“Reading this volume will enhance your therapeutic efforts regardless of your preferred approach. Donovan, Osborn, and Rice’s collaboration resulting in this landmark work, Paraverbal Communication in Psychotherapy, offers us deep insight into the often-ignored realm of what transpires nonverbally in healing relationships. This represents a must-read for beginning and seasoned psychotherapists.” 

Jeffrey J. Magnavita, PhD, ABPP, author of Unifying Psychotherapy: Principles, Methods, and Evidence from Clinical Science

“In this creative and forward-looking volume, Donovan, Osborn, and Rice make a persuasive case for the important role of paraverbal communication in psychotherapy. Be it posture, tone, facial expression or emotions, these extra-verbal ways by which therapist and client or members of a couple relate to each other receive the theoretical, clinical, and research attention they merit. Therapists of all theoretical persuasions will learn helpful new ways to understand and relate to their clients through the fascinating, often verbatim case studies presented. I recommend this gem of a book most enthusiastically.” 

Stanley B. Messer, PhD, Rutgers University


By James M. Donovan, Kristin Osborn, & Susan Rice

The universe of dynamic psychotherapy has undergone slow, but ultimately dramatic change, since the 1970s. Now a new psychotherapist has taken up residence in the office. This book tells the story of what we found when we studied that new therapist directly, by watching her work, on videotape or through extended case excerpts. Here we learn that today’s counselor’s thoughts, words and behaviors sharply set her in contrast to her counterparts of just twenty-five years earlier.

The videotape, for the first time, reveals to us the verbatim spoken exchanges, but also the bodily messages: the tones of voice – the facial expressions – the gestures of patient and therapist as they choreograph their interaction. When we begin to examine the therapy participants as embodied speakers, at this moment we find ourselves on the outskirts of mostly untrodden territory. We sense an evolutionary advance perhaps about to take place on the screen, because we can now choose to study all the extra-verbal information, as well as the verbal, in the therapy interchange.

For an interesting article on the importance of studying both the therapist and patient in psychotherapy research, we recommend you read Koole, Sander L. & Teacher, Wolfgang (2016), A Review and an Integrative Framework for the Therapeutic Alliance, Frontiers in Psychology, 14 June 2016, doi: 10.3389/fpsyg.2016.00862

The In-Sync model treats psychotherapy as the product of two interacting brains. This is a fundamentally new perspective because psychotherapy research to date has only considered the patient’s brain as the locus of therapeutic effects (Etkin et all., 2005; Beauregard, 2014; Weingarten and Strauman, 2015). Although the single-brain approach has generated important insights, we believe that it falls short of explaining the dynamic interpersonal aspects of psychotherapy. Ignoring these dynamic denies the inherent interpersonal nature of the alliance, including those aspects of the alliance that are most likely to bring relief from psychological functioning. To fully understand how psychotherapy works, researchers should therefore adopt an inter-brain perspective, by unraveling the interactions between the patient’s and therapist’s brains.

Read further excerpt from this upcoming book by James M. Donovan, Kristin Osborn & Susan Rice

James Donovan

Jim Donovan graduated from Stanford in 1965 and received his Phd from the Univ of Michigan in 1970. He is a founder and co-director of the Behavioral Health Fellowship at Atrius Health in Boston Mass. He has written two previous books and some 20 papers about psychotherapy education, short term therapy and Couple treatment. For

Kristin A.R. Osborn

Kristin A. R. Osborn, MA, LMHC was trained by Dr. Leigh McCullough, PhD, founder of Affect Phobia Therapy (APT), and then trained others on her behalf. She founded the Certified APT™-Training Program in 2009 and presents internationally, offering ongoing training in Boston, London, Stockholm and Amsterdam. She is a lecturer (part-time) in Psychiatry at Harvard

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