This study predicted that the quality of trauma narratives written before and following emotion-focused therapy for child abuse trauma would be positively associated with psychological disturbance before and following therapy. Narratives for 37 clients were coded for emotion words, temporal orientation, incoherence, and depth of experiencing. At pretreatment, negative emotion words and experiencing were correlated with abuse resolution, r(35) = −.36, and r(35) = −.34, respectively. At posttreatment, narrative incoherence was correlated with trauma symptoms, r(35) = .33, whereas present–future orientation and experiencing were correlated with abuse resolution, r(35) = −.37, and r(35) = −.31, respectively. Pretreatment incoherence was associated with posttreatment trauma symptoms, r(35) = .42, and pretreatment depth of experiencing was associated with posttreatment abuse resolution, r(35) = −.37. Results support narrative quality as an index of trauma disturbance.