The role of interpersonal coordination dynamics in alliance rupture and repair processes in psychotherapy-A systematic review

S S Høgenhaug; M T Kongerslev; G Kjaersdam Telléus

doi:10.3389/fpsyg.2023.1291155

The role of interpersonal coordination dynamics in alliance rupture and repair processes in psychotherapy-A systematic review

Front Psychol. 2024 Jan 4:14:1291155. doi: 10.3389/fpsyg.2023.1291155. eCollection 2023.

Authors

S S Høgenhaug^{1

2}, M T Kongerslev^{3

4}, G Kjaersdam Telléus^{5

6}

Affiliations

¹ Clinic North, Psychiatric Hospital, Bronderslev, Denmark.
² Department of Clinical Medicine, Faculty of Medicine, Aalborg University, Aalborg, Denmark.
³ Department of Psychology, University of Southern Denmark, Odense, Denmark.
⁴ Mental Health Services West, Region Zealand, Slagelse, Denmark.
⁵ Psychiatry, Aalborg University Hospital, Aalborg, Denmark.
⁶ Psychology, Department of Communication and Psychology, Aalborg University, Aalborg, Denmark.

Abstract

Introduction: The purpose of this systematic review is to expand our knowledge of the underlying mechanisms of the alliance in psychotherapy. This is done by examining the association between alliance rupture and repair processes and interpersonal coordination dynamics.

Method: A systematic review based on PRISMA guidelines was conducted, aimed at papers investigating the association between alliance rupture and repair episodes and different behavioral modalities (i.e., physiology, movement) in the psychotherapeutic interaction. Seventeen studies were included for full text-analysis.

Results: The results indicate that rupture and repair episodes were associated with interpersonal coordination dynamics. Different modalities (movement, heart rate, and vocalization) were found to serve as markers for alliance rupture and repair events. Facial expressions, physiological arousal, vocalization, and behavior were found to play important roles in the therapeutic interaction in relation to mutual emotion regulation, empathic response, safety, trust, and meaning-making.

Discussion: Limitations of this review are discussed, including the great methodological variation and selection bias observed in the reviewed studies. Recommendations for future research in this area are presented. Overall, interpersonal coordination dynamics was found to have the potential to help identify and manage alliance ruptures and foster repairs in the therapeutic interaction, which has high potential for future clinical work and training.

Keywords: interpersonal coordination; process research; psychotherapy; repair; rupture; therapeutic relationship.

Publication types

Review

Grants and funding

The author(s) declare financial support was received for the research, authorship, and/or publication of the article. This review was funded by the Unit for Psychiatric Research at Aalborg University Hospital, Psychiatry, Denmark, and Den Sundhedsvidenskabelige Forskningsfond.