Mentalization promotes psychoanalytic effect: Automated text analysis of transcribed psychoanalysis sessions to reflective performance evaluation

Psychoanalysis session transcriptions provide a thorough account of therapeutic exchanges that captures the subtleties of the therapist-client conversation. The Reflective Functioning (RF) scale was created to scientifically evaluate a person's ability to mentally represent their own and other people's ideas, intentions, emotions, and beliefs pertaining to attachment connections. The Automated Text Analysis of Reflective Functioning (ARF) was developed to overcome the scoring challenge of the RF scale. Research presents the findings of an exploratory investigation that used the ARF to analyze 540 sessions from 27 psychoanalytic therapies. The findings demonstrate a favorable correlation between patients' RF, as assessed at the start of therapy, and the Global Assessment of Functioning (GAF) and the Personality Health Index (PHI), two international indicators of healthy personality functioning, as assessed at the conclusion of treatment. These relationships persisted even after taking into the PHI and GAF degrees at the beginning of treatment, the length of the treatments, and the average number of weekly sessions. However, the RF of the patients did not rise over the course of therapy. It means that reflective functioning itself is highly correlated with the overall mental health outcomes, however, it might not be directly enhanced due to such psychoanalytic interventions. The findings highlight the predictive nature of the baseline RF levels to the long-term outcomes of therapeutic actions, indicating that those who enter the treatment with higher reflective abilities are more likely to have higher levels of functional changes. In addition, the results demonstrate that ARF is a useful and effective instrument in conducting large-scale assessments of reflective functioning in clinical situations. These ramifications have implications in both clinical practice and research whereby reflective functioning has been noted as an important psychological construct in determining the efficacy of psychoanalytic therapy.