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Browsing by Author "Krause, Mariane"

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An Adjunctive Internet-Based Intervention to Enhance Treatment for Depression in Adults: Randomized Controlled Trial
(2021) Pérez Ewert, J. Carola; Fernández, Olga; Cáceres, Cristián; Carrasco, Álvaro E.; Moessner, Markus; Bauer, Stephanie; Espinosa-Duque, Daniel; Gloger, Sergio; Krause, Mariane
Background: Internet-based interventions promise to enhance the accessibility of mental health care for a greater number of people and in more remote places. Their effectiveness has been shown for the prevention and treatment of various mental disorders. However, their potential when delivered as add-on to conventional treatment (ie, blended care) is less clear. Objective: The aim of this study is to study the effectiveness of an internet intervention (ASCENSO) implemented in addition to face-to-face treatment as usual (TAU) for depression. Methods: A 2-arm, parallel-group, randomized controlled trial was conducted in an outpatient private mental health care center in Chile. In all, 167 adults, diagnosed with major depressive disorder, without severe comorbidities, and with internet access, were included. Eighty-four participants were assigned to the intervention group and received medical and psychological TAU from the mental health center plus access to the ASCENSO online platform. The control group (n=83) received only TAU. The ASCENSO platform includes psycho-educational information, depressive symptom monitoring and feedback, and managing emergencies based on the principles of cognitive behavioral therapy. Emergency management was mental health provider–assisted. TAU includes access to primary care physicians and psychiatrists, to a brief individual psychotherapy, and to medication when needed. The baseline questionnaires were administered in person, and 6- and 9-months assessments were conducted online. Depression symptoms and quality of life were measured by self-administered questionnaires, and treatment adherence was determined via the Mental Health Center’s internal records. The usage of ASCENSO was assessed by server logs. Reduction on depressive symptomatology was considered as the primary outcome of the intervention and quality of life as a secondary outcome. Results: Of the 84 participants in the intervention group, 5 participants (6%) never accessed the online platform. Of the remaining 79 participants who accessed ASCENSO, 1 (1%, 1/79) did not answer any of the symptom questionnaire, and most participants (72/79, 91%) answered the monitoring questionnaires irregularly. The ASCENSO intervention implemented in addition to face-to-face care did not improve the outcome of the usual care delivered at the mental health center, either in terms of reduction of depressive symptoms (F2,6087= 0.48; P=.62) or in the improvement of quality of life (EQ-5D-3L: F2,7678=0.24; P=.79 and EQ-VAS: F2,6670= 0.13; P=.88). In contrast, for the primary (F2,850=78.25; P<.001) and secondary outcomes (EQ-5D-3L: F2,1067=37.87; EQ-VAS: F2,4390= 51.69; P<.001) in both groups, there was an improvement from baseline to 6 months (P<.001), but there was no change at 9 months. In addition, no effects on adherence to or use of TAU were found. Finally, the dropout rate for the face-to-face treatment component was 54% (45/84) for the intervention group versus 39% (32/83) for the control group (P=.07). Conclusions: The fact that the adjunctive access to ASCENSO did not improve outcome could be due to both the rather high effectiveness of TAU and to patients’ limited use of the online platform. Trial Registration: ClinicalTrials.gov NCT03093467; https://clinicaltrials.gov/ct2/show/NCT03093467
Biological stress reactivity as an index of the two polarities of the experience model
(2017) Silva, Jaime R.; Vivanco-Carlevari, Anastassia; Barrientos, Mauricio; Martínez, Claudio; Salazar, Luis A.; Krause, Mariane
The two-polarities model of personality argues that experience is organized around two axes: interpersonal relatedness and self-definition. Differential emphasis on one of these poles defines adaptive and pathological experiences, generating anaclitic or introjective tendencies. The anaclitic pattern, on one hand, has been conceptually related with an exaggerated emphasis on interpersonal relatedness. On the other hand, the introjective pattern has been connected to high levels of self-criticism. The aim of this study was to investigate the psychophysiological basis for this relationship. Specifically, we hypothesized that the anaclitic individual should have a higher biological reactivity to stress (BRS), measured by the cortisol concentration in saliva, in an interpersonal stress induction protocol (Trier Social Stress Test). Contrary to what was expected, the results indicated that introjective participants presented a higher BSR than the anaclitic group. Interestingly, in contrast to their higher BSR, the introjective group reported a diminished subjective stress in relation to the average. In the anaclitic group, a tendency that goes in the opposite direction was found. Theoretical implications of these findings were discussed.
