Therapist Relationship Research Articles

Testing the predictions of Chapman's five love languages theory: Does speaking a partner's primary love language predict relationship quality?

Chapman's claim that the key to marital happiness is "speaking" your partner's primary "love language" has been highly influential in pop culture and incorporated into therapeutic practice. However, the theory has not yet been empirically validated. The current study tests his theory, examining the hypothesis that satisfaction with one's partner's primary love language behavior predicts relationship satisfaction better than satisfaction with one's partner's nonprimary love language behavior. We recruited a sample (n = 696, M = 43.8 years, 70% married, 97.3% cohabitating) through Amazon CloudResearch. Chapman's hypothesis was not supported. Participants' satisfaction with their partners' primary love language behavior no better-predicted relationship satisfaction or perceived love than the lower-ranked love languages. Words of Affirmation and Quality Time better predicted perceived love and relationship satisfaction than participants' primary love language. These results replicate previous research and suggest that these should remain targets of intervention for relationship therapists.

AI in Relationship Counselling: Evaluating ChatGPT’s Therapeutic Capabilities in Providing Relationship Advice

Recent advancements in AI have led to chatbots, such as ChatGPT, capable of providing therapeutic responses. Early research evaluating chatbots’ ability to provide relationship advice and single-session relationship interventions has showed that both laypeople and relationship therapists rate them high on attributed such as empathy and helpfulness. In the present study, 20 participants engaged in single-session relationship intervention with ChatGPT and were interviewed about their experiences. We evaluated the performance of ChatGPT comprising of technical outcomes such as error rate and linguistic accuracy and therapeutic quality such as empathy and therapeutic questioning. The interviews were analysed using reflexive thematic analysis which generated four themes: light at the end of the tunnel; clearing the fog; clinical skills; and therapeutic setting. The analyses of technical and feasibility outcomes, as coded by researchers and perceived by users, show ChatGPT provides realistic single-session intervention with it consistently rated highly on attributes such as therapeutic skills, human-likeness, exploration, and useability, and providing clarity and next steps for users’ relationship problem. Limitations include a poor assessment of risk and reaching collaborative solutions with the participant. This study extends on AI acceptance theories and highlights the potential capabilities of ChatGPT in providing relationship advice and support.

Association of Patient-Surgeon and Patient-Physical Therapist Relationships With Return to Sports After ACL Reconstruction: The Untested Dimension in Outcome Assessments.

The Quality of Patient-Surgeon Relationship (QPASREL) is an 11-item questionnaire developed and validated to assess the relationship between practitioners and patients on recovery and return to work after surgery. To evaluate the association of patient-surgeon relationship (PSR) and patient-physical therapist relationship (PPR), as measured by QPASREL, with a patient's return to sports (RTS) after anterior cruciate ligament reconstruction (ACLR). Case-control study; Level of evidence, 3. This study targeted patients who underwent primary ACLR at a specialized sports surgery referral center between January and May 2021. Patients who had revision surgery, multiligamentous knee injury, and sedentary status were excluded from the study. Patients were grouped based on ability to RTS at the preinjury level 1 year postoperatively (RTS group and no-RTS group). The primary outcome was rate of RTS at 1 year postoperatively, and the primary dependent variables were the quality of PSR and PPR as measured by QPASREL scores at 6-month intervals. Secondary outcomes were the correlation and discriminative capacity of the QPASREL compared with the Anterior Cruciate Ligament-Return to Sport After Injury (ACL-RSI) scores (collected at 6-month intervals). The study included 243 patients. Patients in the RTS group exhibited a higher mean PPR QPASREL score (36.6 ± 5.1) compared with no-RTS patients (34.8 ± 5.2; P = .01) as well as a higher mean PSR score (35.7 ± 5.1) compared with no-RTS patients (33.8 ± 5.9; P = .01). Multivariate analysis showed that every 5-point increase in the QPASREL scores for PPR and PSR resulted in a 39% (odds ratio [OR] = 1.39; P = 0.014) and 35% (OR = 1.35, P = 0.021) increased odds of RTS, respectively. A weak yet positive correlation was found between QPASREL and ACL-RSI. The predictive capacity of the QPASREL (area under the curve [AUC] = 0.60 for PPR and 0.61 for PSR), although significant, was less powerful compared with that of the ACL-RSI (AUC = 0.73). The quality of the PPR and PSR, as measured by QPASREL scores, demonstrated a significant association with RTS rates at 1 year after ACLR. A weak yet positive correlation was found between QPASREL and ACL-RSI.

