Abstract
Communication represents the core of psychotherapy. The dynamic interaction between verbal and non-verbal components during patient-therapist exchanges, indeed, promotes the co-construction of meanings bringing about change within a process of reciprocal influence of participants. Our paper aims to illustrate the building of a new observational instrument of the therapeutic discourse, the Communicative Modes Analysis System in Psychotherapy (CMASP), and its reliability study from Mixed Methods framework. The CMASP is a single classification system analyzing the communication features within therapeutic exchanges. Born to overcome the limits of traditional psychotherapy research which considers verbal and non-verbal dimensions of communication as in polar opposition, the CMASP building was based on the performative function derived from the Speech Act Theory. We used this function as a comprehensive theorization to interpret the communication components in psychotherapy as an integrated and interacting system. In fact, the instrument detects and classifies, at the overall and dimension level, the verbal and extra-linguistic components of psychotherapeutic communication implemented by the therapist and patients in the form of communicative modes. From the observational methodology framework, it was built an instrument able to record and analyze verbal, vocal and interruption behaviors by combining elements of qualitative and quantitative research approaches. The sample consisted of 30 psychotherapy audio recordings and verbatim transcripts of psychotherapy sessions (for a total of 8327 speaking turns). Four main dimensions were elaborated (Verbal Mode-Structural Form, Verbal Mode-Communicative Intent, Vocal Mode, and Interruption Mode) according to the agency role of communication components. The instrument is a field format combined with category systems. For each dimension, we built a category system that is exhaustive and mutually exclusive. From all dimensions, we have a total of 33 categories. Intra-and inter-judge reliability among four independent judges was computed on a total of 503 speaking turns coded through Cohen’s κ and Krippendorff’s canonical agreement coefficients (Cc), respectively. The CMASP showed high intra-and inter-judge agreement at the global, dimensional, and categorical level providing researchers and professionals with a single and flexible classification system, able to give multiple and concurrent information about the psychotherapy process.
Highlights
Psychotherapy, as an asymmetric help-relationship focused on the patient, represents an experience of sharing and communication (Molina et al, 2013)
We developed the Communicative Modes Analysis System in Psychotherapy (CMASP) at the Dynamic Psychotherapy Service belonging to the Interdepartmental Laboratories for Research and Applied Psychology (LIRIPAC), a recognized research center of the University of Padua (Italy)
The instrument consists of four dimensions (VeM-SF, VeMCI, Vocal Mode (VoM), Interruption Mode (IM)), two of them referred to two aspects of verbal behaviors and the others related to vocal and interruption behaviors of communication, respectively
Summary
Psychotherapy, as an asymmetric help-relationship focused on the patient, represents an experience of sharing and communication (Molina et al, 2013). Therapist and patient implement a specific type of communication in the form of therapeutic conversation, as mutual research and exploration through dialogue (Soares et al, 2010). Speech content (verbal dimension) and the different channels conveying it (nonverbal dimension) are the core ingredients of communicative exchanges (Ephratt, 2011). Weick (1968) claims that linguistic content, in the form of verbal behaviors, constitutes only a small portion of human communication and most of it rests on extra-linguistic behaviors. Voice and interruption behaviors (Mahl, 2014) are important indicators of the underlying psychological processes in communicative exchanges (Weick, 1968)
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