ABSTRACT

Ruptures in the alliance have a potential to either undermine the treatment, leading to its premature termination, or to enhance it, leading to its success. Detecting ruptures is a critical step in therapy, especially concerning withdrawal ruptures that often go unnoticed because of the indirect expression of negative emotions. The present study explored whether acoustic data of a particular patient can serve as markers for ruptures, particularly withdrawal ruptures. Given the pioneering nature of the study, an exploratory approach based on a case study was chosen. The case-study showed that acoustic data can serve as markers of withdrawal ruptures (characterized by higher F0-span, pause proportion, and shimmer, and lower articulation rate than neutral speech) and of confrontation ruptures (characterized by higher F0-span and pause proportion than neutral speech). The limitations of a case study design are discussed. These findings add to previous knowledge and help to open the door to using feedback to assist clinicians in identifying the occurrence of ruptures and prevent deterioration in alliance and dropout.

摘要

联盟的破裂有可能破坏治疗，导致其过早终止，或增强治疗，导致其成功。检测破裂是治疗中的一个关键步骤，尤其是对于由于消极情绪的间接表达而经常被忽视的戒断破裂。本研究探讨了特定患者的声学数据是否可以作为破裂的标志，尤其是撤回破裂。鉴于这项研究的开创性，我们选择了基于案例研究的探索性方法。案例研究表明，声学数据可以作为撤回破裂的标志（以较高的 F0 跨度、停顿比例和微光为特征，和比中性语音更低的清晰度）和对抗破裂（以比中性语音更高的 F0 跨度和停顿比例为特征）。讨论了案例研究设计的局限性。这些发现增加了以前的知识，有助于打开使用反馈的大门，以帮助临床医生识别破裂的发生并防止联盟恶化和辍学。