Mapping the dialogue of change: A systematic review of sequential and moment-to-moment dynamics in psychotherapy

Abstract

This systematic review (PROSPERO CRD42023399665) synthesized evidence from process-based microanalytic studies investigating therapist–client verbal exchanges in psychotherapy, focusing on sequential and timeseries patterns. Although outcomes were not directly assessed, findings suggest that therapist-client verbal interaction systematicity relates to in-session change. To enhance microanalytic research, we argue for a bottom-up approach emphasizing detailed, AI-assisted descriptions of therapist–client interactions before applying theory-driven sequential analyses.