Corrective Emotional Experience as Systemic Practice: Embedding Unconditional Positive Regard Across Roles

Authors

Frederick Shack, LMSW^1,4
Mardoche Sidor, MD^1,2,3
Jose Cotto, LCSW^1,5
Karen Dubin, PhD, LCSW^2,4
Lesmore Willis Jr, MPA, MHA¹
Gary Jenkins, MPA¹ 

Affiliations

¹Urban Pathways, New York, NY
²SWEET Institute, New York, NY
³Columbia University Center for Psychoanalytic Study and Research, New York, NY
⁴Columbia University, School of Social Work, New York, NY
⁵New York University, Department of Social Work, New York, NY

Correspondence concerning this article should be addressed to Mardoche Sidor, MD, Urban Pathways, at msidor@urbanpathways.org

Abstract

Corrective emotional experience (CEE) and unconditional positive regard (UPR) are often described in psychotherapy literature as mechanisms of individual healing. Yet in supportive housing and community mental health, these principles can and ought to be embedded at a systemic level across roles, case managers, housing specialists, security staff, administrators, medical staff, and leadership. This article analyzes how Urban Pathways operationalized CEE and UPR within the Four-Stage Engagement Model. We draw from attachment theory, trauma-informed care, and common factors research to demonstrate that unconditional regard is not just a therapist’s stance but a systemic practice. Case studies illustrate how cross-role UPR has the potential to reduce resident crises, built trust, and shift organizational culture.

Keywords

Corrective Emotional Experience, Unconditional Positive Regard, Trauma-Informed Care, Organizational Culture, Supportive Housing, Engagement, Common Factors, Community Mental Health

Introduction

CEE, first conceptualized by Alexander and French (1946), refers to relational experiences that disconfirm maladaptive expectations, offering healing through new relational patterns. Carl Rogers (1957) described UPR as one of the necessary and sufficient conditions for therapeutic change. Traditionally confined to psychotherapy, these principles are now supported by neuroscience and common factors research as universal mechanisms of change (Norcross & Wampold, 2019). Embedding them into supportive housing acknowledges that healing occurs in every interaction, not only in therapy rooms.

Theoretical Framework

Systemic CEE and UPR draw upon:

1. Attachment Theory: Secure relational experiences rebuild trust and safety across relationships (Mikulincer & Shaver, 2016).
2. Trauma-Informed Care: Healing requires safety and empowerment; UPR provides relational safety (SAMHSA, 2014).
3. Neuroscience: Positive relational experiences reshape neural pathways for emotion regulation and trust (Cozolino, 2017; Siegel, 2012).
4. Common Factors Research: Relational qualities such as empathy and acceptance explain more variance in outcomes than techniques (Wampold & Imel, 2015).

Application/Analysis

Urban Pathways are implementing systemic UPR and CEE by:

• Training All Staff: Security personnel have been trained in Motivational Interviewing, and to greet residents respectfully and consistently, conveying unconditional acceptance.
• Supervision: Supervisors are learning to encourage staff to explore their own barriers to UPR and provide corrective experiences within supervision itself.
• Organizational Messaging: Leadership is reinforcing UPR as a cultural value, framing it as central to mission.
• Composite Case Example: A resident with a history of incarceration assumed staff would view him as “dangerous.” Repeated experiences of calm, respectful interactions from both case management and security staff shifted his relational expectations, leading him to engage in housing planning.

Implications

• Practice: UPR is to be embraced as a cross-role responsibility, not limited to clinicians or social services staff.
• Supervision: Reflective practice is needed to address staff frustrations and sustain unconditional acceptance.
• Policy: Agencies ought to embed UPR in training, job descriptions, and evaluation metrics.
• Research: Future studies need to measure organizational outcomes (e.g., crisis incidents, retention) linked to systemic UPR.
• Systems: Embedding CEE across roles provides a replicable model for trauma-informed organizational transformation.

Conclusion

Corrective emotional experience and unconditional positive regard are not just clinical ideals but systemic practices. Embedding them across roles at Urban Pathways is demonstrating that unconditional acceptance can shift organizational culture, foster resident trust, and improve outcomes in supportive housing.

References

• Alexander, Franz, and Thomas French. Psychoanalytic Therapy: Principles and Application. Ronald Press, 1946.
• Cozolino, Louis. The Neuroscience of Psychotherapy: Healing the Social Brain. 3rd ed., W. W. Norton, 2017.
• Mikulincer, Mario, and Phillip R. Shaver. Attachment in Adulthood: Structure, Dynamics, and Change. 2nd ed., Guilford Press, 2016.
• Norcross, John C., and Bruce E. Wampold. “Evidence-Based Therapy Relationships: Research Conclusions and Clinical Practices.” Psychotherapy, vol. 56, no. 3, 2019, pp. 419–430.
• Rogers, Carl R. “The Necessary and Sufficient Conditions of Therapeutic Personality Change.” Journal of Consulting Psychology, vol. 21, no. 2, 1957, pp. 95–103.
• Substance Abuse and Mental Health Services Administration (SAMHSA). SAMHSA’s Concept of Trauma and Guidance for a Trauma-Informed Approach. HHS Publication, 2014.
• Siegel, Daniel J. The Developing Mind: How Relationships and the Brain Interact to Shape Who We Are. 2nd ed., Guilford Press, 2012.
• Wampold, Bruce E., and Zac E. Imel. The Great Psychotherapy Debate: The Evidence for What Makes Psychotherapy Work. 2nd ed., Routledge, 2015.

      

This article is part of a collaboration between SWEET Institute and Urban Pathways.

Read the full scientific version HERE