ABSTRACT
OBJECTIVE: The literature on affective regulation in psychotherapy has traditionally relied on explicit client self-report measures. However, both clients' and therapists' affect fluctuate moment-to-moment during a session, highlighting the need for more implicit and continuous indices to better understand these dynamics. This study examined parasympathetic interpersonal and intrapersonal regulation dynamics between therapists and clients with Major Depressive Disorder during Supportive-Expressive Therapy. METHOD: Data were collected from 52 dyads across five preselected sessions, using the Respiratory Sinus Arrhythmia (RSA) index. We employed a longitudinal Actor-Partner Interdependence Model, with clients self-reporting their functioning level before and after each session, as the moderator. RESULTS: Therapists' RSA at one time point negatively associated with clients' RSA at the next, and vice-versa, indicating interpersonal regulation. Clients' RSA at one time point was positively associated with their RSA at the next, indicating intrapersonal regulation. However, only interpersonal regulation was significantly moderated by clients' pre-to-post session functioning. Specifically, sessions where clients led positive dyadic RSA associations showed greater improvement in clients' functioning than those led by therapists. CONCLUSION: Physiological interpersonal regulation, measured by RSA, may be a catalyst for change in depression treatment. Therapists who are responsive to clients' arousal levels may help clients improve their functioning.
ABSTRACT
OBJECTIVE: The present study implements an automatic method of assessing arousal in vocal data as well as dynamic system models to explore intrapersonal and interpersonal affect dynamics within psychotherapy and to determine whether these dynamics are associated with treatment outcomes. METHOD: The data of 21,133 mean vocal arousal observations were extracted from 279 therapy sessions in a sample of 30 clients treated by 24 therapists. Before and after each session, clients self-reported their well-being level, using the Outcome Rating Scale. RESULTS: Both clients' and therapists' vocal arousal showed intrapersonal dampening. Specifically, although both therapists and clients departed from their baseline, their vocal arousal levels were "pulled" back to these baselines. In addition, both clients and therapists exhibited interpersonal dampening. Specifically, both the clients' and the therapists' levels of arousal were "pulled" toward the other party's arousal level, and clients were "pulled" by their therapists' vocal arousal toward their own baseline. These dynamics exhibited a linear change over the course of treatment: whereas interpersonal dampening decreased over time, there was an increase in intrapersonal dampening over time. In addition, higher levels of interpersonal dampening were associated with better session outcomes. CONCLUSIONS: These findings demonstrate the advantages of using automatic vocal measures to capture nuanced intrapersonal and interpersonal affect dynamics in psychotherapy and demonstrate how these dynamics are associated with treatment gains. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
