes a much deeper…”
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Cognitive Behavioural Chairwork
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“…a unique ‘felt truth’ (Chadwick 2003) and that improvements in target symptoms are significantly greater following the use of empty-chair techniques (effecting the implicational code) compared to psychoeducation-based interventions (effecting the propositional code) (Paivio and Greenberg 1995).”
BackgroundContemporary Brief Experiential Psychotherapy
Elliott, R. (2001) · Clinical Psychology Science and Practice · doi:10.1093/clipsy.8.1.38 · Cited by 14
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“As the two-chair dialogue work intervention is assumed to be emotionally evocative (Paivio & Greenberg, 1995), we were somewhat surprised not to see a clearer increase in the arousal after introducing the intervention.”
BackgroundEmotions and Eating Disorders: Treatment Implications
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“The imaginal dialogue’s intensity of emotional arousal has been correlated with better treatment outcomes (Greenberg, 1979; Greenberg & Malcolm, 2002; Greenberg & Pascual-Leone, 2006; Paivio & Greenberg, 1995).”
BackgroundRohde, K., Stein, M., Pascual‐Leone, A., & Caspar, F. (2015) · Cognitive Therapy and Research · doi:10.1007/s10608-015-9680-x · Cited by 11
“It assesses how clients feel in terms of their long-standing interpersonal grievances and has been used in several studies exploring the resolution of negative feelings through specific therapeutic interventions (Greenberg and Malcolm 2002; Greenberg et al. 2008; Paivio and Greenberg 1995).”
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Kramer, U., & Pascual‐Leone, A. (2013) · Pratiques Psychologiques · doi:10.1016/j.prps.2012.12.002 · Cited by 12
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“…as facilitated by specific EFT tasks, like two-chair or empty chair dialogues, can lead to the restructuring of emotion schemes, which in turn leads to more enduring changes in clients (Greenberg & Pedersen, 2001; Greenberg & Safran, 1987, 1989; Paivio & Greenberg, 1995; Watson & Greenberg, 1996).”
BackgroundBaelemans, M. C. E., Plooij, P., Bachrach, N., & Arntz, A. R. (2025) · Clinical Psychology & Psychotherapy · doi:10.1002/cpp.70045 · Cited by 8
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“…productivity of these strategies of approach and connection, including the restaging of specific memories, approach behaviours (Pay ´ as & Chaurand, 2019) or triggering imaginary conversations with the loved one (Greenberg et al., 1993; Paivio & Greenberg, 1995; Pay ´ as, 2010; Shear et al., 2005).”
BackgroundEffectiveness of emotion-focused therapy: Main results of a practice–research network study
Kramer, U., Sutter, M., Rubel, J. A., Machinea, J. B., Meneses, C. W., Auszra, L., Herrmann, I. R., & Holtforth, M. G. (2025) · Psychotherapy Research · doi:10.1080/10503307.2025.2454455 · Cited by 8
“…depressive symptoms over time; Watson et al., 2003), for the treatment of interpersonal injuries (i.e., a large pre– post effect size was found; Paivio & Greenberg, 1995), for the treatment of complex trauma (i.e., large pre–post effects were found for the reduction in symptoms of…”
‘Prove it’ Working with LBGTQ+ Asylum Seekers who Must Prove their Sexuality to Stay in the UK
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“The client can safely become empowered and shift themselves from a position of weakness to one of strength (Paivio and Greenberg 1995).”
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Attitudes and applications of chairwork amongst CBT therapists: a preliminary survey
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“…research suggests that chairwork is an effective method for modifying maladaptive thoughts and feelings (e.g. de Oliveira, 2008; Greenberg and Malcolm, 2002; Paivio and Greenberg, 1995), support for chairwork as a behaviour change method is as equally strong (Lazarus, 1966; Sanchez et al., 1980).”
MethodClient Satisfaction Survey of Inpatient Trauma and Dissociative Disorders Program
Dougherty, M. J. (2002) · Journal of Trauma & Dissociation · doi:10.1300/j229v03n02_06 · Cited by 7
“Positive results can offer what Paivio and Greenberg (1995) refer to as the link for the patient between the past trauma and understanding current perceptions.”
BackgroundEmotion-Focused Therapy’s Empty-Chair Task for Complicated Grief: An Open Trial
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“Several studies tested the efficacy of the Emotion-Focused Therapy’s Empty-Chair Task for Unfinished Business specifically in problems such as depression or trauma (Greenberg & Malcolm, 2002; Paivio et al., 2001, 2010; Paivio & Greenberg, 1995).”
Expressions of anger during advising on life dilemmas predict suicide risk among college students
Hu, C., Huang, J., Huang, C., Munroe, M., Xie, D., & Li, M. (2022) · PsyCh Journal · doi:10.1002/pchj.529 · Cited by 6
Giacomucci, S., Marquit, J., & Walsh, K. M. (2022) · Zeitschrift für Psychodrama und Soziometrie · doi:10.1007/s11620-022-00665-w · Cited by 9
“Little research has been published on the effectiveness of psychodrama in the treatment of PTSD (Baumgartner 1986; Lind et al. 2006; Paivio and Greenberg 1995; Ragsdale et al. 1996) or the Therapeutic Spiral Model specifically (Giacomucci and Marquit 2020; Gow and McVea 2006; Hudgins and Drucker 1998; Hudgins et al.”
