Synchrony and Reciprocity of Body Movements and Prosody Between Psychotherapist and Patient

Condition(s) studied

Investigational drug(s) / intervention(s)

Psychotherapy - Gestalt psychotherapy: Gestalt psychotherapy is an aesthetic-phenomenological approach that aims to improve self-awareness and integration by promoting emotional and relational well-being through what is happening in the present moment in the relationship with the therapist. The patient's current experiences are explored to better understand problems and behaviors and by promoting relational self-regulation

Study summary

Modern psychotherapy focuses on co-regulation, where therapist and patient interactively manage emotions. This co-regulation is seen in nonverbal communication like facial expressions, gestures, and prosody (vocal pitchs). Studies show body movements and even skin conductance synchronize between patients and therapists during sessions.

The RECiPROsody project builds on this by using technology (cameras, sensors) to record and analyze these synchronies in psychotherapy sessions. This project aims to understand how this "attunement" between therapist and patient contributes to successful therapy.

Researchers will explore how patients and therapists interact using a mobile app that records video, audio, physiological signals (heart rate), and movements. Questionnaires will assess patient well-being and therapist experience.

By studying these micro-processes, RECiPROsody hopes to gain insights into how the therapeutic relationship develops, including the connections between physical reactions, nonverbal communication, and overall progress. This knowledge can improve psychotherapeutic techniques and highlight the importance of the nonverbal communication in therapy.

Eligibility

Primary outcome measure(s)

• Clinical Outcomes in Routine Evaluation Outcome Measure (CORE-OM) — The questionnaire will be administered to patients pre-intervention, before the start of psychotherapy [T0] and 6 months after the start of psychotherapy [T1].
  CORE-OM is a 34-item self-administered questionnaire useful for assessing the outcome of psychological interventions. The CORE items relate to four domains: subjective well-being (4 items), symptoms/problems (12 items), functioning (12 items), and risk (6 items). Use of the CORE-OM provides useful insights by facilitating understanding of the patient's progress during the psychotherapeutic process. Each item is scored on a 5-point scale ranging from 0 (not at all) to 4 (most or all the time). The total score is calculated by adding the response values of all 34 items. The minimum score that can be achieved is 0 and the maximum 136, with higher scores indicating higher distress. Severity consists of six categories, characterizing respondents' psychological distress as either healthy (a score \< 6), low-level (6-9), mild (10-14), moderate (15-19), moderate-severe (20-24) or severe (a score \> 24).
• Therapist Response Questionnaire (TRQ) — The questionnaire will be filled out by psychotherapists after the first 4 psychotherapy sessions and every 4 sessions.
  The TRQ is a clinician report of 79 items that measure a wide spectrum of thoughts, feelings, and behaviors expressed by therapists toward their patients, ranging from relatively specific feelings (e.g., "I feel bored in sessions with him/her") to complex constructs, such as projective identification (e.g., "More than with most patients, I feel like I've been pulled into things that I didn't realize until after the session was over"). Items are derived by reviewing the clinical, theoretical, and empirical literature on countertransference and related variables, so that the instrument could be used comparably by therapists of any orientation. The clinicians assess each item on a 5-point Likert scale, ranging from 1 (not true) to 5 (very true). A total TRQ score was calculated by summing all 79 variables. The minimum score that can be achieved is 79 and the maximum 395. This TRQ total score was supposed to capture the general level of self-reported countertransference.
• Aesthetic Relational Knowing of the Therapist (ARK-T) — The questionnaire will be filled out by psychotherapists after the first 4 psychotherapy sessions.
  The ARK-T scale is a 21-items measure of the therapist's aesthetic and field intuition during the psychotherapeutic process. It is composed by three main factors, "Bodily Awareness" (8 items), "Intuitive Resonance" (8 items), "Affective Empathy" (5 items). Each item is scored on a 5-point scale ranging from 1 (strongly disagree) to 5 (strongly agree). The score could range from 21 to 105 and it could be correlate with the outcome of psychotherapy, or even with the measurement of relational factors such as the therapist's responsiveness, his or her self-compassion, and many other aspects developed within the various psychotherapeutic approaches. It will thus be possible to correlate this particular type of insight, to date little studied in the literature, with the effectiveness of psychotherapy, as well as with other aspects of the therapist's training and personality, e.g., personal psychotherapy, caring attitude toward self, ethics of responsivity toward the patient.
• Clinical Outcomes in Routine Evaluation - Assessment (CORE-A) — The instrument will be filled out by the therapist after the first 4 sessions.
  The CORE-A allows for the collection of demographic data regarding patient, referral (date, first episode, relapse), patient's resources (family, financial condition), previous or ongoing treatment to ongoing drug treatments, on the severity of the disorder (4-point scale) and its duration (\<6 months, 6-12 months, \>12 months, recurrent), data on self- and heterolesive risk (4-point scale), on the outcome of the assessment (accepted psychotherapy, sent, etc.)
• Clinical Outcomes in Routine Evaluation - End of therapy (CORE-E) — The instrument will be filled out by the therapist 6 months after the start of psychotherapy [T1].
  The CORE-E, also filled out by the therapist, collects data (comparable with the Assessment) on the type of psychotherapy performed, modality, frequency, mode of termination, reassessment of problems assessed at assessment and risk, assessment of contextual factors (motivation, therapeutic alliance, level of mentalization), benefits of therapy (e.g, insight capacity, expression of problems and moods, coping strategies, ability to make decisions, to ask for help, subjective well-being, symptoms, daily functioning, interpersonal relationships, possible drug therapy, and to agreements on possible follow-up).

Trial sites (1)

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