Linguistic features of the therapeutic alliance in the first session: a psychotherapy process study

Abstract

Critical aspects of the therapeutic alliance appear to be established as early as the first session. Specifically, the affective bond between the therapeutic dyad appears to develop early in treatment and tends to remain stable over time, while agreements on goals and tasks tend to fluctuate over the course of treatment. Are there distinguishable early signs of a strong therapeutic alliance? In this study, we examined how some linguistic measures indicative of joint emotional elaboration correlated with a measure of the therapeutic alliance assessed within a single session. Initial intake sessions with 40 patients with varying diagnoses were videotaped, transcribed, and analyzed using linguistic measures of referential process and then scored with the Segmented Working Alliance Inventory-Observer form. Results showed that patients who were rated as more emotionally engaged in relating their experiences and then reflecting on them by mid-session also had higher scores in the therapeutic alliance by the final part of that same session. An implication of this study is that the interpersonal factors facilitating elaboration of inner experience, including elements of warmth, safety, and analytic trust, are related to the development of early therapeutic alliance. These findings did not appear to be dependent on the patient’s psychopathology. This study is one in a growing line of research exploring how patients speak rather than just the content of what they say.

Linguistic Markers of the Emotion Elaboration Surrounding the Confinement Period in the Italian Epicenter of COVID-19 Outbreak

“…This study takes as a point of reference the theories and research of Bucci (1997Bucci ( , 2013 and Pennebaker (1982Pennebaker ( , 2011, which connect the linguistic qualities of speech to specific psychological and interpersonal processes. Bucci (1997Bucci ( , 2013 (Maskit and Murphy, 2011;Maskit, 2012;Mariani et al, 2013Mariani et al, , 2020Negri et al, 2019) have developed computerized linguistic measures of what they call the "referential process, " which is based on Multiple Code Theory (MCT). The referential process is the ability of human beings to translate the continuous and indistinct flow of emotional and sensorial experience into images and words, thus making it mentally manageable and communicable to others.…”

“… Bucci (1997 , 2013 ) ( Maskit and Murphy, 2011 ; Maskit, 2012 ; Mariani et al, 2013 , 2020 ; Negri et al, 2019 ) have developed computerized linguistic measures of what they call the “referential process,” which is based on Multiple Code Theory (MCT). The referential process is the ability of human beings to translate the continuous and indistinct flow of emotional and sensorial experience into images and words, thus making it mentally manageable and communicable to others.…”

Narratives of Dreams and Waking Thoughts: Emotional Processing in Relation to the COVID-19 Pandemic

“… Bucci and Maskit (2007) hypothesize that if the RP is disrupted (e.g., by conflict or trauma), or fails to develop adequately, the verbal and non-verbal systems within the schemas may be disconnected, thereby affecting the organization of the schemas, the regulation of emotional arousal, and the construction of emotional meanings. The idea of disconnection within the emotional schemas can be applied to both somatic and mental pathology ( Di Trani et al, 2018 ; Negri et al, 2019 ; Mariani et al, 2020 ; Negri and Ongis, 2021 ). A specific pattern of disconnection is given by the high use of defenses, such as rationalizations or an abstract language ( Renzi et al, 2020 ; Mariani and Hoffman, 2021 ; Negri and Ongis, 2021 ).…”

Putting into Words the COVID-19 Lockdown Experience: Psychological Symptoms and the Referential Process

“…RP is not one-way, but works in a bidirectional way, so that the verbal material can be translated to a nonverbal form. The RP can be activated by interpersonal relationships and, also, by psychotherapy [ 21 ]. It can be defined by three principal phases: emotional arousal, narrating/symbolizing, and reflecting/reorganizing.…”