Abstract

Objective: The alliance between patient and therapist is central for therapeutic progress. Social mimicry, the automatic imitation of another person, has been linked to building relationships. This is the first preregistered study to systematically investigate mimicry and its effects on the working alliance in real psychotherapy sessions.

Method: Sixty-four different patient-therapist dyads were filmed during a cognitive behavioral therapy (CBT) treatment for obsessive-compulsive disorder (OCD). By using actor-partner interdependence models, we analyzed the extent to which therapists’ and patients’ earlier mimicry predicted their own mimicry (actor effect), how they influenced each other in their mimicry (partner effect) and the effects of mimicry on the patients’ alliance. Videos of 151 sessions were rated by two observers.

Results: Patients showed stable low mimicry levels. Furthermore, the patients’ mimicry predicted that of the therapists, indicating that therapists adapt their mimicry levels to patients. Only the patients’ but not the therapists’ mimicry at the beginning of treatment predicted the patients’ alliance.

Conclusion: The results suggest that the role of the active patient is underestimated. Furthermore, results offer new treatment targets by shedding light on low mimicry levels displayed by patients, which might lead to social costs.

摘要

目的：患者与治疗师之间的联盟对于治疗进展至关重要。模仿他人（自动模仿他人）已与建立人际关系联系在一起。这是第一项预先注册的研究，可以在真实的心理治疗会议中系统地研究模仿行为及其对工作联盟的影响。

方法：在强迫症（OCD）的认知行为疗法（CBT）治疗期间，拍摄了64种不同的患者-治疗者二元组。通过使用演员-伴侣相互依赖模型，我们分析了治疗师和患者的早期模仿在多大程度上预测了自己的模仿（演员效应），他们在模仿中如何相互影响（伴侣效应）以及模仿对患者的影响联盟。两名观察员对151节视频进行了评分。

结果：患者表现出稳定的低拟态水平。此外，患者的模仿程度预测了治疗师的水平，这表明治疗师会根据患者的适应水平进行调整。在治疗开始时，只有患者的模仿而不是治疗师的模仿才能预测患者的联盟。

结论：结果提示活跃患者的作用被低估了。此外，结果通过揭示患者显示的低拟态水平提供了新的治疗目标，这可能会导致社会成本。