Presession mood induction in therapists: Effects on therapist empathy.

Previous studies show that therapist mood is associated with psychotherapy processes, but the observational nature of these studies does not allow for causal inference. It is also unclear if other therapist characteristics, such as therapist trait empathy, moderate the relation between therapist mood and process variables. Thirty-four therapists and volunteer client dyads participated in three weekly counseling sessions. Before each session, therapists were induced to experience one of three moods, elation, depression, or neutral, in a counterbalanced order, using a combination of music and the Velten method. After each session, clients rated therapist empathy and session quality, therapists rated session quality, and observers rated therapist empathy using videotapes. Electrocardiogram was collected from therapists and clients during the session to assess heart rate synchrony as an indicator of therapist empathy. Therapist trait empathy moderated the effect of mood induction on observer-rated therapist empathy, such that when induced to experience elation, therapists with high trait empathy were observed to be more empathic, whereas therapists with low trait empathy were observed to be less empathic. Therapists of different trait empathy levels did not differ on observer-rated empathy when induced to experience depression or neutral mood. No significant effect of mood induction was found for client-rated empathy, client- and therapist-rated session quality, or heart rate synchrony. The experimental design offers preliminary evidence that therapist presession mood may influence the psychotherapy process. The findings are explained in light of empathy amplification and empathy attenuation hypotheses in relation to positive emotion. Practice and research implications are discussed. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

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).

Referring students for professional psychological help: A qualitative study of teachers' experience in Hong Kong.

Teachers have frequent interaction with students and are well positioned to refer students for mental health assistance when needed. Twelve secondary schoolteachers in Hong Kong were interviewed about their experience referring students to mental health professionals (MHPs). Using consensual qualitative research, multiple factors were found to influence teachers' referral decisions, including problem severity, students' willingness, stigma of help-seeking, parent/guardian's beliefs, teacher-parent/guardian relationship, MHPs' effectiveness and availability, quality of interaction with MHPs, and teachers' self-efficacy in handling student issues. Based on the findings, we propose a conceptual model of factors influencing teachers' referral decisions. Implications for research, practice, and training are discussed.

Therapist emotion and emotional change with clients: Effects on perceived empathy and session quality.

Therapists' emotion and therapist-client emotional congruence are associated with psychotherapy process and outcome. However, their presession emotional states are not consistently accounted for across studies, and the underlying mechanism is unclear. This study introduces the concepts of directional correspondence (DC), where therapists' and clients' emotions move in a similar direction from pre to postsession, and absolute agreement (AA), where therapist and client become closer in emotions from pre to postsession, to examine congruence in emotional change in therapist and client from pre to postsession. In addition, clients' perception of therapist empathy was investigated as a mediator between therapists' emotion/therapist-client emotional congruence and session outcome. Sixty nine clients and 49 therapists participated in this study over the course of therapy (593 sessions in total). They rated their emotions before and after each session, and clients rated therapist empathy and session quality after each session. Multilevel models showed that therapist presession emotions, therapist-client presession emotional similarity, and DC did not predict therapist empathy and session quality. However, AA predicted better therapist empathy, which in turn predicted better session quality. The partial mediation path was also stronger when therapist and client had more dissimilar presession emotions. Thus, clients may rate a session based on their perception of therapist empathy, which may reflect therapist and client moving toward more similar emotions over a session. In addition, the positive effect of therapist and client growing closer in emotions is especially pronounced when they start sessions in different emotional states. Implications of the findings are discussed. (PsycInfo Database Record (c) 2022 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.

Does peer relationship matter? A multilevel investigation of the effects of peer and supervisory relationships on group supervision outcomes.

Research in clinical supervision has primarily focused on the contribution of supervisors to training outcome. However, peers may also play a significant role in trainees' development, particularly during group supervision. Fifty-three trainees from 10 supervision groups completed measures of peer relationship, supervisory working alliance (SWA), supervision satisfaction (SAT), and counseling self-efficacy (CSE) at three time points during a 20-week counseling practicum at a department clinic in Hong Kong. Multilevel modeling was conducted to test the hypothesis that both peer relationship and SWA contribute to SAT and CSE. The path model results showed that higher within- and between-trainee SWA was associated with higher SAT, and higher between-trainee SWA was associated with higher CSE. Better within- and between-trainee peer relationship was associated with higher CSE, but not with SAT. Thus, when peer relationship and SWA were entered as predictors into the same analysis and allowed to control for each other's effects, they each have unique contributions to the outcome of group supervision. Implications for training and supervision research are discussed. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Altered topological organization of brain structural network in Chinese children with developmental dyslexia.

Increasing evidence indicates that developmental dyslexia (DD) is a "disconnection syndrome", and new probes of connectome were applied to investigate the "disconnection" in DD. However, there is a lack of brain connectome studies of Chinese dyslexics, who may have a different neural impairment pattern due to the logographic nature of Chinese. The aim of this study was to investigate the topological organization characteristics of the DD brain using a structural network based analysis on the volumetric covariance, which is a method with the advantage of reflecting brain developmental changes. Twenty-five children diagnosed with DD and twenty-five typically developing controls were included. The structural networks based on the pair-wise correlation of gray matter volume from 90 brain regions were constructed for the two groups and compared. Compared to controls, the structural network of dyslexic children exhibited significantly increased local efficiency combined with a tendency of decreased global efficiency and prolonged characteristic path length, thus reflecting a more locally specialized topological organization. Two brain areas showed significantly altered local regional network properties: the left precentral gyrus with increased bi, and the right Heschl's gyrus with decreased bi and ki. Moreover, a series of hub regions (especially the right fronto-temporal regions) identified in the network of typically developing children were not presented in the brain of DD. To our knowledge, this is the first whole-brain structural network study on Chinese dyslexics. This study provides evidence of brain topological organization changes in Chinese children with DD, and thus may help shed light on its neurobiological basis.