Nonverbal synchrony in psychotherapy: coordinated body movement reflects relationship quality and outcome

J Consult Clin Psychol. 2011 Jun;79(3):284-95. doi: 10.1037/a0023419.


Objective: The authors quantified nonverbal synchrony--the coordination of patient's and therapist's movement--in a random sample of same-sex psychotherapy dyads. The authors contrasted nonverbal synchrony in these dyads with a control condition and assessed its association with session-level and overall psychotherapy outcome.

Method: Using an automated objective video analysis algorithm (Motion Energy Analysis; MEA), the authors calculated nonverbal synchrony in (n = 104) videotaped psychotherapy sessions from 70 Caucasian patients (37 women, 33 men, mean age = 36.5 years, SD = 10.2) treated at an outpatient psychotherapy clinic. The sample was randomly drawn from an archive (N = 301) of routinely videotaped psychotherapies. Patients and their therapists assessed session impact with self-report post-session questionnaires. A battery of pre- and postsymptomatology questionnaires measured therapy effectiveness.

Results: The authors found that nonverbal synchrony is higher in genuine interactions contrasted with pseudointeractions (a control condition generated by a specifically designed shuffling procedure). Furthermore, nonverbal synchrony is associated with session-level process as well as therapy outcome: It is increased in sessions rated by patients as manifesting high relationship quality and in patients experiencing high self-efficacy. Higher nonverbal synchrony characterized psychotherapies with higher symptom reduction.

Conclusions: The results suggest that nonverbal synchrony embodies the patients' self-reported quality of the relationship and further variables of therapy process. This hitherto overlooked facet of therapeutic relationships might prove useful as an indicator of therapy progress and outcome.

MeSH terms

  • Adult
  • Databases, Factual
  • Female
  • Humans
  • Male
  • Mental Disorders / psychology
  • Mental Disorders / therapy*
  • Middle Aged
  • Motor Activity*
  • Movement*
  • Personal Satisfaction
  • Professional-Patient Relations*
  • Psychotherapy*
  • Self Efficacy
  • Treatment Outcome