A curvilinear association between therapists' use of discourse particles and therapist empathy in psychotherapy

This study investigates the relationships between therapists' use of discourse particles and therapist empathy. Discourse particles, commonly found in non-English languages, are verbal elements that constitute metacommunication by encoding speakers' emotions and attitudes, which are typically expressed by nonverbal behaviors (e.g., intonation, tone, facial expression, nodding). We hypothesize an inverted U-shaped curvilinear relationship between therapists' use of discourse particles and therapist empathy, given the notion that an optimal level of therapists' emotion in psychotherapy can facilitate clients' inner experiencing and self-expression. Four psychotherapy sessions each from 39 therapist-client dyads were analyzed. After each session, therapist empathy was rated by trained observers using the Therapist Empathy Scale (TES) and by clients using the Barrett-Lennard Relationship Inventory (BLRI). Multilevel modeling shows that both the person-level negative quadratic term and positive linear term for therapists' usage of discourse particles are significant in predicting mean TES with large effect sizes. The same predictors do not yield significant results in predicting mean BLRI but they trend in similar directions of associations with medium effect sizes. Our results suggest the optimal usage of discourse particles by therapists is around 20.3% (out of all utterances). The nonsignificant results in BLRI may be attributed to the relatively small sample size of our data and the noncommunication orientation of the client-rated measure. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Formality in psychotherapy: How are therapists' and clients' use of discourse particles related to therapist empathy?

INTRODUCTION

Previous studies explored the preferences for therapists' attire and office setting based on initial impressions as a reference for the formality in psychotherapy. This study examines the formality of psychotherapy by investigating therapists' and clients' use of discourse particles, the linguistic marker and quantifier of the formality in speech, in relation to therapist empathy in different stages of psychotherapy.

METHODS

Four psychotherapy sessions (representing early, mid, and late stages) each from 39 therapist-client dyads were analyzed. Trained observers rated therapist empathy in each session using the Therapist Empathy Scale.

RESULTS

Results of multilevel modeling show that synchrony in particle usage, hence synchrony in formality, between clients and therapists is not associated with therapist empathy. Therapists' use of particles (i.e., absolute formality of therapists) was also not associated with therapist empathy. In contrast, the relative formality of therapists plays significant roles: therapist empathy is generally observed when therapists are relatively more formal than the clients (i.e., lower relative usage of particles by the therapists when compared to the clients). However, for clients who speak formally with few particles, therapist casualness (i.e., higher relative usage of particles than the clients) at the beginning of therapy may be interpreted as therapist empathy as therapists help these clients ease into the therapeutic relationships.

DISCUSSION

Our results suggest that the examination of therapists' and clients' use of particles across different stages of treatment may illuminate dynamic interactional styles that facilitate or hinder the psychotherapy process.