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Trunk posture
Empathy 6.9 6.7 5.09
p .05.
161 NONVERBAL BEHAVIOR AND PERCEPTIONS
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Two of the therapists in the study reported a
constructivist orientation and two therapists re-
ported a cognitivebehavioral perspective. Anal-
ysis indicated that the effects of posture on per-
ceived empathy depended on the orientation of the
therapists, Posture Therapist Orientation, F(1,
142) 18.46, p .001. For constructivist thera-
pists, a forward leaning posture (M6.9) yielded
higher ratings of empathy compared with an up-
right posture (M 6.4), F(1, 142) 22.36, p
.001. There was a difference in mean judged em-
pathy when cognitivebehavioral therapists
leaned forward; however, the difference when
cognitivebehavioral therapists adopted a forward
leaning posture (M 7.0) compared with an up-
right posture (M 7.1) was not statistically sig-
nicant, F(1, 142) 1.82, p .2.
Analysis also indicated that the effect of posture
on perceived treatment credibility depended on
the orientation of the therapists, Posture Ther-
apist Orientation, F(1, 142) 7.94, p .006. For
constructivist therapists, ratings of treatment cred-
ibility were higher when the therapist adopted a
forward leaning posture (M6.0) compared with
an upright posture (M 5.3), F(1, 142) 11.98,
p .001. For cognitivebehavioral therapists, the
ratings of treatment credibility were slightly lower
when the therapist leaned forward (M5.9) than
when upright (M6.0); however, this difference
was not statistically signicant, F(1, 142) 0.28,
p .6.
The effect of eye contact or posture might vary
depending on whether a therapist is a male or
female. Analyses, however, did not suggest vari-
ation as a function of therapist sex in this study:
The effect of eye contact and posture on ratings of
empathy, therapeutic alliance, and treatment cred-
ibility did not differ reliably between male and
female therapists (interaction ps .08).
Another possibility is that the results could vary
as a function of participant sex. However, analysis
failed to reveal such interactions: As with therapist
sex, the effect of eye contact and posture on rat-
ings of empathy, therapeutic alliance, and treat-
ment credibility did not vary reliably between
male and female participants (interaction ps .1).
Discussion
These results demonstrate the inuence of
nonverbal actions on perceptions of the psycho-
therapy interaction. When therapists engage in
greater eye contact or adopt a forward-leaning
posture, they are viewed as more empathic and
their treatment is judged to be more credible.
Therapists also appear to enhance perceptions
of their relationship with the client when they
lean forward; however, this effect seems to oc-
cur only when therapists also maintain high eye
contact. The results lend empirical support for
the importance of eye contact and posture in
psychotherapy.
Analyses also suggest that the effects of pos-
ture on perceived empathy and treatment cred-
ibility depend on the orientation of the thera-
pists. The two constructivist therapists were
perceived to be more empathetic and their treat-
ment was seen as more credible when they
adopted a forward-leaning posture. A similar
effect was not observed when the two cogni-
tivebehavioral therapists were in a forward-
leaning posture.
One explanation for these effects concerning
therapist orientation is that an engaging and
potentially empathetic behavior like leaning
forward complements the techniques used in
constructivist therapy (e.g., Spooner & Lyddon,
2007) and therefore more strongly inuences
perceptions of constructivist therapists and their
treatment. The fact that this effect for trunk
posture was not observed for the cognitive
behavioral therapists may also be due to a dif-
ference in training. During the creation of the
therapy videos, it was noted that the two cog-
nitivebehavioral therapists did not appear as
comfortable executing the forward lean, possi-
bly because the exercise was newer to them than
to the constructivist therapists. However, there
were only two therapists of each orientation and
they differed in other qualities, so the observed
interaction effect involving therapist orientation
may have very well been a result of other indi-
vidual differences. Given the limited number of
therapists, it would be risky to draw any rm
conclusions about differences arising from ther-
apist orientation.
