What can Speech and Language Tell us About the Working Alliance in Psychotherapy

TL;DR

This study explores how speech and language features in psychotherapy sessions relate to the therapeutic working alliance, using audio and video data to identify indicators of alliance quality.

Contribution

It introduces a novel approach linking speech and language features to working alliance ratings in psychotherapy sessions, with empirical evidence.

Findings

Certain speech and language features strongly correlate with alliance ratings

Speech turn dynamics and lexical entrainment are key indicators

First study to use speech features for characterizing working alliance

Abstract

We are interested in the problem of conversational analysis and its application to the health domain. Cognitive Behavioral Therapy is a structured approach in psychotherapy, allowing the therapist to help the patient to identify and modify the malicious thoughts, behavior, or actions. This cooperative effort can be evaluated using the Working Alliance Inventory Observer-rated Shortened - a 12 items inventory covering task, goal, and relationship - which has a relevant influence on therapeutic outcomes. In this work, we investigate the relation between this alliance inventory and the spoken conversations (sessions) between the patient and the psychotherapist. We have delivered eight weeks of e-therapy, collected their audio and video call sessions, and manually transcribed them. The spoken conversations have been annotated and evaluated with WAI ratings by professional therapists. We have investigated speech and language features and their association with WAI items. The feature types include turn dynamics, lexical entrainment, and conversational descriptors extracted from the speech and language signals. Our findings provide strong evidence that a subset of these features are strong indicators of working alliance. To the best of our knowledge, this is the first and a novel study to exploit speech and language for characterising working alliance.