More than words: The role of therapists' prosody—Reflections from practitioners

OBJECTIVE: Aspects of prosody, such as speech rate and pitch, influence how speakers are perceived and are likely to be relevant in psychotherapy. However, the role of prosody in therapy and how therapists use it is not well understood. This study aims to understand how therapists experience the role that their prosody plays in their daily work. METHOD: We conducted 25 semi-structured interviews and analyzed accounts by therapists from different theoretical backgrounds. Responses were analyzed using reflexive thematic analysis. RESULTS: Therapists attributed important functions to their use of voice and variations in prosody during therapeutic interactions. We describe key functions of prosody in five themes: Theme I: creating a feeling of calm, safety, consolation and benevolence; Theme II: making patients feel acknowledged and understood empathically; Theme III: providing a holding and stable counterpart; Theme IV: Create space and awareness for new depth; Theme V: Model affectivity. CONCLUSION: Prosodic variations that respond to patients' needs are thought to facilitate emotion regulation and insight. Studying prosody in therapy enables researchers to examine micro-level processes and unconscious dynamics.