Patterns of early change in interpersonal problems and their relationship to nonverbal synchrony and multidimensional outcome.

Early change is an increasing area of investigation in psychotherapy research. In this study, we analyzed patterns of early change in interpersonal problems and their relationship to nonverbal synchrony and multiple outcome measures for the first time. We used growth mixture modeling to identify different latent classes of early change in interpersonal problems with 212 patients who underwent cognitive-behavioral treatment including interpersonal and emotion-focused elements. Furthermore, videotaped sessions were analyzed using motion energy analysis, providing values for the calculation of nonverbal synchrony to predict early change in interpersonal problems. The relationship between early change patterns and symptoms as well as overall change in interpersonal problems was also investigated. Three latent subgroups were identified: 1 class with slow improvement (n = 145), 1 class with fast improvement (n = 12), and 1 early deterioration class (n = 55). Lower levels of early nonverbal synchrony were significantly related to fast improvement in interpersonal change patterns. Furthermore, such patterns predicted treatment outcome in symptoms and interpersonal problems. The results suggest that nonverbal synchrony is associated with early change patterns in interpersonal problems, which are also predictive of treatment outcome. Limitations of the applied methods as well as possible applications in routine care are discussed. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Physiological synchrony and therapeutic alliance in an imagery-based treatment.

Client-therapist synchrony in various channels (e.g., self-reported affect or physical movement) has been shown as a key process in the construction and development of therapeutic alliance. However, psychophysiological synchrony between clients and therapists has been understudied, with the few extant studies typically relying on single-session data, and no studies examining it within the context of emotion-focused techniques. The main aim of the current paper is to examine the role of client-therapist physiological synchrony during segments of one emotion-focused technique-namely, imagery (IM) work-in predicting therapeutic alliance, and to compare it to the role of synchrony during segments of more traditional cognitive-behavioral (CB) techniques. We conducted an open-trial study in which 31 clients with test anxiety received a 6-session protocol-based treatment. Both clients' and therapists' electrodermal activity (EDA) were continuously assessed during sessions. The physiological measures for 5 sessions each (N = 128) were used to compute client-therapist synchrony in IM and CB segments. Therapeutic alliance was assessed using the Session Alliance Inventory. Client-therapist dyads' synchrony during IM and CB segments was, on average, greater than chance. Synchrony varied mostly at the session (vs. the dyad) level. Multilevel analyses revealed that the synchrony within IM segments (but not within CB segments) was significantly associated with the therapeutic bond aspect (but not the task/goal aspects) of alliance. Physiological synchrony during emotion-focused IM is tied to the bond component of the therapeutic alliance at the session level. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Imagery-based treatment for test anxiety: A multiple-baseline open trial.

BACKGROUND: Many students are affected by test anxiety (TA), which involves considerable distress and can lead to reduced performance. Despite its prevalence, TA has been under-studied; specifically, few effective and brief interventions have been identified to date. In our work, we explore the adaptation of imagery, an emotion-focused treatment technique used widely in the treatment of other anxiety disorders, for addressing TA. METHODS: In a two-site concurrent multiple-baseline pilot study (n = 31), we examined the effectiveness of a targeted six-session protocol developed for the treatment of TA, which integrates traditional cognitive behavioral techniques with imagery work. RESULTS: The protocol was well-accepted by clients. We found that students' test anxiety levels did not drop between the recruitment and pre-intervention assessments, but did drop significantly from recruitment or baseline to the delayed follow-up (Cohen's d = 0.75 and 0.84, respectively). We also found evidence for session-level processes tying the quality of the imagery work with session efficacy. LIMITATIONS: The study involved a relatively small sample size, leading to weaker power to detect treatment effects. Moreover, some clients did not have any exams scheduled before the delayed follow-up assessment. Due to the scheduling intensity of the sessions, some clients had insufficient time to implement or practice skills and to complete tasks discussed in the sessions. CONCLUSIONS: This study provides preliminary evidence for the utility of integrating imagery work with traditional cognitive-behavioral techniques for treating test anxiety.