iCAST: Ein praktisches Modell für die Integration nonverbaler Signale in die Psychotherapie

Background Nonverbal behavior is considered an important factor of the therapeutic relationship across therapy schools. Despite a multitude of findings from a fruitful research phase in the 1960s–1980s, the currently available knowledge in this area is relatively moderate, and specific instructions for its use in psychotherapy remain rare. Research question Based on a practical model for the theory-independent utilization of nonverbal signals, a beneficial consideration and integration of this channel of communication is proposed. Material and methods The iCAST model with its five domains offers a possible framework, which encourages the concrete usage of nonverbal signals in psychotherapeutic interactions. An exemplary analysis of the movement behavior of therapists illustrates the current technological possibilities and offers insights into the potential of this observational position. Results Nonverbal signals expand the therapeutic degrees of freedom in diverse areas: besides the countless possibilities to address elements and to experience and practice them in sessions, nonverbal behavior can also provide important information on the level of case conceptualization. Discussion The focus on the dyad underlines the dynamic, joint process between patient and therapist and invites therapists to reflect on their own feelings and behavior against the background of mutual influence (attunement) and to incorporate them into the therapeutic process

Nonverbal synchrony in subjects with hearing impairment and their significant others.

Introduction Hearing loss has a great impact on the people affected, their close partner and the interaction between both, as oral communication is restricted. Nonverbal communication, which expresses emotions and includes implicit information on interpersonal relationship, has rarely been studied in people with hearing impairment (PHI). In psychological settings, non-verbal synchrony of body movements in dyads is a reliable method to study interpersonal relationship. Material and methods A 10-min social interaction was videorecorded in 39 PHI (29 spouses and 10 parent-child dyads) and their significant others (SOs). Nonverbal synchrony, which means the nonverbal behaviors of two interacting persons (referring to both general synchrony and the role of leading) and verbal interaction (percentage of speech, frequency of repetitions, and queries) were analyzed by computer algorithms and observer ratings. Hearing-related quality of life, coping mechanisms, general psychopathology, quality of relationship, and burden of hearing loss experienced by SOs were assessed using questionnaires. Results In the 39 dyads, true nonverbal synchrony differed from pseudosynchrony [t (43.4) = 2.41; p = 0.02] with a medium effect size (d = 0.42). Gender of PHI had a significant effect on general synchrony (p = 0.025) and on leading by SOs (p = 0.017). Age gap correlated with synchronic movements (p = 0.047). Very short duration of hearing impairment was associated with lower nonverbal synchrony in the role of leading by SOs (p = 0.031). Feeling of closeness by PHI correlated negatively with the role of leading by SOs (p > 0.001) and feeling of closeness by SOs was positively associated with leading by PHI (p = 0.015). No correlation was detected between nonverbal synchrony and other questionnaires. Burden experienced by the SOs was higher in SOs who reported less closeness (p = 0.014). Discussion A longer hearing impairment leads to more nonverbal leading by SOs compared to PHI with very short duration of hearing loss, possibly because of the long-lasting imbalance in communication. If PHI felt more closeness, SOs led less and vice versa. Burden experienced by SOs negatively correlated with closeness reported by SOs. Use of nonverbal signals and communication might help to improve benefits of auditory rehabilitation for PHI and decrease burden experienced by SOs

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

Background: Psychological literature emphasizes that self-regulation is important as goal intentions, goal setting, or implementation intention does not automatically result in effective results in coaching. The question which coaching strategies to apply to strengthening clients' self-regulatory capacities as prerequisites of effective change outcomes remains a black box in coaching.Method: This quantitative study explored clients' self-regulatory mechanisms by addressing how nonverbal synchrony influences clients' cognitive and emotional self-regulation across sessions. One hundred eighty-four coach–client pairs and their evolving change process were observed over 8 months. Video-recorded sessions were assessed with motion energy analysis to automatically capture coach and client nonverbal behavior and quantify nonverbal synchrony at the level of the dyad.Results: Synchrony was differentially associated with clients' post-session questionnaires on result-oriented problem-reflection and self-reflection, affect balance, and working alliance. Network analyses suggested that the association between synchrony and other process variables did not correspond to the previously found positive association between synchrony and positive aspects of alliance or outcome. Instead, this association depended on the level of perceived outcome.Discussion: Coaching success may be predicted by process variables assessed after each session: goal reflection, alliance, and mood all predict successful coaching. The assessment of nonverbal synchrony suggests a state-dependent effect of embodied processes on a coaching outcome that warrants further inspection

Nonverbal Synchrony: An Indicator of Clinical Communication Quality in Racially-Concordant and Racially-Discordant Oncology Interactions

