Intrapersonal and Interpersonal Vocal Affect Dynamics During Psychotherapy

Objective: The present study implements an automatic method of assessing arousal in vocal data as well as dynamic system models to explore intrapersonal and interpersonal affect dynamics within psychotherapy and to determine whether these dynamics are associated with treatment outcomes. Method: The data of 21,133 mean vocal arousal observations were extracted from 279 therapy sessions in a sample of 30 clients treated by 24 therapists. Before and after each session, clients self-reported their well-being level, using the Outcome Rating Scale. Results: Both clients' and therapists' vocal arousal showed intrapersonal dampening. Specifically, although both therapists and clients departed from their baseline, their vocal arousal levels were "pulled" back to these baselines. In addition, both clients and therapists exhibited interpersonal dampening. Specifically, both the clients' and the therapists' levels of arousal were "pulled" toward the other party's arousal level, and clients were "pulled" by their therapists' vocal arousal toward their own baseline. These dynamics exhibited a linear change over the course of treatment: whereas interpersonal dampening decreased over time, there was an increase in intrapersonal dampening over time. In addition, higher levels of interpersonal dampening were associated with better session outcomes. Conclusions: These findings demonstrate the advantages of using automatic vocal measures to capture nuanced intrapersonal and interpersonal affect dynamics in psychotherapy and demonstrate how these dynamics are associated with treatment gains. Public Health Significance Statement The current findings highlight the potential of computerized vocal analyses to capture moment-by-moment processes within psychotherapy sessions. They suggest that clients and therapists exhibit both intrapersonal (within person) as well as interpersonal (between person) affect dynamics in their in-session emotional arousal levels. Specifically, both clients and therapists not only tended to return to their own affective arousal baseline but also tended to be "pulled" by their partner toward their baseline arousal level. The findings advance the idea that therapists who are synchronized with their clients, but at the same time downregulate their own and their clients' affect, may be more successful in helping their clients develop better affective regulation capabilities.