Associations between interpersonal synchrony and clients’ perception of session quality are moderated by depression severity

Objective: Previous research has identified a complex relationship between client-therapist synchrony and therapy outcomes. We investigated the ways in which depression severity influences this relationship. Method: The sample was comprised of 30 clients undergoing a 16-session supportive-expressive dynamic therapy for depression. Client-therapist interpersonal synchrony was assessed using the Client-Therapist interpersonal Synchrony (CIB) coding system during five pre-selected sessions. After each session, the clients evaluated their satisfaction with the session. We employed multi-level modeling (MLM) to analyze the data. Results: Sessions characterized by higher levels of interpersonal synchrony were associated with better session quality, both within and between dyads. Depression severity moderated this association, such that the correlation between interpersonal synchrony and session outcome was weaker in dyads where clients reported greater depression severity. Conclusions: These findings suggest that to facilitate effective synchrony it is important to consider the clients’ level of depression.