Analysis of the Emails From the Dutch Web-Based Intervention "Alcohol de Baas": Assessment of Early Indications of Drop-Out in an Online Alcohol Abuse Intervention.

Nowadays, traditional forms of psychotherapy are increasingly complemented by online interactions between client and counselor. In (some) web-based psychotherapeutic interventions, meetings are exclusively online through asynchronous messages. As the active ingredients of therapy are included in the exchange of several emails, this verbal exchange contains a wealth of information about the psychotherapeutic change process. Unfortunately, drop-out-related issues are exacerbated online. We employed several machine learning models to find (early) signs of drop-out in the email data from the "Alcohol de Baas" intervention by Tactus. Our analyses indicate that the email texts contain information about drop-out, but as drop-out is a multidimensional construct, it remains a complex task to accurately predict who will drop out. Nevertheless, by taking this approach, we present insight into the possibilities of working with email data and present some preliminary findings (which stress the importance of a good working alliance between client and counselor, distinguish between formal and informal language, and highlight the importance of Tactus' internet forum).

Embodiment of Wearable Technology: Qualitative Longitudinal Study.

BACKGROUND: Current technology innovations, such as wearables, have caused surprising reactions and feelings of deep connection to devices. Some researchers are calling mobile and wearable technologies cognitive prostheses, which are intrinsically connected to individuals as if they are part of the body, similar to a physical prosthesis. Additionally, while several studies have been performed on the phenomenology of receiving and wearing a physical prosthesis, it is unknown whether similar subjective experiences arise with technology. OBJECTIVE: In one of the first qualitative studies to track wearables in a longitudinal investigation, we explore whether a wearable can be embodied similar to a physical prosthesis. We hoped to gain insights and compare the phases of embodiment (ie, initial adjustment to the prosthesis) and the psychological responses (ie, accept the prosthesis as part of their body) between wearables and limb prostheses. This approach allowed us to find out whether this pattern was part of a cyclical (ie, period of different usage intensity) or asymptotic (ie, abandonment of the technology) pattern. METHODS: We adapted a limb prosthesis methodological framework to be applied to wearables and conducted semistructured interviews over a span of several months to assess if, how, and to what extent individuals come to embody wearables similar to prosthetic devices. Twelve individuals wore fitness trackers for 9 months, during which time interviews were conducted in the following three phases: after 3 months, after 6 months, and at the end of the study after 9 months. A deductive thematic analysis based on Murray's work was combined with an inductive approach in which new themes were discovered. RESULTS: Overall, the individuals experienced technology embodiment similar to limb embodiment in terms of adjustment, wearability, awareness, and body extension. Furthermore, we discovered two additional themes of engagement/reengagement and comparison to another device or person. Interestingly, many participants experienced a rarely reported phenomenon in longitudinal studies where the feedback from the device was counterintuitive to their own beliefs. This created a blurring of self-perception and a dilemma of "whom" to believe, the machine or one's self. CONCLUSIONS: There are many similarities between the embodiment of a limb prosthesis and a wearable. The large overlap between limb and wearable embodiment would suggest that insights from physical prostheses can be applied to wearables and vice versa. This is especially interesting as we are seeing the traditionally "dumb" body prosthesis becoming smarter and thus a natural merging of technology and body. Future longitudinal studies could focus on the dilemma people might experience of whether to believe the information of the device over their own thoughts and feelings. These studies might take into account constructs, such as technology reliance, autonomy, and levels of self-awareness.

Towards text mining therapeutic change: A systematic review of text-based methods for Therapeutic Change Process Research.

Therapeutic Change Process Research (TCPR) connects within-therapeutic change processes to outcomes. The labour intensity of qualitative methods limit their use to small scale studies. Automated text-analyses (e.g. text mining) provide means for analysing large scale text patterns. We aimed to provide an overview of the frequently used qualitative text-based TCPR methods and assess the extent to which these methods are reliable and valid, and have potential for automation. We systematically reviewed PsycINFO, Scopus, and Web of Science to identify articles concerning change processes and text or language. We evaluated the reliability and validity based on replicability, the availability of code books, training data and inter-rater reliability, and evaluated the potential for automation based on the example- and rule-based approach. From 318 articles we identified four often used methods: Innovative Moments Coding Scheme, the Narrative Process Coding Scheme, Assimilation of Problematic Experiences Scale, and Conversation Analysis. The reliability and validity of the first three is sufficient to hold promise for automation. While some text features (content, grammar) lend themselves for automation through a rule-based approach, it should be possible to automate higher order constructs (e.g. schemas) when sufficient annotated data for an example-based approach are available.

Understanding Therapeutic Change Process Research Through Multilevel Modeling and Text Mining.

Online interventions hold great potential for Therapeutic Change Process Research (TCPR), a field that aims to relate in-therapeutic change processes to the outcomes of interventions. Online a client is treated essentially through the language their counsellor uses, therefore the verbal interaction contains many important ingredients that bring about change. TCPR faces two challenges: how to derive meaningful change processes from texts, and secondly, how to assess these complex, varied, and multi-layered processes? We advocate the use text mining and multi-level models (MLMs): the former offers tools and methods to discovers patterns in texts; the latter can analyse these change processes as outcomes that vary at multiple levels. We (re-)used the data from Lamers et al. (2015) because it includes outcomes and the complete online intervention for clients with mild depressive symptoms. We used text mining to obtain basic text-variables from e-mails, that we analyzed through MLMs. We found that we could relate outcomes of interventions to variables containing text-information. We conclude that we can indeed bridge text mining and MLMs for TCPR as it was possible to relate text-information (obtained through text mining) to multi-leveled TCPR outcomes (using a MLM). Text mining can be helpful to obtain change processes, which is also the main challenge for TCPR. We showed how MLMs and text mining can be combined, but our proposition leaves open how to obtain the most relevant textual operationalization of TCPR concepts. That requires interdisciplinary collaboration and discussion. The future does look bright: based on our proof-of-concept study we conclude that MLMs and text mining can indeed advance TCPR.

Narrative health psychology: once more unto the breach. Introduction.

In this editorial, we position narrative health psychology as a variety of narrative psychology, a form of qualitative research in health psychology, and a psychological perspective that falls under the interdisciplinary term narrative health research. The aim of this positioning is to explore what are the most important features of the proposed approach and how they are relevant. We illustrate each positioning with the scope and diversity of narrative health psychology brought together in this special issue. Finally, we reflect on where narrative health psychology is now and how it could develop in the future.

Mapping letters from the future: exploring narrative processes of imagining the future.

This article uses Letters from the Future (a health promotion instrument) to explore the human capacity of imagining the future. From a narrative perspective, letters from the future are considered to be indicative of a variety of forms through which human beings construct and understand their future selves and worlds. This is consistent with an interpretive approach to understanding the human mind, which offers an alternative for the current dominant causal-explanatory approach in psychology. On the basis of qualitative analysis of 480 letters from the future, collected online from a diverse group of Dutch and German persons, we first identified five narrative processes operating in the letters: imagining, evaluating, orienting, expressing emotions and engaging in dialogue. Second, using comparative analysis, we identified six types of how these processes are organized in the letters as a whole. These types differ regarding functionality (which of the five processes was dominant); temporality (prospective, retrospective and present-oriented); the extent to which a path between present and future was described; and the vividness of the imagination. We suggest that these types can be used in narrative health practice as 'pathways' to locate where letter writers are on their path to imagine the future, rather than as a normative taxonomy. Future research should focus on how these pathways can be used to navigate to health and well-being.