Orienting to Emotion in Computer-Mediated Cognitive Behavioral Therapy

ABSTRACT

Exploring emotions is a defining feature of psychotherapy. This study explores how therapists orient to emotions when they cannot see or hear their clients. In analyzing 1,279 sessions of online text-based Cognitive Behavioral Therapy (CBT), we focused on therapists’ commiserations (e.g., “I’m sorry to hear that”) and their affective inferences (e.g., “that sounds very scary for you”). Both practices routinely prefaced moves to pursue a range of therapeutic activities, many of which did not prioritize sustained focus on the emotion that had just been oriented to. By separating message composition from message transmission, the modality used for these therapy sessions enabled therapists to combine orientations to emotion with attempts to shift the focus of discussion. Our analysis finds that although physically co-present and computer-mediated psychotherapy share a common focus on emotional experience, the modality used for therapy can be relevant in the design and use of these orientations. Data are in British English.

Notes

¹ Most uses of “sorry” in the corpus were used as apologies (Robinson, 2004), such as for arriving late to a session. Where there was ambiguity as to whether particular instances were apologies or commiserations (e.g., “Sorry for raising painful memories”), these were included in our collection for further analysis.

² “It sounds,” “that sounds,” or “sounds”-prefaced posts were used by therapists in our corpus to mark a diverse range of inferences. Given our focus on orientations to emotion, our study was restricted to affective inferences, with other types of inferences (e.g. “Well it does sound like you have left no stone unturned”) omitted from the collection.

³ Unlike commiserations, there is no vernacular gloss that describes the action accomplished by these practices (a potentially common problem in CA; see Schegloff, 1996, pp. 209–212). The closest technical term we are aware of, which is common in counseling literature, is “reflection of feeling” (Trepal et al., 2007). We have not appropriated this term here, however, in recognition that professional understandings of interactional practices may differ from empirical accounts of those practices (Peräkylä & Vehviläinen, 2003).

⁴ Prior research has demonstrated how the type of sequential organization found in talk-in-interaction can be disrupted in quasi-synchronous text-based online interaction (Garcia & Jacobs, 1998, 1999). Such disruption, however, does not routinely appear in the sequences we study. The variation between this study and Garcia and Jacobs’s research may reflect differences between the types of interactions examined. For example, where the current study has focused on dyadic interactions, Garcia and Jacobs focused on interactions involving larger numbers of participants. The impact of such factors on the sequential organization of quasi-synchronous text-based online interaction therefore warrants further investigation.