Nonverbal Synchrony as a Marker of Alliance Ruptures

Keren Deres-Cohen, Tohar Dolev-Amit, Galit Peysachov, Fabian T. Ramseyer, Sigal Zilcha-Mano

Research output: Contribution to journalArticlepeer-review


Findings from the past 5 decades of empirical research on the working alliance suggest its importance in psychotherapy. Recent studies have sought to identify markers of the alliance, of which one of themost promising candidates is nonverbal synchrony. Delving into processes that constitute the alliance,such as alliance ruptures, may shed light on underlying mechanisms of the association between nonverbal synchrony and the therapeutic relationship. The present study examines whether nonverbal synchrony can serve as a marker of alliance ruptures. To achieve this aim, 418 sessions of 75 therapeuticdyads were coded for ruptures, using the Rupture Resolution Rating System, and for nonverbal synchrony, using motion energy analysis. A mixed-method analysis, integrating multilevel nested modelswith a case study analysis, was implemented. The results of the multilevel nested models suggest thatnonverbal synchrony is significantly associated with confrontational ruptures, whereas withdrawal ruptures showed no such association. The findings of the case analysis suggest that moments of especiallyhigh nonverbal synchrony during a rupture are those in which the therapist made great efforts to beattentive to the patient when the patient acted in a confrontational manner. The findings of the presentstudy demonstrate the potential of nonverbal synchrony to serve as a marker of confrontational ruptures.The findings support the social glue assumption, according to which therapists may seek higher levelsof nonverbal synchrony with patients to maintain a strong alliance in the face of difficulties.

Original languageEnglish
Pages (from-to)499-509
Number of pages11
Issue number4
StatePublished - 2021

Bibliographical note

Funding Information:
This work was supported by the Israeli Science Foundation (Grant 186/ 15) and the Society for Psychotherapy Research.

Publisher Copyright:
© 2021. American Psychological Association


  • Alliance ruptures
  • Confrontation ruptures
  • Nonverbal synchrony
  • Process
  • Treatment

ASJC Scopus subject areas

  • Clinical Psychology
  • Psychiatry and Mental health


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