The association of therapist empathy and synchrony in vocally encoded arousal.

Abstract

Empathy is a critical ingredient in motivational interviewing (MI) and in psychotherapy generally. It is typically defined as the ability to experience and understand the feelings of another. Basic science indicates that empathy is related to the development of synchrony in dyads. However, in clinical research, empathy has proved difficult to operationalize and measure, and has mostly relied on the felt sense of observers, clients, or therapists. We extracted estimates of therapist and standardized patient (SP) vocally encoded arousal (mean fundamental frequency; mean f0) in 89 MI sessions with high and low empathy ratings from independent observers. We hypothesized (a) therapist and SP mean f0 would be correlated and (b) the correlation of therapist and SP mean f0 would be greater in sessions with high empathy as compared with low. On the basis of a multivariate mixed model, the correlation between therapist and SP mean f0 was large (r = .71) and close to 0 in randomly assigned therapist–SP dyads (r = −.08). The association was higher in sessions with high empathy ratings (r = .80) than in sessions with low ratings (r = .36). There was strong evidence for vocal synchrony in clinical dyads as well as for the association of synchrony with empathy ratings, illustrating the relevance of basic psychological processes to clinical interactions. These findings provide initial evidence for an objective and nonobtrusive method for assessing therapist performance. Novel indicators of therapist empathy may have implications for the study of MI process as well as the training of therapists generally.

Using fundamental frequency of cancer survivors’ speech to investigate emotional distress in out-patient visits

“…anxiety, distress) can be identified as they are associated with higher f0 within the speaker's vocal range and context [16,26]. Furthermore, f0 is an advantage over other behavioural signals, as it is a nonintrusive tool and extracting vocal arousal can assess therapist's empathy through their relational pitch [22] [23]. A systematic search of 'Web of Science' and 'PubMed' databases demonstrated that f0 has never been used in oncology before.…”

“…One of the current goals of behavioural signal processing (BSP) is to combine human and machine observations of dyadic interactions to develop computational models that can assess social, emotional, and communicative states of interlocutors in great detail [21]. Beginning to integrate and test the applicability of these approaches to the study of health communication could therefore lead to great benefits, particularly when studying the vocal properties of empathy [22,23] Kirshnan and Fernandez's methods for recognising emotional states from speech indicate the importance of f0 (U.S. Patent No. 8,595,005 B2, 2013) [24].…”

“…If an abundance of neutral statements were present compared to cues and concerns for one patient, they were chosen at random. Following this, the prosody of the unit chunks was analysed using PRAAT 5.3.51 software [31] using a script developed by Imel et al [22] which calculated the mean f0 every 0.25 seconds and a band pass filter of 75 to 500 Hz was set to accommodate the range of human speech.…”

Soft Prosody and Embodied Attunement in Therapeutic Interaction: A Multimethod Case Study of a Moment of Change

“…the perception that a therapist is wholly engaged in and attuned with and for the client. Imel et al (2014) found strong evidence for vocal synchrony in clinical dyads, as well as an association between synchrony and client empathy ratings. On the basis of these observations, they suggested that synchrony in physiological arousal could be mediated in part via vocal cues.…”

“…Given the evidence underlining the importance of empathic communication in psychotherapy (e.g. Elliott, Bohart, Watson, and Greenberg, 2011) and the role of non-verbal aspects (Imel et al, 2014;Weiste and Peräkylä, 2014), we anticipated that soft prosody would be a prominent feature of expressions of affiliation. It appeared that soft prosody did indeed have a role in how the therapist and student showed affiliation with the weeping client.…”