Nonverbal synchrony of head- and body-movement in psychotherapy: different signals have different associations with outcome

OBJECTIVE The coordination of patient's and therapist's bodily movement - nonverbal synchrony - has been empirically shown to be associated with psychotherapy outcome. This finding was based on dynamic movement patterns of the whole body. The present paper is a new analysis of an existing dataset (Ramseyer and Tschacher, 2011), which extends previous findings by differentiating movements pertaining to head and upper-body regions. METHOD In a sample of 70 patients (37 female, 33 male) treated at an outpatient psychotherapy clinic, we quantified nonverbal synchrony with an automated objective video-analysis algorithm (motion energy analysis). Head- and body-synchrony was quantified during the initial 15 min of video-recorded therapy sessions. Micro-outcome was assessed with self-report post-session questionnaires provided by patients and their therapists. Macro-outcome was measured with questionnaires that quantified attainment of treatment goals and changes in experiencing and behavior at the end of therapy. RESULTS The differentiation of head- and body-synchrony showed that these two facets of motor coordination were differentially associated with outcome. Head-synchrony predicted global outcome of therapy, while body-synchrony did not, and body-synchrony predicted session outcome, while head-synchrony did not. CONCLUSION The results pose an important amendment to previous findings, which showed that nonverbal synchrony embodied both outcome and interpersonal variables of psychotherapy dyads. The separation of head- and body-synchrony suggested that distinct mechanisms may operate in these two regions: Head-synchrony embodied phenomena with a long temporal extension (overall therapy success), while body-synchrony embodied phenomena of a more immediate nature (session-level success). More explorations with fine-grained analyses of synchronized phenomena in nonverbal behavior may shed additional light on the embodiment of psychotherapy process.