ABSTRACT
OBJECTIVE: In an attempt to operationalize an implicit aspect of the therapeutic relationship, this study assesses reciprocal linguistic style entrainment (rLSM) between the patient and therapist. rLSM is defined as the dynamic adjustment of function word usage to synchronize or to be in rhythm with another person as they change over time. METHOD: In this exploratory study, levels of rLSM per talk turn were analyzed for 540 sessions of 27 long-term psychoanalytic treatments in relation to treatment outcomes. RESULTS: Within sessions, rLSM appeared to decrease by the end of sessions and followed a negative linear trajectory, ßlinear = -0.0002, SE < .001, t = -13.04, p < .001. Between sessions, rLSM showed significant variability such that neither a linear, nor a quadratic, nor a cubic trend line fit the session-by-session change over treatment. On average, therapist talk turns had significantly lower rLSM than patient talk turns, while accounting for the nested nature of the data using multilevel models ßSpeakerT = -0.033, SE = 0.009, t = -3.65, p < .001. Levels of rLSM did not relate to treatment outcome. CONCLUSION: Most of the rLSM variance was at the within-patient and within-session level. rLSM was no indicator of psychoanalytic treatment outcomes.
ABSTRACT
OBJECTIVE: In the wake of the COVID-19 pandemic, the use of teletherapy has become more pervasive than ever. Many therapists faced this move to a remote setting with little experience or training. We aimed to qualitatively examine therapists' subjective experience of providing teletherapy, including changes in technique, the therapeutic relationship, and the therapeutic process. METHODS: Thirty-one psychotherapists participated in semistructured interviews. Interviews were recorded, then transcribed and analyzed using the Consensual Qualitative Research method. RESULTS: Therapists typically reported a change in the therapeutic relationship in terms of an increased sense of disconnection as well as shifts in various aspects of the relational dynamics, and they also typically experienced differences in the therapy process due to changes in patient and therapist engagement in the therapeutic work. Additionally, some therapists also reported that they became more active and directive in sessions, took a more informal, personal, or relaxed approach to interacting with patients, and while the emotional connection changed and they missed the energy and intimacy of in-person sessions, the relationship in telesessions felt more authentic and human for some, and teletherapy also provided a way to discuss new dimensions in the process. CONCLUSION: Overall, these results suggest great variability in therapists' subjective experiences with teletherapy, and present teletherapy as a distinct therapy format in many aspects. Further process-level research and subsequent training is needed to better equip therapists to navigate teletherapy's challenges and harness its unique opportunities.
Subject(s)
COVID-19 , Pandemics , Humans , Psychotherapy/methods , Psychotherapists , Qualitative ResearchABSTRACT
A wide-ranging survey focusing on the experiences of analysts providing telehealth treatment approximately six months into the pandemic was sent to one hundred randomly selected APsaA graduate analysts, one hundred randomly selected APsaA candidate analysts, and then to everyone on the APsaA members' Listserv. Presented both open-ended and closed-ended questions, analysts were invited to quantify and reflect on their experience. Responding analysts in each of the three groups described similar experiences. Each group noted that they have, overall, moved from a neutral to a modestly positive acceptance of telehealth as a means of delivering psychoanalysis. In describing the frame and process of telehealth, the analysts reported wide differences in patient response to the change in format, including positive, negative, and highly specific shifts in the treatment process attributable to the change in format. Telehealth, it appears, is a distinct space in which psychoanalysis can be conducted. In general, respondents minimized the impact of the pandemic itself on the analytic process, though the process may have been more impacted by the pandemic than they were reporting. All three groups almost unanimously reported interest in exploring innovative psychoanalytic techniques.
