The language of psychotherapists Systematic review on the association of semantic characteristics with the therapeutic relationship and therapy outcome

Background Psychotherapy is based on conversations between patients and therapists. Today, there is a wide range of observer-based and computer-automated instruments available to study the language of therapists. Objective This article provides a systematic overview of empirical studies on the association between semantic characteristics of the language of therapists and the therapeutic relationship as well as the therapy outcome. Material and method The databases PubMed, PsycINFO and PSYNDEX were used to search for studies that examined the language of therapists in individual therapy settings with adult patients. Two authors screened titles, abstracts and full texts independently. From these studies relevant data, such as the measurement of dependent and independent variables and the key outcomes were extracted. A quality analysis was performed using the Quality in Prognosis Studies tool. Results Based on 3524 search results, 10 studies were finally included. The results of the lexical semantic studies related to therapeutic relationship and therapy outcome showed a) a negative association between words with cognitive connotation and the therapeutic relationship and therapy outcome, b) a negative association between neutral affective words and the therapeutic relationship, c) a positive association between words with affective connotation and therapy outcome and d) a positive association between words with emotional connotation and therapy outcome. The results of the discourse semantic studies showed that a reserved behavior of the therapist, opening up space to the patient while staying engaged, is more favorable for the therapeutic relationship and therapy outcome. Discussion With 10 included studies, the evidence base remains small. All studies show an association between the language of therapists and the therapeutic relationship and therapy outcome. In order to strengthen the evidence in this promising interdisciplinary field of research, it is recommended to consider further therapist, patient and process factors as potential influencing variables in future studies.

Automated summary

This article provides a systematic overview of empirical studies on the association between semantic characteristics of the language of therapists and the therapeutic relationship as well as the therapy outcome, highlighting both positive and negative associations between certain words and therapy outcomes.