Research identifies effective counseling tactics to cope crisis

Three researchers at Stanford University have analyzed anonymous data files and learned which tactics work best in counseling sessions over text-based crisis help lines.

Designed for people who prefer texting to talking over crisis hotlines, the text-based services generate large datasets of anonymous counseling sessions that researchers can study to identify the words and techniques that seem to improve outcomes.

Jure Leskovec, an associate professor of computer science at Stanford, worked with graduate students Tim Althoff and Kevin Clark to analyze 660,000 text messages from 15,000 crisis counseling sessions, and discovered that all counseling conversations followed five stages: introduction, problem setting, problem exploration, problem solving, and wrap-up.

Each stage can be characterized by the words counselors as well as texters use, according to a news release from Stanford.

For example, the introduction stage was marked by greetings on both sides and the wrap-up stage showed texters expressing appreciation and counselors using words like "any time."

These stages were independent of the topic, which could be anything from relationship troubles to thoughts of suicide.

The researchers developed new methods of natural language analysis to determine how the words and phrases that counselors used influenced whether distressed texters reported feeling better at the end of the conversation.

And by analyzing and comparing how the most successful and least successful counselors progressed through the stages, they discovered one key difference.

"Successful counselors quickly got to the heart of the issue and spent more of the conversation dealing with the problem," Althoff said. "The less successful counselors took a lot more time to get to know the problem."

In addition, successful counselors tend to respond more effectively to ambiguous messages. Presented with the same situation -- a breakup with a boyfriend or girlfriend, for example -- a successful counselor typically asks more clarifying questions. They paraphrase responses to make sure they understand, and they thank the texter for reaching out.

The analysis led the researchers to identify several techniques associated with successful sessions, such as personalizing exchanges, quickly getting to the root of the problem, and using words and phrases to steer conversations onto a positive track.

The study showed that texters tended to talk more about certain topics once counselors broached those topics. So counselors can put texters in a better frame of mind by making subtle changes to their own language.

"If you talk about the future, I will be more likely to talk about the future," Althoff said. "If I talk positively, you'll be more likely to talk positively."

"Until now, most research on counseling has remained small-scale, looking at voice transcripts of only a few dozen sessions," said Leskovec, who believes that new findings could be used to train counselors how to respond most effectively when a person in the midst of a crisis reaches out for help.

"We can look at orders of magnitude more data than previous studies allowed, to gain new insights and precisely quantify which counseling strategies worked." Endit