Client deception in therapy is associated with worse therapeutic relationships and perceived therapeutic outcomes

AbstractObjectivesIn psychotherapy, clients and therapists work together to forge a path towards better mental health. Key to this process is genuine and honest communication. However, much previous research suggests that clients are not always fully truthful with their therapists. In this study, we make a preliminary examination of the relationship between client deception in therapy, the quality of the therapeutic relationship and therapeutic outcomes.MethodsParticipants who had been involved in psychotherapy completed a variety of measures that assessed their use of dishonesty in therapy. They also completed measures of the quality of the client–therapist relationship and measures of their perceived therapeutic outcomes. We hypothesised that client dishonesty would negatively correlate with the perceived quality of the therapeutic relationship and the therapeutic outcomes. Furthermore, we predicted that the quality of the therapeutic relationship would mediate the relationship between client dishonesty and perceived therapeutic outcomes.ResultsThe results of correlation and mediation analyses supported these hypotheses. Client dishonesty was associated with poorer therapeutic relationships and worse perceived therapeutic outcomes. Additionally, therapeutic relationship quality partially mediated the relationship between client dishonesty and therapeutic outcomes.ConclusionsThis initial study provides important tentative insights into the possible negative correlates of client dishonesty in the therapeutic environment.

Experiences From Treatment for Anxiety and Depression Among Youth in Foster Care: A Qualitative Study

ABSTRACTYouth in foster care are at high risk of internalizing problems. However, research is scarce regarding their experiences of mental health treatment. This knowledge is important if mental health services are to meet their needs. Through qualitative interviews, we explored the experiences of youth in foster care (N = 9, aged 16–18 years) having been treated for anxiety and depression. Systematic text condensation was used to analyse the transcribed interviews. The youth reported different paths to accessing treatment. They conveyed the need for therapists to build trust and demonstrate genuine care by advocating for them. They valued learning strategies to manage their symptoms and reported that to adopt these strategies, introspection and psychoeducation were necessary. Finally, they emphasized the importance of the treatment setting (e.g., outdoors versus in a traditional office setting). Findings indicate that it was arbitrary as to who helped the youth access treatment. Moreover, for youth to feel they benefitted from the treatment, certain features of the youth–therapist relationship and treatment content proved central. The findings are relevant for clinicians and policymakers within child welfare and youth's mental health services.

"You can't really have a relationship with them because they just ask you questions": understanding adolescent dropout - an empirical single case study.

High dropout rates are common in youth psychotherapy, including psychoanalytic psychotherapy, yet the reasons behind this trend remain obscure. A critical focus to enhance adolescent engagement could be the therapeutic alliance, particularly in resolving alliance ruptures. This study sought to clarify the complex relationships between the therapeutic alliance, encompassing alliance ruptures and resolutions, and dropout within the context of poor outcome. It investigated a single case of an adolescent with depression who dropped-out of Short-Term Psychoanalytic Psychotherapy, without showing clinical improvement. Data was garnered from diverse sources, including questionnaires, interviews, and session recordings, and analyzed through a mixed-method longitudinal framework. This encompassed views from the adolescent, therapist, parents, and external evaluators. The study identifies several factors impacting the decision to drop out, including initial profound distrust toward the therapist, a complex and difficult therapeutic relationship characterized by unresolved alliance ruptures, and sporadic attendance. External factors including minimal parental engagement with therapy were also seen as detrimental to the adolescent's involvement and progress. The research underscores the challenges in engaging adolescents, especially when there may be distrust of professionals, and in the absence of parental involvement with treatment.

Romantic relationships and attitudes in Asian emerging adults: Review and critique

AbstractThis article summarizes and critiques existing literature on the factors that might influence romantic relationships and attitudes among Asian emerging adults (18–29 years old). Forty‐one studies were identified. Findings were categorized into two groups based on outcome variables: romantic relationship qualities (e.g., satisfaction; N = 22) and attitudes toward dating and marriage (N = 19). Common predictors of relationship qualities include parenting factors (e.g., parental divorce), culture‐specific factors (e.g., filial piety), and psychological factors (e.g., identity status). Furthermore, findings suggest that Asian emerging adults tend to hold more conservative dating attitudes, prioritize parental approval, but also share some similarities in dating attitudes with their Western counterparts. We proposed specific recommendations regarding sample diversity and areas for further investigation in future research. Clinical implications are also discussed that highlight the importance of relationship therapists showing empathy and building therapeutic alliance with Asian emerging adult clients.

