Changes in Speech Rhythm and Language-Style Between In-Person and Remote Treatment.

This study examined differences in clinical process-as measured via pause length and frequency, and language-style-between in-person and Zoom treatment formats in the psychodynamic treatment of a man with a diagnosis of Body Dysmorphic Disorder. While the COVID-19 pandemic saw the widespread adoption of remote videoconferencing software across a range of talk therapy formats, differences in clinical process between Zoom and in-person treatment formats still have not been widely investigated. This study examined turn-taking dynamics in therapy, a development with ramifications for clinical process as conceptualized via the Referential Process construct of Multiple Code Theory. This study is the first application of the new T-DAAP, the Time-based Discourse Attributes Analysis Program, which analyzes transcripts using measures of Referential Process functions-Arousal, Symbolizing, and Reflecting/Reorganizing-in terms of elapsed time rather than standard methods based on word count. Differences in number and length of pauses, and Referential Process measures (WRAD and WRRL) were compared between 8 in-person and 8 Zoom sessions from the Spring of 2020. Mean pause length was significantly lower in the Zoom condition than in the in-person condition, for both participants, for both within-, and between-speakers pauses. The patient also showed a larger number of turn-taking pauses, and a higher level of Reflection in the Zoom condition, while other Referential Process measures remained largely consistent for the two participants. Ramifications for the understanding of clinical process were explored.