Clinical Validation of the Italian Measures of Referential Process to Match Practice and Research

Multiple Code Theory (MCT, Bucci 1997, 2020) provides an insightful psychodynamic framework for understanding psychopathology and psychotherapeutic work. A key concept of MCT is Referential Process (RP), through which individuals connect the different processing systems with which they experience the world. RP typically takes place in three phases during psychotherapy: the activation of emotion schemas; the narration of events, experiences and feelings related to them; and the reflection phase in which the emotion schemas can be reorganized. Several computerized linguistic measures, developed first in English and then in Italian, allow to detect the presence of these three RP phases by analyzing the language used in session. In this study, we wanted to validate the Italian version of these measures by testing their correlation with the clinical assessment performed by external judges on the same session excerpts. Applying the DAAPLab app to 20 transcripts of therapeutic sessions, we identified 103 session excerpts that clearly represented the three phases of RP, based on the computerized language measures. Five trained judges independently rated the presence of RP phases in these excerpts using a 5-point Likert scale. Discriminant analysis revealed that in 80% of the cases, the judges' ratings aligned with the classification based on the DAAPLab measures. These results confirm the reliability and sensitivity of the computerized language measure of RP. Several examples will be presented to show the potential of the DAAPLab application for therapists, supervisors, and researchers to identify the three phases of RP.