Depression and attachment: how do personality styles and social support influence this relation?
(2017) Dagnino, Paula; Pérez, Carola; Gloger, Sergio; Gómez, Adriana; Krause, Mariane
The purpose of this study is to improve the current understanding of the relation between depression and attachment through the evaluation of the role of personality styles (dependent vs self-critical) and social support in this association. These variables were studied in a clinical sample of 70 depressed outpatients (83% women; M=41.47 years, SD=12.91). Depressive symptomatology was assessed through the Beck Depression Inventory, adult attachment through the Experiences in Close Relationships Scale, social support through the Social Support Questionnaire and dependency and self-criticism through the Depressive Experiences Questionnaire. Mediational and moderation regression analyses were performed. Results show that the association between the dimensions of attachment (anxiety and avoidance) and depression was partially mediated by self-criticism. Furthermore, results demonstrate the role of social support as a moderating variable: when the level of satisfaction with social support was low and the anxiety dimension in the attachment scale was high, as avoidance increased, depressive symptoms increased as well. Results are discussed in relation to their importance for understanding the complex interplay of the variables involved in depression.
Discourse-voice regulatory strategies in the psychotherapeutic interaction: a state-space dynamics analysis
(2015) Tomicic, Alemka; Martínez, Claudio; Pérez Ewert, J. Carola; Hollenstein, Tom; Angulo, Salvador; Gerstmann, Adam; Barroux, Isabelle; Krause, Mariane
This study seeks to provide evidence of the dynamics associated with the configurations of discourse-voice regulatory strategies in patient–therapist interactions in relevant episodes within psychotherapeutic sessions. Its central assumption is that discourses manifest themselves differently in terms of their prosodic characteristics according to their regulatory functions in a system of interactions. The association between discourse and vocal quality in patients and therapists was analyzed in a sample of 153 relevant episodes taken from 164 sessions of five psychotherapies using the state space grid (SSG) method, a graphical tool based on the dynamic systems theory (DST). The results showed eight recurrent and stable discourse-voice regulatory strategies of the patients and three of the therapists. Also, four specific groups of these discourse-voice strategies were identified. The latter were interpreted as regulatory configurations, that is to say, as emergent self-organized groups of discourse-voice regulatory strategies constituting specific interactional systems. Both regulatory strategies and their configurations differed between two types of relevant episodes: Change Episodes and Rupture Episodes. As a whole, these results support the assumption that speaking and listening, as dimensions of the interaction that takes place during therapeutic conversation, occur at different levels. The study not only shows that these dimensions are dependent on each other, but also that they function as a complex and dynamic whole in therapeutic dialog, generating relational offers which allow the patient and the therapist to regulate each other and shape the psychotherapeutic process that characterizes each type of relevant episode.