MethodExperiential Financial Therapy
Klontz, B. T., Klontz, P. T., & Tharp, D. T. (2014) · Springer eBooks · doi:10.1007/978-3-319-08269-1_7 · Cited by 7
Healing Emotional Affective Responses to Trauma (HEART): A Christian Model of Working with Trauma
Keyes, B. B. (2018) · Frontiers in the Psychotherapy of Trauma and Dissociation · doi:10.46716/ftpd.2017.0006 · Cited by 5
Gabińska, A., Suszek, H., & Jankowska, W. (2023) · Journal of Constructivist Psychology · doi:10.1080/10720537.2023.2194695 · Cited by 5
“The empty chair technique has proven to be useful in anger reduction (Conoley et al., 1983), solving "unfinished business" (Paivio & Greenberg, 1995), and facilitating forgiveness (Greenberg et al., 2008).”
MethodThe Possibilities of Modern Client-Centered and Experiential Psychotherapy
Kocharian, O., Barinova, N. V., & Barinov, S. A. (2023) · Psychological Counseling and Psychotherapy · doi:10.26565/2410-1249-2023-20-01 · Cited by 5
Couple Rage and Emotional Distancing when a Partner is Dying
Yang, S., & Rosenblatt, P. C. (2007) · Journal of Loss and Trauma · doi:10.1080/15325020601138799 · Cited by 5
“There is a concept in the therapy literature of “unfinished business” (eg, Paivio & Greenberg, 1995 ) that may be framed in terms of equity theory.”
BackgroundAdvantageous Use of Hypnosis in a Case of Psychogenic Vomiting
Chandrashekhar, R. (2016) · American Journal of Clinical Hypnosis · doi:10.1080/00029157.2015.1046981 · Cited by 5
“Paivio and Greenberg (1995) found the empty chair dialogue a more efficient method to reduce symptoms and bring about resolution of unfinished business as compared to psychoeducation.”
BackgroundKönig, J., Karl, R., Rosner, R., & Butollo, W. H. (2018) · The Journal of Nervous and Mental Disease · doi:10.1097/nmd.0000000000000844 · Cited by 6
The framework for integrating common and specific factors in therapy: A resolution
Yii-nii, L. (2016) · International Journal of Psychology and Counselling · doi:10.5897/ijpc2016.0398 · Cited by 5
“Third, experiential-humanistic therapy in general achieved clinically meaningful, stable gains than the psychoeducational group for most clients with significantly greater improvement (Paivio and Greenberg, 1995).”
BackgroundLa psychothérapie de l’adolescent centrée sur les émotions
Har, A. (2018) · Perspectives Psy · doi:10.1051/ppsy/2018573214 · Cited by 8
The resolution of anger in psychotherapy: A task analysis.
Kannan, D., Henretty, J. R., Piazza-Bonin, E., Levitt, H. M., Coleman, R. A., Bickerest-Townsend, M., & Mathews, S. S. (2011) · The Humanistic Psychologist · doi:10.1080/08873267.2011.563724 · Cited by 5
“Task analytic research has indicated that facilitating the experience and expression of anger within this theoretical framework leads to productive psychotherapy outcome within different emotion focused therapy (EFT) interventions (eg, self-critical two-chairing dialogues, Greenberg & Foerster, 1996 ; unfinished inter…”
BackgroundTheory Development: Chronic Sorrow and the Gestalt Construct of Closure
Roos, S. (2001) · Gestalt Review · doi:10.5325/gestaltreview.5.4.0289 · Cited by 5
Qualitative study on the virtual reality-based empty-chair technique in middle-aged South Korean men
Yoo, K., & Kim, E. (2025) · Frontiers in Psychology · doi:10.3389/fpsyg.2025.1559171 · Cited by 4
Metadata
- Authors
- Paivio, S. C., & Greenberg, L. S.
- Affiliations
- University of Saskatchewan (CA)
- ORCID
- Greenberg, Leslie S.
- Venue
- Journal of Consulting and Clinical Psychology
- Published
- 1995
- Volume
- 63
- Issue
- 3
- Pages
- 419-425
- ISSN
- 0022-006X (ISSN-L)
- 1939-2117
- OpenAlex
- W4229837551
- Cited by
- 233
- References
- 0
- Citations by year
- 2026: 8 · 2025: 11 · 2024: 7 · 2023: 7 · 2022: 10 · 2021: 8 · 2020: 14 · 2019: 5 · 2018: 15 · 2017: 9 · 2016: 8 · 2015: 9 · 2014: 13 · 2013: 13 · 2012: 5
- FWCI
- 6.95
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Consulting and Clinical Psychology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
- Social Sciences › Psychology › Clinical Psychology › Counseling, Therapy, and Family Dynamics
- Social Sciences › Psychology › Clinical Psychology › Counseling Practices and Supervision
- Keywords
- experiential therapy, unfinished business, unresolved conflicts, treatment efficacy
- MeSH terms
- Adaptation, Psychological, Adult, Emotions, Female, Gestalt Therapy, Humans, Interpersonal Relations, Male, Middle Aged, Personality Assessment, Problem-Based Learning
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