‘It's a magnifying glass for your relationship’: a thematic analysis of motivations, benefits, and challenges in consensually non‐monogamous relationships

AbstractThe last decade has seen an increase in public and academic interest in consensual non‐monogamy (CNM). CNM involves sexual and/or romantic relationships between multiple partners, with the consent of all individuals involved. Engagement in CNM is estimated at 5% of the general population, although due to stigma with the strong idealisation of monogamy in many cultures, it is a hidden population. This qualitative study explores the motivations, benefits, and challenges experienced in CNM relationships, an area that has been understudied despite the resurgence of interest in it. While previous research has mainly focused on comparisons between CNM and monogamy or individual types of CNM such as polyamory, this study seeks to provide a broader understanding of CNM relationships. We employ a critical realist framework and thematically analyse semi‐structured interviews with eight participants. The results identify three overarching themes: mononormativity and cultural norms; growth and responsibility; and diversity and complexity; each has several subthemes. These findings suggest that CNM provides opportunities for greater diversification of needs and increased community and individual growth. The study also highlights the challenges experienced in CNM relationships and the strategies used to manage them, such as personal responsibility for managing difficult emotions and temporarily closing a relationship at times for relationship security. A novel finding in this study is that some individuals involved in CNM have internalised cultural norms and the idealisation of monogamy and need to unlearn these norms. This study adds to the existing knowledge on CNM and is expected to be of interest to clinicians and researchers seeking to understand its motivations, benefits, and challenges. Relationship therapists will benefit from increased knowledge of how to work with clients interested or engaged in CNM relationships. Overall, this study supports previous findings that CNM is a viable, enjoyable, yet sometimes challenging type of relationship.

Yours, mine, or ours: Does bank account status in early marriage affect financial behavior and financial satisfaction?

The relationship between an individual’s financial behavior and financial satisfaction is well known. Less evidence is available about how these two constructs interplay within couples. This considered, the current paper aims to (a) examine whether individuals’ financial satisfaction is influenced by their own financial behavior (actor effect) and their partner’s financial behavior (partner effect); (b) examine whether these two effects vary between husbands and wives; and (c) verify how couples’ bank account status (i.e., only joint bank accounts, only separate bank accounts, both joint and separate bank accounts) moderate these effects. The current study draws 1,475 heterosexual early married couples from Couple Relationships and Transition Experiences study and modeled dyadic data through an Actor Partner Interdependence Model. Results indicate that actor’s financial behavior is associated only with one’s own financial satisfaction (actor effect) and not one’s partner’s financial satisfaction (partner effect). This holds for both wives and husbands. Furthermore, individuals who hold only joint bank account(s) are more likely to have financial behaviors similar to their partner than individuals who hold only separate bank accounts or both joint and separate accounts. Couples who hold only separate accounts are more likely to engage in less positive financial behavior than their counterparts. Implications for relationship therapists and financial professionals are discussed.

THE INFLUENCE OF PHYSICAL THERAPIST APPROACH IN THE PARENT’S COMPLIANCE OF INFANTILE CEREBRAL PALSY DIAGNOSED CHILDREN. A RANDOMIZED CONTROLLED TRIAL

Abstract. Many methods of approaching the parents or guardians of neuromuscular diagnosed 0-4 years old children have been investigated, and the most efficient on the long period of time, as the diagnose needs a long-term medical program, has been found to be the clearly, detailed and constructive information. The lack of discernment and reason of a 0-4 year old child make his family role essential after the medical diagnose, especially the parents or guardians (P/G). The study’s objective is to demonstrate that the physical therapist relationship with P/G determines his treatment compliance. The research is based on the data collected from 2 groups, representative sample and a control group. Both groups followed the instructions of the medical rehabilitation program DinaCord which had a 4 months duration, being designed the same but having other approach from the physical therapist side, depending on which group the subjects belonged. The specialist’s participation must be active in both ways of transmitter and receiver. Thereby, the transmitted information is received then processed by the parent or guardian depending on the reception and empathize of the physical therapist by the paraverbal, nonverbal and verbal parent or guardian feedback. As results, the rehabilitation program has better output when the physical therapist’s P/G approach is optimized, compared to a passive information transmitter physical therapist. The conclusions underline the parent or guardian (P/G) compliance potential in the physical therapy program as he is let know about all the information consisting of the diagnosis, the approach (the therapy, the consequences, the result projection in an estimated period of time) and the influence of an active participation from his part.

