Oxytocin as a biomarker of the formation of therapeutic alliance in psychotherapy and counseling psychology.

Abstract

The therapeutic alliance is one of the most consistent predictors of therapeutic change, including symptom reduction and improvement in wellbeing and quality of life, across a variety of mental health interventions. Yet, little is known about its biological mechanisms. Oxytocin (OT) has been suggested as a biological mechanism by which bonds are formed and strengthened across species. This article is intended to demonstrate the potential of OT as a biomarker of therapeutic change in psychotherapy and counseling psychology, especially of the therapeutic alliance. We delineate three main potential paths of investigation based on the most recent research on OT in parent–child and romantic partner dyads. For each path, we provide a detailed explanation for whom, when, and how OT should be measured. Each path is illustrated using data collected in a randomized controlled trial of psychotherapy for major depressive disorder. These illustrations demonstrate the great potential of OT as a biomarker of (a) trait-like characteristics of the patients and the therapists, (b) the processes of therapeutic change, and (c) the dyadic synchrony between patients and their therapists. The potential clinical contribution of OT as a biomarker for each of these three paths is further demonstrated using a case study. Practical suggestions and directions for future research are discussed.

Oxytocin as the Neurobiological Basis of Synchronization: A Research Proposal in Psychotherapy Settings

“…On the other hand, oxytocin administration was also found to enhance therapeutic response in hypnotic-based settings (Bryant et al, 2012), and recent studies have also demonstrated that oxytocin synchronization predicted better therapeutic outcome (Zilcha-Mano et al, 2020). Oxytocin has also been suggested to exert effects on synchronization phenomena in psychotherapy settings.…”

Patient and Therapist In-Session Cortisol as Predictor of Post-Session Patient Reported Affect

“…Considering their relative scarcity, the study adds to a burgeoning field of research that attempts to exploit biological markers as an additional avenue towards our understanding of in-session therapeutic dynamics [ 41 , 42 , 43 , 44 ]. The general importance of a holistic approach towards illness has repeatedly been highlighted, and many are the arguments supporting a biopsychosocial approach to mental disorders [ 45 ].…”

Intranasal Oxytocin for Stimulant Use Disorder Among Male Veterans Enrolled in an Opioid Treatment Program: A Randomized Controlled Trial

“…This trial also found positive effects of oxytocin on aspects of group cohesion ( 19 ) and physiological synchrony ( 21 ); although oxytocin had no significant effect on methamphetamine use or craving after 6 weeks of treatment. Of note, endogenous oxytocin has been nominated as a possible biomarker for therapeutic alliance ( 22 ); and—regardless of the therapeutic modality—the strength of the therapeutic alliance consistently predicts addiction treatment engagement and retention as well as long-term relapse ( 7 , 23 ). Thus, it is important that we gain a better understanding of the relationship between oxytocin and therapeutic alliance, particularly among individuals with SUDs in controlled therapeutic environments ( 24 , 25 ).…”