Nonverbal synchrony: A new approach to better understand psychotherapeutic processes and drop-out.

Abstract

Video-based measurement methods are new to psychotherapy research and provide new opportunities to investigate mechanisms of psychotherapeutic change related to nonverbal synchrony (movement coordination between patient and therapist). In this study, we validated the applied video-based procedures and evaluated nonverbal synchrony in association with the therapeutic relationship, therapy outcome, and drop-out. The naturalistic analysis sample consisted of 143 patients (136 videotaped sessions), who were treated with integrative cognitive–behavioral therapy at an out- patient clinic in southwest Germany. The videos were analyzed using Motion Energy Analysis (MEA), which provided a value for nonverbal synchrony. Patients routinely completed questionnaires assessing the therapeutic relationship and treatment success. We tested various confounding variables using multilevel modeling and investigated nonverbal synchrony in relation to measures of the therapeutic relationship. Further- more, we compared different types of outcomes with regard to nonverbal synchrony by means of multilevel modeling. The video-based procedures were shown to be highly valid. We found a link between the amount of nonverbal synchrony and therapeutic success; patients with nonimprovement and consensual termination showed the highest level, improved patients a medium level, and nonimproved patients with drop-out the lowest level of synchrony at the beginning of therapy, even when controlling for the therapeutic relationship. The study applied and evaluated a novel video-based approach in psychotherapy research and related it to common factors and the therapeutic process. Limitations of the automatic measurement methods and opportunities for the future routine prediction of drop-out are discussed.