Caring, Chemistry, and Orgasms: Components of Great Sexual Experiences.

Sexual satisfaction is important to individual well-being and relationship satisfaction, making it a research topic relevant for sex clinicians and relationship therapists. The current study adds to sexuality literature by asking participants questions about the factors involved in "great sex." We conducted 78 interviews via email or phone with participants ranging in age from 18 to 69. The sample included a diverse range of sexual orientations and identities, and various relationship statuses. Three primary themes emerged regarding great sex: orgasm, an emotional component, and chemistry/connection. Though some participants equated an emotional aspect as love; most participants made clear the difference between love and emotional elements in sex. Many participants shared their belief that a man only invests in his female partner's orgasm when he also invests in her emotionally. Thus, some women explained that the emotional component helped them be present enough to orgasm. Others explained the emotional component as trust and affection. Participants also elaborated to define chemistry, which they regarded as out of one's control and impossible to manufacture. A smaller number of participants stated unequivocally the lack of necessity of an emotional aspect to great sex; they stated instead that physical connection trumped an emotional component.

Exploring erotic potential: mixed methods study on effects of a sexological bodywork retreat for people who identify as women

Within the field of sexuality in the United States, the use of hands-on work is controversial, although it is practiced internationally and has been researched in other countries. This mixed methods study explored effects of sexological bodywork within the context of Back to the BodyTM retreats for people who identify as women. Quantitative data were gathered from a survey of participants at past retreats (n = 48) and from pre and posttest surveys of participants before and after a retreat (n = 35). The survey of past participants found moderate to very positive changes across all constructs: 75% for arousal, sexual self-image, and sisterhood; 72% for body image; 71% for feelings about genitals and sexual assertiveness; and 66% for sexual satisfaction. Pre and posttest surveys revealed statistically significant increases in genital self-image, body image, sexual self-image, and sexual satisfaction; however, sexual assertiveness decreased. Qualitative analysis of open-ended survey responses and from 21 in-depth interviews revealed five major themes: feeling safe, connecting to self and others, feeling acceptance and permission, exploring arousal and pleasure, and transformative life changes. Sex and relationship therapists can use these findings to add to their own knowledge and to assist clients who may be interested in these modalities.

Adolescents' experiences of acceptance and commitment therapy for depression: An interpretative phenomenological analysis of good-outcome cases.

Acceptance and commitment therapy (ACT) has been shown to help treat depression. However, little is known about the patient's experiences with ACT. This study aimed to learn how it was used in adolescents with major depressive disorder who have achieved good treatment outcomes. Five adolescents with major depressive disorder with good treatment outcomes of ACT were enrolled in the semi-structured qualitative interview and analyzed using systematic textual condensation and interpretative phenomenological analysis. Four primary themes emerged from the investigation. "Therapist relationships and characteristics" describes the therapist's receptiveness and respect for adolescents with depression and having a trustworthy and sincere therapist. "Spaces to explore and experience" describes the ongoing process and content of acceptance of negative emotions and mindfulness practices in the healing process. "Do important things" refers to values and committed action. The "time settings" include the frequency and duration of treatment. Adolescents make positive changes with a receptive and respectful therapist by exploring themselves in a genuine and trusting therapeutic relationship. Improvement seems to come from being open to all thoughts and feelings and developing the ability to live in the present moment. Teenagers attach great importance to value-oriented behaviour. Therefore, treatment should target the critical areas of depressed adolescents to guide them towards recovery effectively.

“The Parallel Dialogue”: Parental experience of their role in the relationship with their child's counsellor/psychotherapist

AbstractThe parent–therapist relationship is a central consideration in child counselling and psychotherapy, particularly in private practice where parents are typically financially, emotionally and practically invested in the process. The relationship, which can be ambiguous and anxiety‐laden on both sides, has historically received scant attention in therapeutic discourse, leading to gaps in practitioner confidence and training. In this context, and seeking to centre parent voices, this study provides an interpretative phenomenological analysis of four mothers' experiences of their role in the relationship with their child's therapist. Key identified themes encompass parental expectation of involvement; the destabilising, disorienting nature of the relationship; the centrality of trust; and critical evaluations of value. Findings are discussed in relation to attachment theory and cultural expectations of parental responsibility. The study concludes that the relationship is a live and potent property with potential to impact the course of the intervention, and recommends that practitioners thoughtfully consider the potential benefits and drawbacks of meeting or frustrating parental involvement expectations.