Objectives The aim of this cross-sectional study was to apply a novel software to measure and compare levels of nonverbal synchrony, as a potential indicator of communication quality, in video recordings of racially-concordant and racially-discordant oncology interactions. Predictions include that the levels of nonverbal synchrony will be greater during racially-concordant interactions than racially-discordant interactions, and that levels of nonverbal synchrony will be associated with traditional measures of communication quality in both racially-concordant and racially-discordant interactions. Design This is a secondary observational analysis of video-recorded oncology treatment discussions collected from 2 previous studies. Setting Two National Cancer Institute-designated Comprehensive Cancer Centers and another large urban cancer center. Participants Participants from Study 1 include 161 White patients with cancer and 11 White medical oncologists. Participants from Study 2 include 66 Black/African-American patients with cancer and 17 non-Black medical oncologists. In both studies inclusion criteria for patients was a recent cancer diagnosis; in Study 2 inclusion criteria was identifying as Black/African American. Main outcome measures Nonverbal synchrony and communication quality. Results Greater levels of nonverbal synchrony were observed in racially-discordant interactions than in racially-concordant interactions. Levels of nonverbal synchrony were associated with indicators of communication quality, and these associations were more consistently found in racially-discordant interactions. Conclusion This study advances clinical communication and disparities research by successfully applying a novel approach capturing the unconscious nature of communication, and revealing differences in communication in racially-discordant and racially-concordant oncology interactions. This study highlights the need for further exploration of nonverbal aspects relevant to patient-physician interactions

Dyadic nonverbal synchrony during pre and post music therapy interventions and its relationship to self-reported therapy readiness

Nonverbal interpersonal synchronization has been established as an important factor in therapeutic relationships, and the differentiation of who leads the interaction appears to provide further important information. We investigated nonverbal synchrony – quantified as the coordination of body movement between patient and therapist. This was observed in music therapy dyads, while engaged in verbal interaction before and after a music intervention in the session. We further examined associations with patients’ self-reported therapy readiness at the beginning of the session. Eleven neurological in-patients participated in this study. Our results showed an increase in both nonverbal synchrony and patient leading after the music intervention. A significant negative correlation was found between self-reported therapy readiness and nonverbal synchrony after the music intervention. These findings point to the empathic ability of the music therapist to sense patients’ therapy readiness. Higher patient leading in nonverbal synchrony after the music intervention may thus indicate that the music intervention may have allowed dyadic entrainment to take place, potentially increasing self-regulation and thus empowering patients

Exploring the evolution of nonverbal synchrony in psychotherapy: The idiographic perspective provides a different picture

Objectives: A methodological obstacle for the assessment of psychotherapy process concerns the compatibility between nomothetic versus idiographic approaches. Using quantitative methodology at an idiographic level, we seek to narrow this gap for the special case of nonverbal synchrony in psychotherapy dyads. Methods: Using quantitative idiographic process analysis (QUIPA), we combined the assessments of nonverbal synchrony—the coordination of patient's and therapist's body-movement—quantified with motion energy analysis (MEA), patient- and therapist session-reports, and patient’s self-reports of symptomatology into multivariate time-series of psychotherapy process across the course of N = 12 dyadic psychotherapies with a total of N = 150 sessions. Adopting both mixed models as well as vector auto regressive models (VAR) to time-series, we aimed to extend previous results assessed in a randomized sample by exploring the evolution of nonverbal synchrony in psychotherapy dyads across time. Results: Aggregated idiographic data revealed that nonverbal synchrony was different from findings based on a previously reported nomothetic account: Associations with session-level outcome were weaker and did not replicate cross-sectional analyses. Conclusions: The application of idiographic assessments may help broadening our conception of synchrony in psychotherapy and also reminds us that ergodicity is not necessarily the usual case, but one of many possibilities

Innovative approaches to exploring processes of change in counseling psychology: Insights and principles for future research

In recent years, innovative approaches have been implemented in counseling and psychotherapy research, creating new and exciting interdisciplinary subfields. The findings that emerged from the implementation of these approaches demonstrate their potential to deepen our understanding of therapeutic change. This article serves as an introduction to the "Innovative Approaches to Exploring Processes of Change in Counseling Psychology" special issue. The special issue includes articles representing several of the most promising approaches. Each article seeks to serve as a sourcebook for implementing a given approach in counseling research, in such areas as the assessment of coregulation processes, language processing, physiology, motion synchrony, event-related potentials, hormonal measures, and sociometric signals captured by a badge. The studies included in this special issue represent some of the most promising pathways for future studies and provide valuable resources for researchers, as well as clinicians interested in implementing such approaches and/or being educated consumers of empirical findings based on such approaches. This introduction synthesizes the articles in the special issue and proposes a list of guidelines for conducting and consuming research that implements new approaches for studying the process of therapeutic change. We believe that we are not far from the day when these approaches will be instrumental in everyday counseling practice, where they can assist therapists and patients in their collaborative efforts to reduce suffering and increase thrivin

Nonverbal Synchrony and the Alliance in Psychotherapy for Major Depression: Disentangling State-Like and Trait-Like Effects

Given the importance of the alliance in psychotherapy, nonverbal synchrony has been suggested as a promising automatic objective marker of its levels and development. Accumulating research presents mixed results regarding the association between alliance and nonverbal synchrony. In the current study, we propose that one of the reasons for the inconsistencies is that previous studies did not disentangle trait-like characteristics from state-like changes occurring throughout treatment. To test this, we had 86 patients enrolled in an ongoing randomized controlled trial, along with their therapists, report their alliance levels after every session. Nonverbal movement synchrony was quantified by motion energy analysis for each of the 16 sessions of treatment. Findings suggest a significant association between nonverbal synchrony and the state-like effect of patient-reported alliance (p < .0001) but not for the trait-like effect. The results confirm the importance of disentangling the state-like and trait-like components because they may have distinct effects