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Yokoyama S, Shikano A, Chiba H, Murakami T, Kawamorita T, Murayama T, Ito D, Ichikura K. Machine learning judged neutral facial expressions as key factors for a "good therapist" within the first five minutes: An experiment to simulate online video counselling. PEC INNOVATION 2024; 4:100302. [PMID: 38966314 PMCID: PMC11222811 DOI: 10.1016/j.pecinn.2024.100302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Revised: 05/15/2024] [Accepted: 06/04/2024] [Indexed: 07/06/2024]
Abstract
Objective Machine learning models were employed to discern patients' impressions from the therapists' facial expressions during a virtual online video counselling session. Methods Eight therapists simulated an online video counselling session for the same patient. The facial emotions of the therapists were extracted from the session videos; we then utilized a random forest model to determine the therapist's impression as perceived by the patients. Results The therapists' neutral facial expressions were important controlling factors for patients' impressions. A predictive model with three neutral facial features achieved an accuracy of 83% in identifying patients' impressions. Conclusions Neutral facial expressions may contribute to patient impressions in an online video counselling environment with spatiotemporal disconnection. Innovation Expression recognition techniques were applied innovatively to an online counselling setting where therapists' expressions are limited. Our findings have the potential to enhance psychiatric clinical practice using Information and Communication Technology.
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Affiliation(s)
- Satoshi Yokoyama
- Faculty of Humanities, Niigata University, 8050 Ikarashi 2-no-cho, Nishi-ku, Niigata, Niigata, 9502181, Japan
| | - Asuna Shikano
- Kitasato University Graduate School of Medical Sciences, 1-15-1 Kitasato, Minami, Sagamihara, Kanagawa 2520373, Japan
| | - Hiroki Chiba
- Department of Medical Education, Kitasato University School of Medicine, 1-15-1 Kitasato, Minami, Sagamihara, Kanagawa 2520374, Japan
| | - Takeshi Murakami
- Kitasato University Graduate School of Medical Sciences, 1-15-1 Kitasato, Minami, Sagamihara, Kanagawa 2520373, Japan
- Kitasato University School of Allied Health Sciences, 1-15-1 Kitasato, Minami, Sagamihara, Kanagawa 2520373, Japan
| | - Takushi Kawamorita
- Kitasato University Graduate School of Medical Sciences, 1-15-1 Kitasato, Minami, Sagamihara, Kanagawa 2520373, Japan
- Kitasato University School of Allied Health Sciences, 1-15-1 Kitasato, Minami, Sagamihara, Kanagawa 2520373, Japan
| | - Takayuki Murayama
- Kanazawa University Graduate School Human and Socio-Environmental Studies, Kakuma-machi, Kanazawa, Ishikawa 9201192, Japan
| | - Daisuke Ito
- Graduate School of Education, Hyogo University of Teacher Education, 1-5-7 Higashikawasaki, Kobe, Hyogo 6500044, Japan
| | - Kanako Ichikura
- Kitasato University Graduate School of Medical Sciences, 1-15-1 Kitasato, Minami, Sagamihara, Kanagawa 2520373, Japan
- Kitasato University School of Allied Health Sciences, 1-15-1 Kitasato, Minami, Sagamihara, Kanagawa 2520373, Japan
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Kleinbub JR, Esposito G, Cutolo AS, Palmieri A, Gonçalves MM. Physiological synchronization and innovative moments in psychotherapy: A single-case study of micro-process. Psychother Res 2024:1-16. [PMID: 38754031 DOI: 10.1080/10503307.2024.2352752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Accepted: 05/02/2024] [Indexed: 05/18/2024] Open
Abstract
OBJECTIVE Interpersonal synchronization is increasingly studied as a biomarker of empathy, therapeutic alliance, and treatment outcome. However, most studies average data over sessions, leaving associations between synchrony and actual interactions largely unexplored. We aim to showcase a novel approach examining synchronization during specific micro-processes: Innovative Moments (IM) as markers of exceptions to clients' problematic patterns of meaning. METHODS Electrodermal activity was recorded over 15 sessions of a psychodynamic psychotherapy single case. Moment-to-moment patient-therapist synchrony was calculated using the Adaptive Matching Interpolated Correlations (AMICo) algorithm. The Innovative Moments Coding System was utilized to identify IMs within session transcripts with precise timing. Monte-Carlo permutation tests were conducted to examine the association between physiological synchrony and IM Levels of increasing complexity (Levels 1-3). RESULTS Higher-than-random synchronization emerged during Level 3 IMs (p = 0.046; d = 0.21) but not in lower Levels. Post-hoc qualitative analyses linked high synchrony to sub-processes of Level 3 IMs, such as positive contrasts and attributions for change. CONCLUSION Our findings show it is possible to link moment-by-moment physiological co-regulation to theoretically identified meaning-making processes. While generalization of these observations is undue, this work demonstrates a robust and promising application of a multimodal approach to investigating psychotherapy, providing insights into both the clinical case and the theoretical model adopted.