Disentangling the change–alliance relationship: Observational assessment of the therapeutic alliance during change and stuck episodes
(2016) Mellado, Augusto; Suárez, Nicolás; Altimir, Carolina; Martínez, Claudio; Pérez Ewert, J. Carola; Krause, Mariane
The therapeutic alliance is considered the most robust process variable associated with positive therapeutic outcome in a variety of psychotherapeutic models [Alexander, L. B., & Luborsky, L. (1986). The Penn Helping Alliance Scales. In L. S. Greenberg & W. M. Pinsoff (Eds.), The psychotherapeutic process: A research handbook (pp. 325–356). New York: Guilford Press; Horvath, A. O., Gaston, L., & Luborsky, L. (1993). The alliance as predictor of benefits of counseling and therapy. In N. Miller, L. Luborsky, J. Barber, & J. P. Docherty (Eds.), Psychodynamic treatment research: A handbook for clinical practice (pp. 247–274). New York, NY: Basic Books; Horvath, A. O., Del Re, A. C., Flückiger, C., & Symonds, D. (2011). Alliance in individual psychotherapy. Psychotherapy, 48, 9–16; Orlinky, D., Grawe, K., & Parks, B. (1994). Process and outcome in psychotherapy: Noch einmal. In A. Bergin & J. S. Garfield (Eds.), Handbook of psychotherapy and behaviour change (4th ed., pp. 270–378). New York, NY: Wiley and Sons]. The relationship between alliance and outcome has traditionally been studied based on measures that assess these therapy factors at a global level. However, the specific variations of the alliance process and their association with therapy segments that are relevant for change have not yet been fully examined. The present study examines the variations in the therapeutic alliance in 73 significant in-session events: 35 change and 38 stuck episodes identified through the observation of 14 short-term therapies of different theoretical orientations. Variations in the alliance were assessed using the VTAS-SF [Shelef, K., & Diamond, G. (2008). Short form of the revised Vanderbilt Therapeutic Alliance Scale: Development, reliability, and validity. Psychotherapy Research, 18, 433–443]. Nested analyses (HLM) indicate a statistically significant better quality of the alliance during change episodes.
Episodios de Cambio y Estancamiento en Psicoterapia: Características de la comunicación verbal entre pacientes y terapeutas
(2012) Fernández, Olga; Herrera, Pablo; Krause, Mariane; Pérez Ewert, J. Carola; Valdés, Nelson; Vilches, Oriana; Tomicic, Alemka
Se presentan los resultados de un microanálisis de la conversación psicoterapéutica en Episodios de Cambio y de Estancamiento. Se realizó un análisis comparativo de la comunicación verbal en una muestra de 33 Episodios de Cambio y 34 de Estancamiento, correspondientes a 15 procesos terapéuticos, aplicando el Sistema de Codificación de la Actividad Terapéutica. Este sistema distingue cinco niveles de análisis: Formas Básicas, Intenciones Comunicacionales, Técnicas, Dominio y Referencia. Los resultados muestran que los Episodios de Cambio y Estancamiento se distinguen en cuanto a que, en los primeros, predomina un lenguaje más asertivo por parte del terapeuta y más receptivo en el paciente, estando ambos involucrados en la activa construcción de nuevos significados y el paciente centrado en sí mismo. En los segundos se rigidiza el lenguaje, se exacerban algunas técnicas por parte del terapeuta y se tiende a focalizar menos en el paciente como referente del diálogo terapéutico.
Generic change indicators in therapeutic processes with different outcomes
(2015) Krause, Mariane; Altimir, Carolina; Pérez Ewert, J. Carola; Parra, Guillermo de la
Objectives: This paper analyzes the relationship between ongoing change and final outcome in therapies carried out in natural settings with 39 clients. Method: Ongoing change was assessed through generic change indicators (GCIs), an observational method designed to label the content of change moments by selecting one specific GCI from the sequence of 19 that covers from more rudimentary and low complexity to more elaborated and complex changes. These GCIs can also be grouped into three broad stages of change, according to their level of complexity. Productivity indicators were generated to account for the number of GCIs (total and grouped by stage) adjusted by the length of therapy and the respective individual production of GCIs. Outcome, in turn, is understood as the final result of therapy and was measured by Lambert's Outcome Questionnaire (OQ 45.2). Results: Using the Reliable Change Index of this measure, which qualifies the difference between initial and final scores, therapies were grouped into “good outcome” and “poor outcome” cases. Findings indicate that therapies with good final outcome show a greater presence of Stage III GCIs during the process. Furthermore, in these therapies there is a significant association between Stage I GCI productivity and the productivity of Stages II and III GCIs. This is not the case for poor outcome cases, where results show a greater productivity of initial stage GCIs, mostly in the second half of therapy and no relation of this productivity with Stage II and Stage III GCIs. Conclusions:Results support the relation of ongoing change and final outcome. Possibilities for the clinical use of GCIs, specifically for monitoring ongoing therapies, are discussed.
