O42&$7!2::07($Y0!$*(0%27($Y0!12((0%*6!$*!(#0!$*(2M0!$*(0%Y$0Z!26!2! 1%0&$7()%!):!)B(7)90!
526($*D_!@>_!F%)6$D_!F>_!F0B(0<_!@>'>_![+,,.^!=<0c$(#49$7!7#2%27(0%$6($76!2*&!12($0*(E(#0%21$6(E$*(0%27($)*?!2! Y$&0)E2*2<46$6!):!:27$2! '(A?-":@,-"B"LA _ &ke _!-,.E--->! 526($*D_!@>!G!F0B(0<_!@>!'>![+,,.^>!O42&$7!2::07($Y0!$*(0%27($Y0!12((0%*6!$*!(#0!$*(2M0!$*(0%Y$0Z!26!2!1%0&$7()%!):! )B(7)90>! '(A?-",-%#@:A&3%(%@#?- _ &IJ _!-bbE-\b>! >-001(3 The study aimed at testing predictions regarding the relationship between affective display and feeling states and between affective interaction patterns and clinical outcomes. The issues of this study were: (1) How do affect displays of patients and therapists differ in the intake interview? (2) How are affect displays of patients and therapists related to each other’s affect displays and respective feeling states? (3) Are specific dyadic interaction patterns predictive for the outcome of inpatient psychotherapy? (4) Are there indicators of higher affective involvement of the therapist in the unsuccessful dyads? We assumed that facial affect displays could serve as indicators of patients’ neurotic relationship offers and therapists’ affective involvement in these interactive patterns in a clinical situation. Facial affect display would be primarily used in its symbolic and relationship regulating function. Therefore, we did not expect a close overall correspondence between feeling states and facial affective display. However, we assumed that hedonic facial affective display might have a regulating effect on the feeling state of the interaction partner. With respect to therapeutic outcome, we hypothesized that unsuccessful dyads were characterized by high involvement of the therapist in reference to reported feeling states and facial affective display. In these dyads, we expected a reciprocal facial lead affect. For the purpose of the study, we recruited ten ‘‘successful’’ and ten ‘‘unsuccessful’’ patients from an inpatient psychotherapy ward. Over a period of 12 months, each patient’s intake and discharge interviews with the two therapists participating in the study were videotaped. According to our hypothesis, we found a strong relationship between dyadic facial affective patterns and outcome of psychotherapy. Reciprocal dyadic lead affect was related to a less favorable outcome. On the basis of the dyadic lead affect (reciprocal or nonreciprocal), 75% of the patients could be classified correctly as being part of the successful or the unsuccessful group. These findings also support the more general hypothesis that relationship patterns between patients and therapists emerge in a very early phase of treatment and have a critical impact on the course and outcome of treatment. Consensual communication, as indicated by reciprocal lead affect, may restrict the potentialities of working through neurotic conflicts in the psychotherapeutic relationship and limit corrective emotional experiences. Especially hedonic facial affects have a high probability of being reciprocated because almost 50% of the dyads with reciprocal lead affect showed a hedonic dyadic lead affect (happiness, social smile). G$#.1/.\!! Prof. Manfred E. Beutel, Dept. of Psychosomatic Medicine and Psychotherapy, University Medicine Mainz, Untere Zahlbacher Str. 8, 55131 Mainz, Germany Email: E-Mail: Manfred.Beutel@unimedizin-mainz.de Website:
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