Evaluating visitor–therapist relationship in Indian spa and wellness resorts

PurposeThis research examines the role of a therapist’s attributes, namely, expertise, sociability, likability and mind-set similarity, in building trust, satisfaction and commitment amongst visitors in Indian wellness resorts and hotels.Design/methodology/approachThe text mining approach was adopted to collect a large corpus of 3,94,373 online reviews from TripAdvisor, Google Reviews and hotels.com. Reviews were taken from 1,677 resorts and hotels that deal in spa and wellness care across India. This study uses unsupervised Naïve Bayes classification and n-gram lexical TF-IDF vectorizer method to classify and find the sentiment of the reviews shared by the visitors of the wellness resorts. Additionally, multiple linear regression is performed to understand the impact of the therapist’s identified attributes on the visitor’s relationship quality.FindingsThe research found positive sentiment towards the therapist’s likability, and visitors seemed satisfied with the overall wellness service. The sentiment towards trust and commitment is low. The study also found significant links between likability and expertise in building the relationship quality between the therapist and the visitors. The expertise of the therapist enhances visitors’ trust and willingness to return. The therapist’s likability nature helps in increasing visitor satisfaction.Research limitations/implicationsThis study helps to understand the service personnel's level of relationship with the customer in hospitality services. Further, the study empirically verifies the important factors that build relationship quality in Indian wellness services.Practical implicationsThe present study argues the need for greater clarity in understanding the customer perception of the services provided by wellness therapists in Indian wellness resorts and hotels. The study guides hotel managers to perform training of wellness therapists to improve customer satisfaction. Using the findings of the current study, managers can prioritize therapists’ attributes and realign their core strategies and provide satisfying wellness services to customers.Originality/valueThis study demonstrates the essential qualities a therapist should develop to enhance the relationship with the resort visitors and foster trust, commitment and satisfaction. The study goes a step further by using a vast database of online data for deep insights into the visitor’s view and the use of machine learning for amplifying results.

Relationship-driven, family-centered care via TelePT: Reflections in the wake of COVID-19.

In response to the throttling of children's therapy programs precipitated by COVID-19 shutdowns, interest in the use of telehealth has increased among service providers at both the clinical and administrative levels. TelePT promises to be particularly appropriate in devising programs of on-going, therapeutic exercise interventions for children with neuromotor disorders. From the lay perspective, physical/physiotherapy (PT) which is seemingly characterized by the "hands-on," and corrective approach to managing impairments, makes it a counter-intuitive candidate for delivery over telehealth. Over the past decades, however, PT as a discipline has increasingly adhered to a relationship-driven, family-centered model of intervention. This model is "hands-off," figuratively if not always literally, and hence is not necessarily disconsonant with delivery mediated by telehealth technology. The current study explores in-depth the experiences and reflections of seven practicing therapists, on the impact of telehealth, telePT on the operationalization of relationship-based, family-centered methods into therapy. Interpretative phenomenological analysis was selected as the analytic method for understanding participants' experience providing services using both distance and standard face-to-face practice modalities. Results identified eight principal themes emerging from participants' descriptions of their experience of delivering therapy over telePT. Four of these themes correspond to the tenets of relationship-driven, family-centered care identified across four frameworks applied to pediatric rehabilitation. The remaining four themes focus on the particularities of the telePT modality and its viability in clinical practice. The ability telePT afforded to "see into the child's environment" emerged arguably as the greatest value of the modality in patient care. It revealed to therapists so much that they did not know about their patients' progress and, more strikingly, had not realized they did not know. TelePT provides a unique window into the child's functioning in the hours he is not in therapy. Given its potential in parent-therapist relationship building, assuring the ecological validity of therapy programs, and the empowerment of families who seek it, telePT is likely to be part of the future of PT and one driver of its evolution as a profession. There is a compelling case to retain telePT modalities offering them alongside in-person formats for convenience, safety, and service quality enhancement.