Introjective Individuals Tend Toward Anhedonia: Self-Report and Experimental Evidence
(2018) Silva, Jaime R.; Vivanco-Carlevari, Anastassia; Martínez, Claudio; Krause, Mariane
A broad line of research has conceptualized personality based on the interaction of two aspects: interpersonal relatedness and self-definition. This theoretical corpus understands these functions as two poles according to the patterns of interaction and relevance in personality. Additionally, the exacerbation of one of these poles generates a psychopathological model that identifies three types of depressive experience: anaclitic, introjective, or mixed pattern. Understanding the lack of interest as a key symptom of depression, this experiment evaluates a relation for anhedonia and the polarities model configuration using an empirical and experimental protocol. We tested 177 individuals using the Beck Depression Inventory (BDI) subscale for anhedonia and a visual discrimination task with a specific reward system, which was implemented to study reinforcement sensitivity. Participants were classified into four groups by the polarities of experience model. The subscale’s results showed that individuals with an introjective character exhibited an enhanced anhedonic symptomatology but no co-occurrence of this evidence on the experimental protocol. These results empirically support the two polarities of the depressive personality model and raise new questions regarding how to experimentally test this relation.
Mindfulness-based interventions in secondary education: a qualitative systematic review.
(2015) Langer, Álvaro I.; Ulloa Jiménez, Valentina; Cangas, Adolfo J.; Rojas, Graciela; Krause, Mariane
In order to study the effects of mindfulness meditation interventions administered to adolescents within their educational institutions, a qualitative systematic review was conducted. Sixteen studies published in main databases were analysed. The results show that mindfulness, as a prevention strategy in educational contexts, resulted in significant changes in the followings variables: (a) psychological (e.g., reduction in depressive symptoms); (b) psychosocial (e.g., increased social skills); and (c) physiological (e.g., improvement of blood pressure). Although the results were conclusive, their interpretation and generalization should be carefully analysed as there were no medium- and long-term follow-up evaluations, in addition to the fact that there has been a minimal assessment of the psychological mechanisms involved in the change processes.
Propiedades psicométricas del inventario de depresión de Beck IA para la población chilena
(2017) Valdés, Camila; Morales-Reyes, Irma; Pérez Ewert, J. Carola; Medellín, Adriana; Rojas, Graciela; Krause, Mariane
Background: According to the Chilean National Health Survey (2009- 2010), 17% of people aged 15 years or more have depressive symptoms. Thus, freely-available, easily-administered, and highly sensitive screening tests for depression are needed in clinical and research settings. Aim: To evaluate the psychometric properties of a Spanish version of the Beck Depression Inventory (BDI-IA) in adult Chilean population. Material and Methods: The inventory was applied to a sample of 1.105 adults aged between 18 to 73 years (94% women). Ninety nine participants were outpatients receiving treatment for affective disorders, 932 were parents and/or guardians of students enrolled in schools and 73 were university students (sample with no known depressive disorder). To perform data analysis, two groups from the random combination of both samples were generated. Results: The inventory showed an appropriate degree of internal consistency (Cronbach alpha = .92). An exploratory factor analysis suggested a one-factor solution. This solution was reinforced with a confirmatory factor analysis, which displayed an adequate goodness of fit. The cutoff score, based on the Youden Index, was 13/14 points. It was able to discriminate between depressed and non-depressed participants. Conclusions: These results indicate that the BDI-IA is an appropriate instrument to assess depressive symptoms in Chilean adults.
