Exploring the Discourse Attributes of Referential Process in Emotion Focused and Cognitive Behavioural Therapies for Depression
Bibliographic record
Abstract
The referential process (RP) refers to the way one’s nonverbal experiences are translated into verbal forms (Bucci, 1993; Bucci, Maskit, & Murphy, 2015). In the context of psychotherapy, three stages of the RP – activation of emotions, symbolization, and reflection – have been presented as a general framework for understanding change (Bucci, 2013). However, most of the studies on RP has been conducted in the context of psychodynamic treatment and in single case designs. Thus, the current study examined the discourse attributes of RP using session transcripts of 40 clients who underwent 16 sessions of cognitive behavioural therapy (CBT) or emotion focused therapy (EFT) for depression.The Discourse Attributes Analysis Program (DAAP; Maskit, Bucci, & Murphy, 2012), a computerized text analysis program that measures the discourse attributes RP, were applied to 80 session transcripts. Given that some therapists had worked with multiple clients and two sessions belonged to each client, Generalized Estimating Equation (GEE) was used to account for the nested structure of the data. The DAAP measures differed between EFT and CBT in the expected ways based on the theories of change that are rooted in each modality: there were more affect words in the EFT transcripts and more reflection words in the CBT transcripts. Overall, the two modalities did not differ in terms of the major measures of RP applied to clients’ and therapists’ speech. This substantiated Bucci (2013)’s theory that RP is an atheoretical framework for understanding change. The study unveiled novel information about specific in-session therapist processes that contribute to clients’ session ratings, as well as their overall treatment outcome. Therapists whose clients belonged to the good outcome group used more concrete, imagistic, specific, and clear language in the highest client rated sessions Additionally, the more that therapists used this style of language and spent more of the sessions doing so, the greater changes their clients perceived from their sessions. These findings imply that it is important for therapists to effectively connect to their experiences and communicate themselves clearly to their clients. Theoretical, clinical, and measurement implications, limitations, and directions for future research are discussed.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".