Assessing the quality of digital patient-therapist communication: the development and validation of a text-based facilitative interpersonal skills task

Abstract

Objective

Text-based communication is becoming an increasingly salient feature of the psychotherapeutic landscape. Yet little is known about the factors distinguishing high- and low-quality therapeutic conversations taking place over this modality. Prior research on therapist effects has outlined several common factors associated with better clinical outcomes. But these common factors can only be researched in the context of text-based communication if they can be measured. Accordingly, we developed and validated a new behavioral task and coding system: the Facilitative Interpersonal Skills Performance Task for Text (FIS-T) to measure therapists’ messaging quality across eight dimensions of facilitative interpersonal skill.

Methods

1150 survey-takers rated the interpersonal dynamics and response difficulty of the FIS-T Task’s text-based stimuli. The FIS-T was then administered to 64 therapists.

Results

The FIS-T stimuli displayed similar interpersonal dynamics to those elicited by the original FIS task, demonstrated a similar range of difficulties to those of the video-based stimuli of the original FIS Task, and showed high inter-rater reliability.

Conclusions

The text-based FIS-T Task demonstrates high reliability and convergent validity with the original FIS Task, making it appropriate for use in assessing the common factors in text-based therapy. Future directions in the quality assessment of internet-delivered psychotherapies are discussed.

Keywords:

• Facilitative interpersonal skills
• common factors
• text-based therapy
• interpersonal circumplex
• paralinguistic restitution

Acknowledgements

We thank the following who provided codes for the FIS-T task: Scott Mimnaugh, Zeynep Guney, Ozge Pazar, Liam Bang, Jerzy Kaufman.

Disclosure Statement

No potential conflict of interest was reported by the author(s).

Supplemental Data

Supplemental data for this article can be accessed at https://doi.org/10.1080/10503307.2022.2156305.

Additional information

Funding

JZ and VKF received modest financial support from an internet-delivered therapy provider (www.talkspace.com) while developing the FIS-T vignettes and drafting the manuscript for publication. TDH is a contractor of the platform; Talkspace.