Observing Dialogue in Therapy: Categorizing and Forecasting Behavioral Codes

Abstract

Automatically analyzing dialogue can help understand and guide behavior in domains such as counseling, where interactions are largely mediated by conversation. In this paper, we study modeling behavioral codes used to asses a psychotherapy treatment style called Motivational Interviewing (MI), which is effective for addressing substance abuse and related problems. Specifically, we address the problem of providing real-time guidance to therapists with a dialogue observer that (1) categorizes therapist and client MI behavioral codes and, (2) forecasts codes for upcoming utterances to help guide the conversation and potentially alert the therapist. For both tasks, we define neural network models that build upon recent successes in dialogue modeling. Our experiments demonstrate that our models can outperform several baselines for both tasks. We also report the results of a careful analysis that reveals the impact of the various network design tradeoffs for modeling therapy dialogue. Code Count Description Examples Client Behavioral Codes FN 47715 Follow/ Neutral: unrelated to changing or sustaining behavior. "You know, I didn't smoke for a while." "I have smoked for forty years now." CT 5099 Utterances about changing unhealthy behavior. "I want to stop smoking." ST 4378 Utterances about sustaining unhealthy behavior. "I really don't think I smoke too much." Therapist Behavioral Codes FA 17468 Facilitate conversation "Mm Hmm.", "OK.","Tell me more." GI 15271 Give information or feedback. "I'm Steve.", "Yes, alcohol is a depressant." RES 6246 Simple reflection about the clients most recent utterance. C: "I didn't smoke last week" T: "Cool, you avoided smoking last week." REC 4651 Complex reflection based on a client's history or the broader conversation. C: "I didn't smoke last week." T: "You mean things begin to change". QUC 5218 Closed question "Did you smoke this week?" QUO 4509 Open question "Tell me more about your week." MIA 3869 Other MI adherent,e.g., affirmation, advising with permission, etc. "You've accomplished a difficult task." "Is it OK if I suggested something?