Mental health counseling is an enterprise with profound societ al importance where conversations play a primary role. In order to acquire the conversational skills needed to face a challenging range of situations, mental health counselors must rely on training and on continued experience with actual clients. However, in the absence of large scale longitudinal studies, the nature and significance of this developmental process remain unclear. For example, prior literature suggests that experience might not translate into consequential changes in counselor behavior. This has led some to even argue that counseling is a profession without expertise. In this work, we develop a computational framework to quantify the extent to which individuals change their linguistic behavior with experience and to study the nature of this evolution. We use our framework to conduct a large longitudinal study of mental health counseling conversations, tracking over 3,400 counselors across their tenure. We reveal that overall, counselors do indeed change their conversational behavior to become more diverse across interactions, developing an individual voice that distinguishes them from other counselors. Furthermore, a finer-grained investigation shows that the rate and nature of this diversification vary across functionally different conversational components.
Language in the mental health domain Prior literature has underlined the importance of linguistic choices and conversational behavior in mental health-related contexts. Qualitative @cite_4 @cite_41 @cite_26 @cite_16 and computational @cite_0 @cite_31 @cite_47 @cite_48 @cite_24 studies of dialogic interactions in counseling and psychotherapy have highlighted the potential benefits of conversational skills---such as a counselor's ability to reflect on a client's particular concerns. Other work has considered a broader range of settings such as online forums, exploring how psychological support is sought and provided @cite_40 @cite_42 @cite_1 @cite_49 @cite_21 @cite_36 . While these studies have focused on linguistic behaviors in the scope of single interactions, we seek to understand how these behaviors develop over time.
@cite_47 @cite_26 @cite_4 @cite_41 @cite_48 @cite_36 @cite_42 @cite_1 @cite_21 @cite_0 @cite_24 @cite_40 @cite_49 @cite_31 @cite_16
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Mental illness is one of the most pressing public health issues of our time. While counseling and psychotherapy can be effective treatments, our knowledge about how to conduct successful counseling conversations has been limited due to lack of large-scale data with labeled outcomes of the conversations. In this paper, we present a large-scale, quantitative study on the discourse of text-message-based counseling conversations. We develop a set of novel computational discourse analysis methods to measure how various linguistic aspects of conversations are correlated with conversation outcomes. Applying techniques such as sequence-based conversation models, language model comparisons, message clustering, and psycholinguistics-inspired word frequency analyses, we discover actionable conversation strategies that are associated with better conversation outcomes. The process of eliciting client language toward change (change talk [CT]) is implicated as a causal mechanism in motivational interviewing (MI) and brief motivational interventions (BMI). We investigated the articulation of counselor behaviors and CT during BMI with young men. We coded 149 sessions using the Motivational Interviewing Skill Code and summarized these codes into three counselor categories (MI-consistent [MICO], MI-inconsistent [MIIN], other) and three client categories (CT, counter CT [CCT], follow neutral [F N]). We then computed immediate transition frequencies and odds ratios using sequential analysis software. CT was significantly more likely following MICO behaviors, whereas MIIN behaviors only led to CCT and F N. This strongly supports the use of MI skills to elicit CT during BMI with young men, whose speech also predicted counselor behaviors (particularly CT to MICO and CCT to MIIN). Additional analyses showed that among MICO behaviors, reflective listening may be a particularly powerful technique to elicit CT. The psycholinguistic theory of communication accommodation accounts for the general observation that participants in conversations tend to converge to one another's communicative behavior: they coordinate in a variety of dimensions including choice of words, syntax, utterance length, pitch and gestures. In its almost forty years of existence, this theory has been empirically supported exclusively through small-scale or controlled laboratory studies. Here we address this phenomenon in the context of Twitter conversations. Undoubtedly, this setting is unlike any other in which accommodation was observed and, thus, challenging to the theory. Its novelty comes not only from its size, but also from the non real-time nature of conversations, from the 140 character length restriction, from the wide variety of social relation types, and from a design that was initially not geared towards conversation at all. Given such constraints, it is not clear a priori whether accommodation is robust enough to occur given the constraints of this new environment. To investigate this, we develop a probabilistic framework that can model accommodation and measure its effects. We apply it to a large Twitter conversational dataset specifically developed for this task. This is the first time the hypothesis of linguistic style accommodation has been examined (and verified) in a large scale, real world setting. Furthermore, when investigating concepts such as stylistic influence and symmetry of accommodation, we discover a complexity of the phenomenon which was never observed before. We also explore the potential relation between stylistic influence and network features commonly associated with social status. Three experiments were conducted to determine the psychometric properties of language in dyadic interactions. Using text-analysis, it was possible to assess the degree to which people coordinate their word use in natural conversations. In Experiments 1 (n = 130) and 2( n = 32), college students interacted in dyadic conversations in laboratory-based private Internet chat rooms. Experiment 3 analyzed the official transcripts of the Watergate tapes involving the dyadic interactions between President Richard Nixon and his aids H. R. Haldeman, John Erlichman, and John Dean. The results of the three studies offer sub- stantial evidence that individuals in dyadic interactions exhibit linguistic style matching (LSM) on both the conversation level as well as on a turn-by-turn level. Furthermore, LSM is unrelated to ratings of the quality of the interaction by both participants and judges. We propose that a coordination-engagement hypothesis is a better description of linguistic behaviors than the coordination-rapport hypothesis that has been proposed in the nonver- bal literature. For years social psychologists have exalted the power of the situa- tion. We comfortably acknowledge that across different situations, with different people, we may act in a range of ways, or even talk using a variety of styles. Aware of this tendency, Gergen (1972) began his explorations of our shifting masks of identity. In writing letters to close friends, he realized that he came across as a "completely different per- son" in each letter. "In one, I was morose, pouring out a philosophy of existential sorrow; in another I was a lusty realist: in a third I was a lighthearted jokester" (p. 32). Based merely on his word choices, Gergen inadvertently varied his style to adapt to the recipients of his letters. This is a prime demonstration of our inherent knowledge of the mutability of our language with respect to varying social contexts.