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Affiliation(s)
- Johann R Kleinbub
- Department of Philosophy, Sociology, Education, and Applied Psychology, University of Padova, Padova, Italy
| | - Giovanna Esposito
- Department of Humanities, University of Napoli Federico II, Napoli, Italy
| | - Anna S Cutolo
- Department of Humanities, University of Napoli Federico II, Napoli, Italy
| | - Arianna Palmieri
- Department of Philosophy, Sociology, Education, and Applied Psychology, University of Padova, Padova, Italy
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Tal S, Ben-David Sela T, Dolev-Amit T, Hel-Or H, Zilcha-Mano S. Reactivity and stability in facial expressions as an indicator of therapeutic alliance strength. Psychother Res 2024:1-15. [PMID: 38442022 DOI: 10.1080/10503307.2024.2311777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 01/22/2024] [Indexed: 03/07/2024] Open
Abstract
Objective: Aspects of our emotional state are constantly being broadcast via our facial expressions. Psychotherapeutic theories highlight the importance of emotional dynamics between patients and therapists for an effective therapeutic relationship. Two emotional dynamics suggested by the literature are emotional reactivity (i.e., when one person is reacting to the other) and emotional stability (i.e., when a person has a tendency to remain in a given emotional state). Yet, little is known empirically about the association between these dynamics and the therapeutic alliance. This study investigates the association between the therapeutic alliance and the emotional dynamics of reactivity and stability, as manifested in the facial expressions of patients and therapists within the session. Methods: Ninety-four patients with major depressive disorder underwent short-term treatment for depression (N = 1256 sessions). Results: Both therapist reactivity and stability were associated with the alliance, across all time spans. Patient reactivity was associated with the alliance only in a short time span (1 s). Conclusions: These findings may potentially guide therapists in the field to attenuate not only their emotional reaction to their patients, but also their own unique presence in the therapy room.
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Affiliation(s)
- Shachaf Tal
- Department of Psychology, University of Haifa, Haifa, Israel
| | | | | | - Hagit Hel-Or
- Department of Computer Science, University of Haifa, Haifa, Israel
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Bani M, Ardenghi S, Rampoldi G, Russo S, Strepparava MG. Impact of facemasks on psychotherapy: Clinician's confidence and emotion recognition. J Clin Psychol 2023; 79:1178-1191. [PMID: 36459660 PMCID: PMC9877818 DOI: 10.1002/jclp.23468] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Revised: 10/04/2022] [Accepted: 11/20/2022] [Indexed: 12/03/2022]
Abstract
OBJECTIVES Facial emotion recognition is a key component of human interactions, and in clinical relationships contributes to building and maintaining the therapeutic alliance with patients. The introduction of facemasks has reduced the availability of facial information in private and professional relationships. This study aimed to assess the impact of facemasks on clinicians' perception of clinical interactions as well as their ability to read facial expressions. METHODS In this cross-sectional study, a purposive sample of 342 clinical psychologists or psychotherapists completed an online survey including the assessment of burnout, alexithymia, emotion dysregulation, and self-perceived ability to build effective relationships and communication with patients with/without facemasks. Participants were randomly assigned to the standardized facial emotion recognition task Diagnostic Analysis of Nonverbal Accuracy FACES 2-Adult Faces including 24 faces representing anger, fear, sadness, and happiness. RESULTS Facemasks impaired the self-perceived ability of clinicians to build effective relationships and communicate with patients and reduced satisfaction in clinical encounters. The ability of clinicians to recognize facial emotions is significantly reduced for masked happy and angry faces, but not for sad and afraid ones. The perceived difficulty in building good relationships and communication with patients had a positive correlation with alexithymia and emotion dysregulation; higher levels of discomfort when wearing facemasks had a positive correlation with burnout and emotion dysregulation. CONCLUSION Facemasks reduced clinicians' self-confidence in clinical encounters with patients wearing facemasks, but their facial emotion recognition performance was only partially impaired.