Given that nonverbal behaviors such as eye
contact and body lean are present in virtually all
forms of psychotherapy, the current observa-
tions could have relevance across therapeutic
orientations. Future research on the relationship
of these and other nonverbal behaviors to treat-
ment outcome could therefore be of importance
to a broad spectrum of psychotherapists, espe-
cially those aiming to integrate and use identi-
ed strengths across orientations.
162 DOWELL AND BERMAN
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Psychotherapy researchers have become in-
creasingly aware of the possibility that the im-
pact of specic therapist behaviors during psy-
chotherapy sessions may be contingent on their
appropriate timing or response to client behav-
iors (e.g., Stiles, Honos-Webb, & Surko, 1998).
However, concerns about timing are less of an
issue in the present study because the two be-
haviors of eye contact and trunk lean were not
used selectively within the brief therapy ses-
sions. Instead, therapists were instructed either
to exhibit or not exhibit each behavior through-
out a session and checks of the videotaped ses-
sions conrmed therapist compliance. Although
our design does not permit an assessment of
timing issues, this question of responsiveness
would be an interesting avenue for future inves-
tigations of these and other therapist nonverbal
behaviors.
Because the results of this study are based on
observer perceptions, they may not reect the
perceptions of actual psychotherapy clients. It
would be helpful for future research to assess
whether the therapist nonverbal behaviors in
this study generate the same perceptions with
therapy clients as found with observers viewing
therapy interactions. On the other hand, the
study did involve experienced therapists, en-
hancing the realism of the expressed nonverbal
behaviors and also increasing the likelihood that
the interaction between the pseudoclients and
therapists mirrored that which would be found
in psychotherapy sessions.
Our research was conducted with a university
population; therefore, the ndings might not
generalize to other groups. For example, differ-
ences have been noted in how nonverbal behav-
iors are interpreted or used depending on the
cultural and diagnostic context (e.g., Annen et
al., 2012; Kim et al., 2003). Additional investi-
gation would be needed to establish whether the
patterns observed in this research extend to
those in other cultures or ethnic groups or to
clients of varying diagnoses.
It has been a common belief that the accuracy
of judgments improves with greater exposure to
the behaviors being observed. For this reason,
some may view the procedure of showing par-
ticipants only brief, 5-min segments of therapy
sessions as a limitation to the study. However,
there is considerable research on the accuracy of
judgments based on limited exposure to nonver-
bal behaviors. Several studies have shown that
meaningful outcomes can be predicted from
very short exposure to nonverbal behavior and
that participant observations over longer peri-
ods of time do not necessarily yield greater
predictive accuracy (e.g., Ambady & Rosenthal,
1992).
The current study did not examine the effects
of therapist nonverbal behaviors on therapy out-
come. The questions of how and to what degree
therapist eye contact and trunk posture affect
therapy outcome have yet to be answered. How-
ever, the results demonstrate that nonverbal be-
haviors inuence perceptions of empathy, ther-
apeutic alliance, and treatment credibility, fac-
tors that are thought to be related to outcome. If
future research conrms that these nonverbal
actions have a similarly positive effect on treat-
ment outcome, it would suggest both the impor-
tance of nonverbal behaviors in the training of
psychotherapists and the benets of therapists
using specic nonverbal behaviors when they
conduct psychotherapy.
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Received April 9, 2012
Revision received August 28, 2012
Accepted September 20, 2012
Call for Brief Reports: Null Results and Failures to Replicate
Journal of Psychotherapy Integration will start publishing a new recurring brief reports
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In an era when ndings from psychological science are called into question, it is
especially important to publish carefully constructed studies that yield surprising null
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The following 2012 article published in JPI is a good example of a paper that would be
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DeGeorge, J., & Constantino, M. (2012). Perceptions of analogue therapist em-
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165 NONVERBAL BEHAVIOR AND PERCEPTIONS
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