A multi-modality and multi-dyad approach to measuring flexibility in psychotherapy

Timur Guralnik, Robert G. Moulder, Daniel Merom, Sigal Zilcha-Mano

Research output: Contribution to journalArticlepeer-review


Introduction: Flexibility, the ability of an individual to adapt to environmental changes in ways that facilitate goal attainment, has been proposed as a potential mechanism underlying psychopathology and psychotherapy. In psychotherapy, most findings are based on self-report measures that have important limitations. We propose a multimodal, multi-dyad approach based on a nonlinear dynamical systems framework to capture the complexity of this concept. Method: A new research paradigm was designed to explore the validity of the proposed conceptual model. The paradigm includes a psychotherapy-like social interaction, during which body movement and facial expressiveness data were collected. We analyzed the data using Hankel Alternative View of Koopmann analysis to reconstruct attractors of the observed behaviors and compare them. Results: The patterns of behavior in the two cases differ, and differences in the reconstructed attractors correspond with differences in self-report measures and behavior in the interactions. Conclusions: The case studies show that information provided by a single modality is not enough to provide the full picture, and multiple modalities are needed. These observations can serve as an initial support for our claims that a multi-modal and multi-dyad approach to flexibility can address some of the issues of measurement in the field.

Original languageEnglish
Number of pages17
JournalPsychotherapy Research
Early online date22 Jan 2024
StateE-pub ahead of print - 22 Jan 2024

Bibliographical note

Publisher Copyright:
© 2024 Society for Psychotherapy Research.


  • dynamical systems
  • flexibility
  • multimodal measurement
  • nonlinear dynamics
  • psychotherapy

ASJC Scopus subject areas

  • Clinical Psychology


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