Consensus for a power wheelchair training approach for people with cognitive impairments

Purpose Power wheelchairs (PWCs) can enhance independent mobility. The World Health Organization recommends training PWC users. However, current PWC training approaches do not always meet the needs of PWC users with complex mobility and cognitive impairment. The aim was to co-develop an innovative approach to PWC training for individuals with complex mobility and cognitive impairments. Materials and methods A two-phase mixed method research, involving PWC users, clinicians and researchers throughout all aspects of the research, was realized. (1) Interviews and focus groups were used. (2) The Delphi method was followed to refine the PWC training approach. Results Phase 1: Twenty-six stakeholders indicated that PWC training should consider the client as a partner, the learning environment, the proposed activities, interactions with the trainer and intervention format. Phase 2: two hundred and seven participants agreed that the PWC training should be goal directed, should be client-centred and occupation-based, should enhance client–therapist relationships and should be realized in a safe and adapted environment. Conclusions Stakeholders on PWC use came to agreement on key components that should be applied when training people with cognitive impairments.

Personality Disorders as a Possible Moderator of the Effects of Relational Interventions in Short-Term Psychoanalytic Psychotherapy with Depressed Adolescents.

A significant proportion of adolescents suffering from major depressive disorder (MDD) are likely to have a co-morbid personality disorder (PD). Short-term psychoanalytic psychotherapy (STPP) was found to be one treatment of choice for adolescents suffering from MDD. Background: The first experimental study of transference work-in teenagers (FEST-IT) demonstrated the efficaciousness of transference work in STPP with adolescents suffering from MDD. The usefulness of STPP may be enhanced by exploring possible moderators. Methods: Depressed adolescents (N = 69), aged 16–18 years, were diagnosed with the structured interview for DSM-IV PDs and randomized to 28 weeks of STPP with or without transference work. A mixed linear model was applied. The moderator effect was investigated by a three-way interaction including “time”, “treatment group” and “number of PD criteria”. Results: A small but significant moderator effect was found for cluster B personality pathology. Patients with a higher number of cluster B PD criteria at baseline did better up to one-year post-treatment where therapists encouraged patients to explore the patient–therapist relationship in the here and now. Conclusion: When treated with psychoanalytic psychotherapy for MDD, adolescents with cluster B PD symptoms seem to profit more from transference work than adolescents without such pathology.

Perceptions of the caregiver-pediatric physical therapist relationship1.

Collaboration between physical therapists and caregivers of children who receive physical therapy is integral to providing family-centered care. Successful collaboration depends upon the therapeutic relationship built within the caregiver-therapist dyad. However, the nature of these relationships is not well understood. The purpose of this study was to explore the caregiver-pediatric physical therapist relationship from the perspectives of the caregiver and pediatric physical therapist. A qualitative multiple case study methodology was used; a caregiver and pediatric physical therapist represented a bounded case. Each caregiver and therapist engaged in separate, semi-structured, in-depth interviews. Through within- and cross-case coding, three themes were identified: physical therapist as a guide, the caregiver-pediatric physical therapist connection, and professional qualities and performance. These themes help to provide an understanding of the therapeutic relationships that can occur between caregivers and pediatric physical therapists, which can help support effective collaboration as part of providing family-centered care.

COME_IN: A qualitative framework for content, meanings and intersubjectivity in free dyadic improvisations

ABSTRACT Introduction A growing body of research reflects the interest in meaningful moments in music therapeutic treatment and the client--therapist relationship; however, little insight has been given into the client’s subjective experience and the interweaving processes between a therapist and a client. Central to this initial research is the question of how dialogue as a substantial relational quality emerges and intersubjectively manifests in free, dyadic improvisations, as is typical in humanistic and/or psychodynamic approaches to music therapy practice. This paper presents the qualitative part of a mixed-methods, multi-phase feasibility study intended to develop a framework for non-clinical and clinical research. Method In a non-clinical setting with adult participants (n=9) and trained music therapists (n=8), a total of 17 free dyadic piano improvisations were recorded and verbally reflected on in semi-structured debriefing interviews. These focused on moments or time periods where one or both improvising people had the feeling that something pivotal happened between them. A qualitative summarizing content analysis of the transcribed interviews, including a selective coding process, was conducted to investigate both perspectives. Results As a two-part category system, the framework for content, meanings and intersubjectivity (COME_IN) covers (a) meanings, i.e. different intra- and interpersonal experiences indicating developments and states of relationship in dyadic improvisations, and (b) intersubjectivity, operationalized in temporal and/or content-related overlaps of subjective experiences. Discussion Showing manifold patterns of how meaning and intersubjectivity nonverbally arise between people, the framework provides a solid base for further mixed-methods analyses. Clinical studies are needed to test and refine the categories.