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Affiliation(s)
- Marco Bani
- School of Medicine and Surgery, University of Milano-Bicocca, Monza (MB), Italy
| | - Stefano Ardenghi
- School of Medicine and Surgery, University of Milano-Bicocca, Monza (MB), Italy
| | - Giulia Rampoldi
- School of Medicine and Surgery, University of Milano-Bicocca, Monza (MB), Italy
| | - Selena Russo
- School of Medicine and Surgery, University of Milano-Bicocca, Monza (MB), Italy
| | - Maria Grazia Strepparava
- School of Medicine and Surgery, University of Milano-Bicocca, Monza (MB), Italy.,Department of Mental Health, Clinical Psychology Unit, San Gerardo Hospital, ASST-Monza, Monza (MB), Italy
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Kulesza W, Dolinski D, Muniak P, Borkowska J, Bibikova P, Grzyb T. The chameleon effect in customer relationship management: Experiments on the spillover effects of mimicry in natural settings of a chain hotel and a chain grocery shop. Front Psychol 2023; 14:1016125. [PMID: 36998361 PMCID: PMC10043486 DOI: 10.3389/fpsyg.2023.1016125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Accepted: 02/23/2023] [Indexed: 03/15/2023] Open
Abstract
Numerous experiments have proven that mimicry is highly beneficial (mainly to the mimicker but also to the mimickee). Some studies have shown initial data suggesting the potential of applying this knowledge to business settings. In the present paper we unpack this issue in two ways. First, by presenting potential benefits stemming from mimicry for the mimicking dyad, and second for the business environment represented by the mimicker. Two consecutive studies: a Pretest and a Main Experiment run in natural settings showed great potential in improving the assessments of quality of service provided by verbally mimicking (or not). The results of both studies showed that mimicry offers benefits for the mimicker (increased employee kindness and employee evaluation), and also spillover to the organization/company represented by the mimicking employee (increased opinion of and willingness to return to the shop/hotel). Future research directions and limitations are discussed.
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Affiliation(s)
- Wojciech Kulesza
- Faculty of Psychology in Warsaw, Centre for Research on Social Relations, SWPS University of Social Sciences and Humanities, Warsaw, Masovian, Poland
| | - Dariusz Dolinski
- Faculty of Psychology in Wroclaw, SWPS University of Social Sciences and Humanities, Warsaw, Masovian, Poland
| | - Paweł Muniak
- Faculty of Psychology in Warsaw, Centre for Research on Social Relations, SWPS University of Social Sciences and Humanities, Warsaw, Masovian, Poland
- *Correspondence: Paweł Muniak,
| | - Joanna Borkowska
- Faculty of Psychology in Warsaw, SWPS University of Social Sciences and Humanities, Warsaw, Masovian, Poland
| | - Polina Bibikova
- Faculty of Psychology in Warsaw, SWPS University of Social Sciences and Humanities, Warsaw, Masovian, Poland
| | - Tomasz Grzyb
- Faculty of Psychology in Wroclaw, SWPS University of Social Sciences and Humanities, Warsaw, Masovian, Poland
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Horowitz-Kraus T, Gashri C. Multimodal Approach for Characterizing the Quality of Parent-Child Interaction: A Single Synchronization Source May Not Tell the Whole Story. BIOLOGY 2023; 12:biology12020241. [PMID: 36829518 PMCID: PMC9952901 DOI: 10.3390/biology12020241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Revised: 01/31/2023] [Accepted: 02/01/2023] [Indexed: 02/05/2023]
Abstract
The interaction between the parent and child is essential for the child's cognitive and emotional development and sets the path for future well-being. These interactions, starting from birth, are necessary for providing the sensory stimulation the child needs in the critical time window of brain development. The characterization of parent-child interactions is traditionally performed by human decoding. This approach is considered the leading and most accurate way of characterizing the quality of these interactions. However, the development of computational tools and especially the concept of parent-child synchronization opened up an additional source of data characterizing these interactions in an objective, less human-labor manner. Such sources include brain-to-brain, voice/speech, eye contact, motor, and heart-rate synchronization. However, can a single source synchronization dataset accurately represent parent-child interaction? Will attending to the same stimulation, often resulting in a higher brain-to-brain synchronization, be considered an interactive condition? In this perspective, we will try to convey a new concept of the child-parent interaction synchronization (CHIPS) matrix, which includes the different sources of signals generated during an interaction. Such a model may assist in explaining the source of interaction alterations in the case of child/parent developmental/emotional or sensory deficits and may open up new ways of assessing interventions and changes in parent-child interactions along development. We will discuss this interaction during one of the parent-child joint activities providing opportunities for interaction, i.e., storytelling.
