Motivation, Rapport, and Resilience: Three Pillars of Adolescent Therapy to Shift the Focus to Adulthood

Purpose The purpose of this clinical focus article is to encourage speech-language pathologists (SLPs) to shift their operational framework as students grow from childhood to adulthood by focusing on three pillars of interaction: motivation, rapport, and resilience. We need to foster greater independence and interpersonal skills in older students, but researchers have not explained how to help SLPs successfully transition their intervention strategies. Here, we identify three pillars of adolescent therapy—motivation, rapport, and resilience—to help clinicians shift their perspective from childhood to adulthood. We rely on social constructivism to guide practice and argue that client-centered models of therapy are more appropriate than therapist-centered models for adolescent students. For each pillar, we discuss clinician behaviors, student results, and clinical implications. Conclusions By strengthening these three pillars of interaction, clinicians can shift their focus toward client-centered therapy models and facilitate skills students need in adulthood. Strengthening skills related to motivation, rapport, and resilience will help support more symmetrical and flexible clinical partnerships in adolescent students with communication disorders.

A Feasibility Study Using a Machine Learning Suicide Risk Prediction Model Based on Open-Ended Interview Language in Adolescent Therapy Sessions

Background: As adolescent suicide rates continue to rise, innovation in risk identification is warranted. Machine learning can identify suicidal individuals based on their language samples. This feasibility pilot was conducted to explore this technology’s use in adolescent therapy sessions and assess machine learning model performance. Method: Natural language processing machine learning models to identify level of suicide risk using a smartphone app were tested in outpatient therapy sessions. Data collection included language samples, depression and suicidality standardized scale scores, and therapist impression of the client’s mental state. Previously developed models were used to predict suicidal risk. Results: 267 interviews were collected from 60 students in eight schools by ten therapists, with 29 students indicating suicide or self-harm risk. During external validation, models were trained on suicidal speech samples collected from two separate studies. We found that support vector machines (AUC: 0.75; 95% CI: 0.69–0.81) and logistic regression (AUC: 0.76; 95% CI: 0.70–0.82) lead to good discriminative ability, with an extreme gradient boosting model performing the best (AUC: 0.78; 95% CI: 0.72–0.84). Conclusion: Voice collection technology and associated procedures can be integrated into mental health therapists’ workflow. Collected language samples could be classified with good discrimination using machine learning methods.

The relation between the therapeutic alliance and communicative intentions in therapeutic interaction during the initial phase of adolescent therapy

This study aims to examine the connection between the therapeutic alliance (TA) – from both the patient’s and the therapist’s perspectives – and communicative intentions during the initial phase of adolescent psychotherapy. The sample comprised the first three sessions of 19 adolescents’ individual psychotherapeutic processes. Fifty therapeutic conversation segments were analyzed, representing 2043 adolescent and 3208 therapist speaking turns. The variables studied were Therapeutic Alliance, measured with the Working Alliance Inventory and Communicative Intentions (Exploring, Attuning and Resignifying), assessed by the Therapeutic Activity Coding System. A multilevel analysis was performed (HLM software). The Tasks dimension of the TA perceived by the adolescents increases the likelihood that their discourse will focus on providing and requesting information (Exploring), while also reducing the probability that they will seek to work together with the therapist to achieve mutual understanding (Attuning). The therapists’ discourse shows that a strong TA in the Bonds dimension makes it more probable for their utterances to focus on the construction of new meanings (Resignifying). Also, a stronger TA in the Goals dimension makes it more likely for their discourse to be directed toward seeking Attunement with the adolescent.

Clinical Use of Video Games

Despite the extreme popularity of video games among adolescents, researchers in the fields of developmental and social psychology examining video games have focused mainly on the association between video game use and negative outcomes, while research on positive outcomes is more limited. Video game, and the usage of video games, in (adolescent) therapy and (adolescent) psychotherapy is anything but ubiquitous. The research and clinical potential for combining video games and the communicative possibilities of the internet are immense. Hence, the purpose of this chapter is on video game and their usages in (adolescent) therapy and psychotherapy. This chapter will cover the history of video games, video games in psychotherapy, and the different types of video games and their usages in psychotherapy.

Clinical Use of Video Games

In the United, despite the extreme popularity of video games among adolescents, however, researchers in the fields of developmental and social psychology examining video game have focused mainly on the association between video game use and negative outcomes, while research on positive outcomes is more limited. Video game, and the usage of video games, in (adolescent) therapy and (adolescent) psychotherapy is any but ubiquitous. The research and clinical potential for combining video games and the communicative possibilities of the internet are immense. Hence, the purpose of this chapter is on video game and their usages in (adolescent) therapy and psychotherapy. This chapter will cover the history of video games, video games in psychotherapy, and the different types of video games and their usages in psychotherapy.