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Effectiveness and Mechanisms of Change in Imagery-Based Techniques

  • Imagery-based techniques have received increasing interest in psychotherapy research. Whereas their effectiveness has been shown for various psychological disorders, their underlying mechanisms remain unclear. Current research predominantly investigates intrapersonal processes, while interpersonal processes have received no attention to date. The aim of the current dissertation was to fill this lacuna. The three interrelated studies comprising this dissertation were the first to examine the effectiveness of imagery-based techniques in the treatment of test anxiety, relate physiological arousal to emotional processing, and investigate the association between physiological synchrony and multiple process measures. Study I investigated the feasibility of a newly developed protocol, which integrates imagery-based and cognitive-behavioral components, to treat test anxiety in a sample of 31 students. The results indicated the protocol as acceptable, feasible, and effective in the treatment of test anxiety. Additionally, the imagery-based component was positively associated with therapeutic bond, session evaluation, and emotional experience. Study II shifted the focus from the effectiveness of imagery-based techniques to client-therapist physiological synchrony as a putative mechanism of change in the same sample. The results suggested that physiological synchrony was greater than chance during both imagery-based and cognitive-behavioral components. Variability of physiological synchrony on the session-level during the imagery-based components and variability on both levels (session and dyad) during the cognitive-behavioral components were demonstrated. Furthermore, physiological synchrony of the imagery-based segments was positively assocatied with therapeutic bond. No association was found for the cognitive-behavioral components. Study III examined both intrapersonal (i.e., clients’ electrodermal activity) and interpersonal (i.e., client-therapist electrodermal activity synchrony) processes and their associations with emotional processing in a sample of 49 client-therapist-dyads. The results suggested that higher client physiological arousal and a moderate level of physiological synchrony were associated with deeper emotional processing. Taken together, the results highlight the effectiveness of imagery-based techniques in the treatment of test anxiety. Furthermore, the results of Studies II and III support the idea of physiological synchrony as a mechanism of change in imagery with and without rescripting. The current dissertation takes an important step towards optimizing process research within psychotherapy and contributes to a better understanding of the potency and mechanisms of change of imagery-based techniques. We hope that these studies’ implications will support everyday clinical practice.

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Author:Jessica Prinz
Document Type:Doctoral Thesis
Date of completion:2020/07/15
Publishing institution:Universität Trier
Granting institution:Universität Trier, Fachbereich 1
Date of final exam:2020/04/09
Release Date:2020/08/19
GND Keyword:Beziehung; Emotionales Verhalten; Erregung; Imagination; Kognitive Psychotherapie; Patient; Physiologische Psychotherapie; Prüfungsangst; Psychotherapeut
Licence (German):License LogoCC BY: Creative-Commons-Lizenz 4.0 International

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