Intrapersonal and interpersonal emotional networks and their associations with treatment outcome

In this study, we used multilevel vector autoregressive network analysis to examine clients' intrapersonal and client-therapist interpersonal emotional dynamics from session to session. We expected to find differences in the network structure (i.e., the density) of responders versus nonresponders to treatment. The sample comprised 95 clients treated by 58 therapists in a university clinic. Clients and therapists self-reported their emotions after each session. The functioning level was assessed at the beginning of each session using clients' self-reports. The results indicated that higher intrapersonal density among clients' emotions within the temporal network (associations from session to session) was associated with less improvement in functioning, but higher intrapersonal density among clients' emotions within the contemporaneous network (same-session associations) was not associated with clients' functioning level. Additionally, higher interpersonal density among clients'-therapists' emotions within the contemporaneous network was associated with greater improvement in clients' functioning. These findings highlight the importance of recognizing the dynamic nature of emotions within the client, as well as between the client and the therapist and the contribution of such session-by-session emotional dynamics to the outcome of psychotherapy.