Psychometric properties of a spanish version of the Beck depression inventory IA
(2017) Valdés, Camila; Morales-Reyes, Irma; Pérez, Carola J.; Medellin, Adriana; Rojas, Graciela; Krause, Mariane
Background: According to the Chilean National Health Survey (20092010), 17% of people aged 15 years or more have depressive symptoms. Thus, freely-available, easily-administered, and highly sensitive screening tests for depression are needed in clinical and research settings. Aim: To evaluate the psychometric properties of a Spanish version of the Beck Depression Inventory (BDI-IA) in adult Chilean population. Material and Methods: The inventory was applied to a sample of 1.105 adults aged between 18 to 73 years (94% women). Ninety nine participants were outpatients receiving treatment for affective disorders, 932 were parents and/or guardians of students enrolled in schools and 73 were university students (sample with no known depressive disorder). To perform data analysis, two groups from the random combination of both samples were generated. Results: The inventory showed an appropriate degree of internal consistency (Cronbach alpha = .92). An exploratory factor analysis suggested a one-factor solution. This solution was reinforced with a confirmatory factor analysis, which displayed an adequate goodness of fit. The cutoff score, based on the Youden Index, was 13/14 points. It was able to discriminate between depressed and non-depressed participants. Conclusions: These results indicate that the BDI-IA is an appropriate instrument to assess depressive symptoms in Chilean adults.
Psychosocial health of the adolescent mother in the relationship with her child and its development
(2017) Alamo, Nicolle; Krause, Mariane; Pérez Ewert, J. Carola; Aracena, Marcela
This study relates adolescent mothers' psychosocial health to the development of their child and to the mother-child relationship, in a sample of 99 mothers. The results show that 39.4% of mothers presented risk for mental health problems; 40.4% of children presented alterations in the language, and 7.1% in their socio-emotional development. We observed a direct association between the risk of developing mental health problems and the potential for abuse and neglect, and between psychosocial well-being and the quality of the relationship; also, we observed an inverse association between psychosocial well-being and potential abuse. It was confirmed that maternal mental health and the potential abuse predict the socioemotional development of the child, while the quality of the relationship predicts the development of language. These results may contribute to future generation of public policies.
Relevance of early changes in psychotherapy with adolescents
(2015) Fernández, Olga; Pérez Ewert, J. Carola; Gloger, Sergio; Krause, Mariane
This research is focused on the study Generic Change Indicators (GCI) in psychotherapies with adolescents conducted in natural settings. Specifically, it is centered on the evolution of GCI during the initial stage of therapy and their relation with treatment adherence. The participants were 19 adolescents with various diagnoses, who were receiving individual therapy with different theoretical approaches. Trained raters identified the CGI in the three initial sessions. The results reveal an evolution during the initial therapy stage, with hierarchically lower indicators dominating the first session and then decreasing in the second and third. In addition, the maximum CGI reached in the initial phase significantly predict the likelihood of completing the therapeutic process. Keywords
The evolution of communicative intentions during change episodes and throughout the therapeutic process
(2012) Dagnino, Paula; Krause, Mariane; Pérez, Carola; Valdés, Nelson; Tomicic, Alemka
The present study examines the heterogeneity of the therapeutic process through the analysis of the conversation between therapists and clients in psychotherapy. The Communicative Intentions dimension of the Therapeutic Activity Coding System (TACS) was applied to 69 change episodes taken from 100 sessions that belong to five brief psychotherapies. Depending on what the participants are trying to achieve with their communication, the TACS distinguishes three types of Communicative Intentions: Exploring, Attuning, and Resignifying. Client and therapist verbalizations corresponding to these categories were analysed searching for differences between (a) both speakers, (b) initial, middle and final change episode stages, and (c) initial, middle and final phases of the whole therapeutic process. Results indicate that, in general, therapists resignify and attune more frequently, while clients explore more often. The analysis of Communicative Intentions within change episodes and during the whole therapeutic process reveals that there is an evolution in both: Even small therapy segments, as change episodes are, show that the process is not homogeneous, since in initial stages, the use of Exploring is more frequent than the use of Resignifying, especially for clients, while during the end of the episode clients and therapists increase their use of Resignifying. The analysis of the whole process confirms that Resignifying surpasses the use of Exploring in the final phases of therapy.
