Patterns of early change in interpersonal problems and their relationship to nonverbal synchrony and multidimensional outcome.

Abstract

Early change is an increasing area of investigation in psychotherapy research. In this study, we analyzed patterns of early change in interpersonal problems and their relationship to nonverbal synchrony and multiple outcome measures for the first time. We used growth mixture modeling to identify different latent classes of early change in interpersonal problems with 212 patients who underwent cognitive-behavioral treatment including interpersonal and emotion-focused elements. Furthermore, videotaped sessions were analyzed using motion energy analysis, providing values for the calculation of nonverbal synchrony to predict early change in interpersonal problems. The relationship between early change patterns and symptoms as well as overall change in interpersonal problems was also investigated. Three latent subgroups were identified: 1 class with slow improvement (n ϭ 145), 1 class with fast improvement (n ϭ 12), and 1 early deterioration class (n ϭ 55). Lower levels of early nonverbal synchrony were significantly related to fast improvement in interpersonal change patterns. Furthermore, such patterns predicted treatment outcome in symptoms and interpersonal problems. The results suggest that nonverbal synchrony is associated with early change patterns in interpersonal problems, which are also predictive of treatment outcome. Limitations of the applied methods as well as possible applications in routine care are discussed.Editor's Note. Sigal Zilcha-Mano served as the action editor for this article.-DMK Jr.

Change Process in Coaching: Interplay of Nonverbal Synchrony, Working Alliance, Self-Regulation, and Goal Attainment

“…Indeed, a further study on nonverbal synchrony in psychotherapy pointed toward an optimal (middle) level of synchrony, where low nonverbal synchrony was found to be an indicator of dropout and high nonverbal synchrony to be a predictor of early termination (Paulick et al, 2018a ). This also falls in line with recent work, where nonverbal synchrony in the third session of psychotherapy predicted lower success later in therapy (Lutz et al, 2020 ). We interpret the goal-related findings in the temporal networks (i.e., low synchrony being associated with high goal attainment while high synchrony being associated with low goal attainment and low goal orientation) as yet another indication that synchrony emerges as a correctional mechanism in dyads, and that we may have to look beyond average levels of synchrony toward more smaller-scale dynamics of synchrony, a phenomenon that has been called “symmetry building” and “symmetry breaking” (Boker and Rotondo, 2002 ).…”

“…Goal attainment is measured through goal-directed behavior scales and is mediated via Self-Regulation as a process. these findings, but other studies failed to confirm a positive association between synchrony and alliance (Paulick et al, 2018b;Schoenherr et al, 2019a,b;Lutz et al, 2020). One of these contradicting studies suggests that the association between nonverbal synchrony and alliance may depend on whether it was assessed from a nomothetic or an idiographic perspective (Ramseyer, 2020a).…”

“…In the domain of psychotherapy process research, nonverbal synchrony was found to embody aspects of the therapeutic alliance (Ramseyer and Tschacher, 2011 ; Altmann et al, 2020 ; Cohen et al, 2020 ) and also predicted therapy outcome assessed by pre-to-post symptomatology (Ramseyer and Tschacher, 2011 ). The In-Sync model (Koole and Tschacher, 2016 ) has been suggested as a possible theoretical framework for these findings, but other studies failed to confirm a positive association between synchrony and alliance (Paulick et al, 2018b ; Schoenherr et al, 2019a , b ; Lutz et al, 2020 ). One of these contradicting studies suggests that the association between nonverbal synchrony and alliance may depend on whether it was assessed from a nomothetic or an idiographic perspective (Ramseyer, 2020a ).…”

Disentangling Trait-Like Between-Individual vs. State-Like Within-Individual Effects in Studying the Mechanisms of Change in CBT

“…In addition to EMA, the expansion of "passive" (i.e., no user input required) measurement methods also holds promise for examining predictors and processes of change, including sensor data (e.g., activity levels and movement from accelerometer and GPS, proxies of social interaction from call and text meta-data) from smartphones and wearables (43), as well as other markers based on motion (44,45), acoustic and language style (46)(47)(48) and physiology (49). The extent to which biological variables, such as hormones (50), neuroimaging (51-53) and inflammatory biomarkers (54), provide incremental predictive validity above conventional (and less costly and time-consuming) self-report measures is also an important area of research (55).…”

Language and Movement Synchronization in Dyadic Psychotherapeutic Interaction – A Qualitative Review and a Proposal for a Classification

“…However, the current evidence on the synchrony-outcome link is not unequivocal (Lutz et al, 2020) investigated the correlation of movement synchrony and early change in psychotherapy. In a sample of 212 patients with mixed diagnoses who underwent cognitive behavioral psychotherapy, three subgroups were identified with regard to early changes in treatment: one subgroup with slow improvement, one with fast improvement and one with early deterioration.…”