Synchrony in psychotherapy: High physiological positive concordance predicts symptom reduction and negative concordance predicts symptom aggravation

Gernert, Clara C.; Nelson, Afton; Falkai, Peter; Falter‐Wagner, Christine M. (2023): Synchrony in psychotherapy: High physiological positive concordance predicts symptom reduction and negative concordance predicts symptom aggravation. International Journal of Methods in Psychiatric Research. ISSN 1049-8931

Abstract

Objective
Therapeutic alliance is often considered as a predictor for therapeutic success. This study explored dyadic synchrony of skin conductance response (SCR) during naturalistic therapeutic interactions and investigated its potential as an objective biomarker for predicting therapy effectiveness.

Methods
In this proof-of-concept study, skin conductance from both dyad members was continuously measured via wristbands during psychotherapy. Patients and therapists completed post-session reports capturing their subjective appraisal of therapeutic alliance. Additionally, patients completed symptom questionnaires. Each therapeutic dyad was recorded twice in a follow-up design. The first session of the follow-up group was assessed for physiological synchrony (Single Session Index (SSI)). Therapy outcome was captured by the difference between symptom severity scores over time.

Results
SCR synchrony significantly predicted the outcome variable of change in patients' global severity index (GSI). High positive SCR concordance was linked to a reduction in patients' GSI, while negative or small positive SSI values were linked to an increase in patients' GSI.

Conclusion
The results demonstrate the presence of SCR synchrony in clinical interactions. Skin conductance response synchrony was a significant predictor for change in patients' symptom severity index, emphasizing its potential as an objective biomarker in the context of evidence-based psychotherapy.

• Doc-Type: Article (LMU Hospital)
• Organisational unit (Faculties): 07 Medicine > Medical Center of the University of Munich > Clinic and Polyclinic for Psychiatry and Psychotherapy
• DFG subject classification of scientific disciplines: Life sciences
• DFG: Funded by the Deutsche Forschungsgemeinschaft (DFG, German Research Foundation) - 491502892