PDF(Pubmed)
Abstract：
BACKGROUND: Building therapeutic relationships and social presence are challenging in digital services and maybe even more difficult in written services. Despite these difficulties, in-person care may not be feasible or accessible in all situations.
OBJECTIVE: This study aims to categorize crisis counselors\' efforts to build rapport in written conversations by using deidentified conversation transcripts from the text and chat arms of the National Child Abuse Hotline. Using these categories, we identify the common characteristics of successful conversations. We defined success as conversations where help-seekers reported the hotline was a good way to seek help and that they were a lot more hopeful, a lot more informed, a lot more prepared to address the situation, and experiencing less stress, as reported by help-seekers.
METHODS: The sample consisted of transcripts from 314 purposely selected conversations from of the 1153 text and chat conversations during July 2020. Hotline users answered a preconversation survey (ie, demographics) and a postconversation survey (ie, their perceptions of the conversation). We used qualitative content analysis to process the conversations.
RESULTS: Active listening skills, including asking questions, paraphrasing, reflecting feelings, and interpreting situations, were commonly used by counselors. Validation, unconditional positive regard, and evaluation-based language, such as praise and apologies, were also often used. Compared with less successful conversations, successful conversations tended to include fewer statements that attend to the emotional dynamics. There were qualitative differences in how the counselors applied these approaches. Generally, crisis counselors in positive conversations tended to be more specific and tailor their comments to the situation.
CONCLUSIONS: Building therapeutic relationships and social presence are essential to digital interventions involving mental health professionals. Prior research demonstrates that they can be challenging to develop in written conversations. Our work demonstrates characteristics associated with successful conversations that could be adopted in other written help-seeking interventions.
OBJECTIVE: This study aims to categorize crisis counselors\' efforts to build rapport in written conversations by using deidentified conversation transcripts from the text and chat arms of the National Child Abuse Hotline. Using these categories, we identify the common characteristics of successful conversations. We defined success as conversations where help-seekers reported the hotline was a good way to seek help and that they were a lot more hopeful, a lot more informed, a lot more prepared to address the situation, and experiencing less stress, as reported by help-seekers.
METHODS: The sample consisted of transcripts from 314 purposely selected conversations from of the 1153 text and chat conversations during July 2020. Hotline users answered a preconversation survey (ie, demographics) and a postconversation survey (ie, their perceptions of the conversation). We used qualitative content analysis to process the conversations.
RESULTS: Active listening skills, including asking questions, paraphrasing, reflecting feelings, and interpreting situations, were commonly used by counselors. Validation, unconditional positive regard, and evaluation-based language, such as praise and apologies, were also often used. Compared with less successful conversations, successful conversations tended to include fewer statements that attend to the emotional dynamics. There were qualitative differences in how the counselors applied these approaches. Generally, crisis counselors in positive conversations tended to be more specific and tailor their comments to the situation.
CONCLUSIONS: Building therapeutic relationships and social presence are essential to digital interventions involving mental health professionals. Prior research demonstrates that they can be challenging to develop in written conversations. Our work demonstrates characteristics associated with successful conversations that could be adopted in other written help-seeking interventions.
摘要：
背景：在数字服务中，建立治疗关系和社交存在具有挑战性，在书面服务中甚至可能更加困难。尽管有这些困难,亲自护理可能并非在所有情况下都可行或可获得。
目的：这项研究旨在通过使用国家虐待儿童热线的文本和聊天臂中的不确定的对话记录，对危机顾问\'在书面对话中建立融洽关系的努力进行分类。使用这些类别，我们确定成功对话的共同特征。我们将成功定义为对话，其中寻求帮助的人报告热线是寻求帮助的好方法，并且他们更有希望，更多的信息，有更多的准备来解决这个问题，经历更少的压力，正如寻求帮助的人所报告的那样。
方法：样本包括2020年7月从1153个文本和聊天对话中故意选择的314个对话的笔录。热线用户回答了对话前调查(即，人口统计)和谈话后调查(即，他们对谈话的看法)。我们使用定性的内容分析来处理对话。
结果：积极的倾听技巧，包括提问,释义,反映感情,解释情况，通常被辅导员使用。验证,无条件的积极态度，和基于评估的语言，比如赞美和道歉，也经常使用。与不太成功的对话相比，成功的对话往往包括较少的涉及情绪动态的陈述。辅导员如何应用这些方法存在质的差异。一般来说,积极对话中的危机顾问倾向于更具体，并根据情况调整他们的评论。
结论：建立治疗关系和社会存在对于涉及心理健康专业人员的数字干预至关重要。先前的研究表明，在书面对话中发展它们可能具有挑战性。我们的工作展示了与成功对话相关的特征，可以在其他书面寻求帮助的干预中采用。
目的：这项研究旨在通过使用国家虐待儿童热线的文本和聊天臂中的不确定的对话记录，对危机顾问\'在书面对话中建立融洽关系的努力进行分类。使用这些类别，我们确定成功对话的共同特征。我们将成功定义为对话，其中寻求帮助的人报告热线是寻求帮助的好方法，并且他们更有希望，更多的信息，有更多的准备来解决这个问题，经历更少的压力，正如寻求帮助的人所报告的那样。
方法：样本包括2020年7月从1153个文本和聊天对话中故意选择的314个对话的笔录。热线用户回答了对话前调查(即，人口统计)和谈话后调查(即，他们对谈话的看法)。我们使用定性的内容分析来处理对话。
结果：积极的倾听技巧，包括提问,释义,反映感情,解释情况，通常被辅导员使用。验证,无条件的积极态度，和基于评估的语言，比如赞美和道歉，也经常使用。与不太成功的对话相比，成功的对话往往包括较少的涉及情绪动态的陈述。辅导员如何应用这些方法存在质的差异。一般来说,积极对话中的危机顾问倾向于更具体，并根据情况调整他们的评论。
结论：建立治疗关系和社会存在对于涉及心理健康专业人员的数字干预至关重要。先前的研究表明，在书面对话中发展它们可能具有挑战性。我们的工作展示了与成功对话相关的特征，可以在其他书面寻求帮助的干预中采用。