The relation between the therapeutic alliance and communicative intentions in therapeutic interaction during the initial phase of adolescent therapy
(2019) Fernández González, Olga; Pérez, J.Carola; Krause, Mariane
This study aims to examine the connection between the therapeutic alliance (TA) - from both the patient's and the therapist's perspectives - and communicative intentions during the initial phase of adolescent psychotherapy. The sample comprised the first three sessions of 19 adolescents' individual psychotherapeutic processes. Fifty therapeutic conversation segments were analyzed, representing 2043 adolescent and 3208 therapist speaking turns. The variables studied were Therapeutic Alliance, measured with the Working Alliance Inventory and Communicative Intentions (Exploring, Attuning and Resignifying), assessed by the Therapeutic Activity Coding System. A multilevel analysis was performed (HLM software). The Tasks dimension of the TA perceived by the adolescents increases the likelihood that their discourse will focus on providing and requesting information (Exploring), while also reducing the probability that they will seek to work together with the therapist to achieve mutual understanding (Attuning). The therapists' discourse shows that a strong TA in the Bonds dimension makes it more probable for their utterances to focus on the construction of new meanings (Resignifying). Also, a stronger TA in the Goals dimension makes it more likely for their discourse to be directed toward seeking Attunement with the adolescent.
Therapeutic Alliance in the initial phase of psychotherapy with adolescents: different perspectives and their association with therapeutic outcomes
(2016) Fernández, Olga; Krause, Mariane; Pérez Ewert, J. Carola
Psychotherapy research focusing on adults as well as on children and adolescents has revealed a positive association between the quality of the therapeutic alliance (TA) in the first sessions and therapeutic outcomes. Nevertheless, there is controversy regarding which perspective (of the adolescents, therapists, or parents) and what moment of evaluation (first, second, or third session) is most strongly associated with outcome. This study aims to describe the TA during the initial phase of psychotherapy with adolescents, from several perspectives, and relate it to the intermediate and final outcomes of the therapy. The study is descriptive-correlational and was conducted in naturalistic settings. The sample comprised 20 individual psychotherapeutic processes (15 females, 5 males; average age: 15.8 years; standard deviation=1.04). The variables studied were: TA, measured with the Working Alliance Inventory, applied to adolescents, therapists, and parents, and therapeutic outcomes, measured using Lambert's Outcome Questionnaire (OQ-45.2). The results show that the TA improved from session one to session three, both in the adolescents and the therapists. The TA, as perceived by the adolescents in the third session, is positively correlated with final outcomes (r=-.732*, P=.025). The TA evaluated from the therapists' perspective in the third session, specifically the bond component of the TA, predicts the final success of psychotherapy with adolescent patients [beta=0.426, Exp. (B)=1.531, degree of freedom=1, P=0.034]. The importance of the initial construction of the working alliance by both participants is discussed.
Therapeutic verbal communication in change episodes: a comparative microanalysis of linguistic basic forms
(2016) Krause, Mariane; Altimir, Carolina; Pérez Ewert, J. Carola; Echávarri, Orietta; Valdés, Nelson; Strasser, Katherine
This study examines clients’ and therapists’ verbal communication during psychotherapy, in order to determine its relation to ongoing change and outcome. It replicates previous studies showing the specificity of verbalizations depending on the speaker (client or therapist) and the phase of therapy, adding its relation to change measured at the level of process and final outcome. 7,009 speaking turns of clients and therapists, nested in 139 change episodes, were analysed regarding the use of the five Linguistic Basic Forms included in the Therapeutic Activity Coding System (TACS) through Hierarchical Modelling. Results show that three of these Linguistic Basic Forms — Question, Assertion and Agreement — are related to ongoing change as well as to final outcome.
