Facilitating dyadic synchrony in psychotherapy sessions: Systematic review and meta-analysis

Dana Atzil-Slonim, Christina S. Soma, Xinyao Zhang, Adar Paz, Zac E. Imel

Research output: Contribution to journalArticlepeer-review


Objective: This paper highlights the facilitation of dyadic synchrony as a core psychotherapist skill that occurs at the non-verbal level and underlies many other therapeutic methods. We define dyadic synchrony, differentiate it from similar constructs, and provide an excerpt illustrating dyadic synchrony in a psychotherapy session. Method: We then present a systematic review of 17 studies that have examined the associations between dyadic synchrony and psychotherapy outcomes. We also conduct a meta-analysis of 8 studies that examined whether there is more synchrony between clients and therapists than would be expected by chance. Results: Weighted box score analysis revealed that the overall association of synchrony and proximal as well as distal outcomes was neutral to mildly positive. The results of the meta-analysis indicated that real client-therapist dyad pairs exhibited synchronized behavioral patterns to a much greater extent than a sample of randomly paired people who did not actually speak. Conclusion: Our discussion revolves around how synchrony can be facilitated in a beneficial way, as well as situations in which it may not be beneficial. We conclude with training implications and therapeutic practices.

Original languageEnglish
Pages (from-to)898-917
Number of pages20
JournalPsychotherapy Research
Issue number7
Early online date31 Mar 2023
StatePublished - 2023


  • coregulation
  • dyadic processes
  • meta-analysis
  • process outcome research
  • psychotherapy method
  • psychotherapy outcome
  • synchrony
  • therapist skills

All Science Journal Classification (ASJC) codes

  • Clinical Psychology


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