The Autonomic Response Screening Tool for Counselors ( ARSTC ): Initial Development and Validation

Objective Autonomic regulation can be skewed by stress or trauma and has important implications for a client's capacity to engage in psychotherapy, yet there are few tools available to support practitioners in assessing autonomic regulation in session. This study was conducted to develop and validate a checklist of cues, based on polyvagal theory (PVT), to aid practitioners in tracking autonomic regulation in psychotherapy sessions. Method Clients ( N = 17) from a university counselling training clinic were recruited to wear pulse sensors during their video‐recorded counselling sessions to provide heart rate variability (HRV) data. Once the Autonomic Response Screening Tool for Counselors (ARSTC) was created, two trained reviewers independently coded and labelled 257 one‐minute clips across 17 sessions. ARSTC labels were analysed against HRV data to explore the accuracy of labels in assessing autonomic responses outlined in PVT. Results A two‐factor model was the best fit for the ARSTC, resulting in a parasympathetic factor and a sympathetic factor. An ANOVA was used to analyse the external validity of the three ARSTC labels compared to measures of HRV, to account for the theoretical differences that informed the development of the ARSTC outlined in PVT. ANOVA and a Tukey's post hoc test results revealed significant differences between the HRV for clips labelled as Social Engagement versus those labelled as Freeze and Fight/Flight versus Freeze. Conclusion The ARSTC is an accessible and psychometrically promising tool to help counsellors track client autonomic regulation in session. Additional research is needed to further validate the ARSTC and to better understand group‐specific differences in autonomic trends.