Abstract
This study aims to analyze the relationship between the sociocognitive skills of a group of children and adolescents with autism spectrum disorder (ASD) at verbal level 1, the variability of the therapist’s heart rate (HRV), and the conversational turn-taking during online psychotherapy sessions. Initially, we assessed the intelligence, narrative, and behavioral characteristics of the participants. We videotaped the online sessions and recorded the therapist’s HRV via a smart wireless sensor. Finally, we analyzed the video sessions using an observation system and the therapist’s HRV using the Poincaré technique. The results show that the patients’ communicative intention was related to their narrative, intellectual and social competencies. Furthermore, the turn-taking between the therapist and the participant was associated with the patient’s emotional and behavioral difficulties. On the other side, the therapist’s heart rate variability (HRV) was related to the synchrony between the therapist and the participant with more significant stress on the therapist, when he shared and expanded the conversation with the patient, and when the patient broadened and shared the conversation with the therapist.
Highlights
The therapist–patient relationship is a specific intersubjective interaction environment, determined by a high level of confidentiality and emotional involvement [1,2]
The results indicate that a higher IQ matches more turn-taking events between patient and tDheersacpriipstti(vre=st0a.5ti3s,tipcs=a0b.0o5u)t, sceosnssiiodnerdiunrgatthioenf,rtehqeuennucmyboefrcohfatnugrens-tianktiunrgne-tvaeknintsg, apnedr stheceotnudrn(F-tiagkuirneg1f)r.eMquoerenocvyepr,etrhseeacgoendreasureltsshaosswonciainteTdawblieth3.higher cohesion and structure
Conversational turn-taking with a specialized professional can underline the relationship between patients’ communicative intention skills, emotional regulation, self-esteem, and behavioral competencies throughout the narrative and shared conversation during the psychotherapeutic session. These findings indicate that the mental health specialist must promote balanced positive and negative representations in the conversation about oneself and the patient, past, present, and future experiences, alternating and balancing own and other representations, a primary objective in dialogic psychotherapy, especially with children and adolescents with autism spectrum disorder (ASD) at the verbal level [35,103,104,105]
Summary
The therapist–patient relationship is a specific intersubjective interaction environment, determined by a high level of confidentiality and emotional involvement [1,2]. It encompasses and respects the same rules and characteristics that appear in all human interactions, where both agents are active parts of the turn-taking process [2]. From this perspective, the synchrony between therapist and young patients can be defined as “responsiveness” [3], “reciprocity” [4], “rhythmicity”, “mutuality” [5,6], “turntaking”, and “shared affect” [7]. Turn-taking includes cognitive, behavioral, emotional, and physiological components [14,15,16]
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