Interpersonal neural synchrony as a mechanism of therapeutic alliance? A systematic review of hyperscanning in clinical encounters
Bibliographic record
Abstract
Therapeutic alliance is defined as the collaborative relationship between patient and therapist. Strong therapeutic alliances have been associated with positive clinical outcomes, but much remains unknown about alliance and its physiological basis. Interpersonal neural synchrony (INS) – the synchronization of neural signals between interacting individuals – is emerging as a novel lens for studying interactions with relatively objective and time-sensitive neuroimaging techniques. We searched four databases to identify studies of INS in clinical encounters. Our search yielded 161 articles, 46 met criteria for full-text review and 12 were included. The included articles reported INS across a total of 174 dyads, all published since 2018. Despite diverse methodologies, INS was observed in all studies and was often related to therapeutic outcomes. However, results were mixed regarding associations between INS and therapeutic alliance. These results highlight that, while promising, additional research is needed to elucidate the relationship between INS, therapeutic alliance and clinical outcomes. Future studies should aim to standardize methodologies, explore temporal dynamics (e.g., through longitudinal assessments), and include larger sample sizes.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.005 | 0.025 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.006 | 0.005 |
| Bibliometrics | 0.009 | 0.009 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.003 | 0.002 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.004 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".