Understanding the use/non-use of an internet-based intervention complementing standard depression treatment: A qualitative study of user's experiences
(2023) Fernández, Olga; Pérez, J. Carola; Fernández, Sofía; Krause, Mariane; Cáceres, Cristián; Espinosa-Duque, Daniel
Introduction: There is sufficient evidence about the effectiveness of internet-based interventions; however, the users’ level of adoption and utilization remains low, with this phenomenon requiring adequate explanation. Objective: The aim of this qualitative study was to explore the users’ perceptions and experience of a web-based program (ASCENSO), designed to complement (usual) in-person depression treatment. Method: Twelve participants of the ASCENSO program, comprised of adult individuals (M = 44.3, SD = 13.4) of both genders (67% women) undergoing treatment for depression, were interviewed through semistructured interviews. The data obtained from these interviews were analyzed utilizing a constructivist grounded theory approach. The interviews were tran scribed and analyzed by trained coders. A constant comparative analysis of emergent themes was conducted. Results: These show that users employ and appreciate the program when their interaction with it emulates a “humanized relationship,” that is, when the program is proactive in assisting users with their requests and when it responds in a pertinent and individualized manner to their emotional states and needs. Conclusions: Our findings highlight the challenges associated with the development of algorithms capable of attracting different potential users. These should be designed to generate a virtual relationship that emulates human interaction and targets the characteristics of each user, for example, considering the specific phenomenology of their health condition, their present emotional states, and perceived needs. Elements that will vary as mental symptomatology evolve.
Using decision trees to characterize verbal communication during change and stuck episodes in the therapeutic process
(2015) Krause, Mariane; Masías Hinojosa, Víctor; Valdés, Nelson; Pérez Ewert, J. Carola; Laengle, Sigifredo
Methods are needed for creating models to characterize verbal communication between therapists and their patients that are suitable for teaching purposes without losing analytical potential. A technique meeting these twin requirements is proposed that uses decision trees to identify both change and stuck episodes in therapist-patient communication. Three decision tree algorithms (C4.5, NBTree, and REPTree) are applied to the problem of characterizing verbal responses into change and stuck episodes in the therapeutic process. The data for the problem is derived from a corpus of 8 successful individual therapy sessions with 1760 speaking turns in a psychodynamic context. The decision tree model that performed best was generated by the C4.5 algorithm. It delivered 15 rules characterizing the verbal communication in the two types of episodes. Decision trees are a promising technique for analyzing verbal communication during significant therapy events and have much potential for use in teaching practice on changes in therapeutic communication. The development of pedagogical methods using decision trees can support the transmission of academic knowledge to therapeutic practice.
Verbal and nonverbal expressions of mutual regulation in relevant episodes of psychotherapy
(2016) Morán, Javier; Martínez, Claudio; Tomicic, Alemka; Pérez Ewert, J. Carola; Krause, Mariane; Guzmán, Marcela
The purpose of this paper is to describe verbal and nonverbal expressions of mutual regulation between patients and therapists through the analysis of relevant episodes of five psychotherapy processes. Microanalyses of discourse, vocal quality and facial expression of emotions were conducted on both patients and therapists in 67 Episodes of Change and 86 Episodes of Rupture of the Therapeutic Alliance. The analyses were carried out using hierarchical regression, showing that both Episodes of Change and Episodes of Rupture correspond to interactional scenarios where patients and therapists use different forms of speech, vocal qualities and facial expressions that account for specific regulation processes which are coherent with such scenarios.

Browsing by Author "Krause, Mariane"

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