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Affiliation(s)
- Tzipi Horowitz-Kraus
- Educational Neuroimaging Group, Faculty of Education in Science and Technology, Technion, Haifa 3200003, Israel
- Faculty of Biomedical Engineering, Technion, Haifa 3200003, Israel
- Neuropsychology Department, Kennedy Krieger Institute, Baltimore, MD 21205, USA
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD 21205, USA
- Correspondence: ; Tel.: +972-522-989298
| | - Carmel Gashri
- Faculty of Biomedical Engineering, Technion, Haifa 3200003, Israel
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Andreas S, Gablonski TC, Tschacher W, Gebhardt A, Rabung S, Schulz H, Kadur J. Long-term psychodynamic psychotherapy in a face-to-face versus videoconferencing setting: A single case study. J Clin Psychol 2023; 79:277-295. [PMID: 35819447 PMCID: PMC10084227 DOI: 10.1002/jclp.23411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Revised: 06/07/2022] [Accepted: 06/26/2022] [Indexed: 01/19/2023]
Abstract
OBJECTIVE Due to the coronavirus pandemic and crisis, psychotherapists around the world were forced to switch to video- or tele-based treatments overnight. To date, only a few studies on the effectiveness of video-based psychodynamic psychotherapy via the Internet exist. Therefore, the goal of the present study was to examine symptom improvement, therapeutic relationship, nonverbal synchrony processes, and intersession processes within a systematic single case design and compare face-to-face to video-based approaches in long-term psychodynamic-oriented psychotherapy. METHODS We examined 85 sessions of a client with major depression whose psychodynamic psychotherapy changed from a face-to-face setting to a video-based setting. Video recordings were analyzed using motion energy analysis, and nonverbal synchrony was computed using a surrogate synchrony approach. Time series analyses were performed to analyze changes in symptom severity, therapeutic relationship, and intersession processes. RESULTS The results showed that symptom severity improved descriptively, but not significantly, across the entire course of psychotherapy. There were significant differences, however, in the therapeutic relationship, intersession experiences, and synchronous behavior between the face-to-face and video-based settings. CONCLUSION The results indicate that the presented methodology is well situated to investigate the question whether psychodynamic psychotherapy in video-based setting works in the sameway as in a face-to-face setting.
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Affiliation(s)
- Sylke Andreas
- Department of Clinical Psychology, Psychotherapy and Psychoanalysis, Institute of Psychology, University of Klagenfurt, Klagenfurt am Wörthersee, Austria
| | - Thorsten-Christian Gablonski
- Department of Clinical Psychology, Psychotherapy and Psychoanalysis, Institute of Psychology, University of Klagenfurt, Klagenfurt am Wörthersee, Austria
| | - Wolfgang Tschacher
- University Hospital of Psychiatry and Psychotherapy, Experimental Psychology Division, University of Bern, Bern, Switzerland
| | - Albrecht Gebhardt
- Department of Clinical Psychology, Psychotherapy and Psychoanalysis, Institute of Psychology, University of Klagenfurt, Klagenfurt am Wörthersee, Austria
| | - Sven Rabung
- Department of Clinical Psychology, Psychotherapy and Psychoanalysis, Institute of Psychology, University of Klagenfurt, Klagenfurt am Wörthersee, Austria
| | - Holger Schulz
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Jennifer Kadur
- Department of Clinical Psychology, Psychotherapy and Psychoanalysis, Institute of Psychology, University of Klagenfurt, Klagenfurt am Wörthersee, Austria
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Introduction to the Special Issue on Nonconscious Mimicry: History, Applications, and Theoretical and Methodological Innovations. JOURNAL OF NONVERBAL BEHAVIOR 2019. [DOI: 10.1007/s10919-019-00323-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
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