Nonverbal Synchrony and Alliance in Exposure Therapy for Pediatric Anxiety: a Case Report



Exposure therapy (ET) has been shown to be effective in working with anxiety disorders in children. In the Russian literature, there are few protocols of ET, and no effectiveness studies have been found. Contribution to the effectiveness of work with anxiety is conditioned by the alliance between psychologist and client, as well as by the phenomenon of temporal attunement of physiological and behavioral parameters of two or more people during their interaction (interpersonal synchrony). This article presents the results of an observation of the dynamics of anxiety symptoms, psychologists' alliance, and synchrony at the behavioral level in a single case analysis of an intensive five-day ET intervention with child anxiety. It was found that high alliance scores and their positive dynamics, as well as the psychologist's adjustment to the client's movements, were observed simultaneously with de-escalation of anxiety symptoms. In addition to these findings, the article provides a detailed description of the research program and recommendations for researchers of the psychotherapeutic process and psychologists-practitioners.

General Information

Keywords: exposure therapy, alliance, interpersonal synchrony, child anxiety

Journal rubric: Medical Psychology

Article type: scientific article


Funding. This work is supported by the Ministry of Science and Higher Education of the Russian Federation (Agreement No. 075-10-2021-093; Project COG-RND-2104).

Acknowledgements. The authors thank Grigorenko E.L. for the idea of this manuscript, study participant and her family for the opportunity to present the results of the exposure therapy, Eremeev V.A. for the contribution to the data collection, Korostelev L.V. for the assistance in the data collection, and Kustova T.A. for the assistance in the processing of synchrony data.

Received: 31.01.2024


For citation: Oreshina G.V., Zhukova M.A. Nonverbal Synchrony and Alliance in Exposure Therapy for Pediatric Anxiety: a Case Report [Elektronnyi resurs]. Sovremennaia zarubezhnaia psikhologiia = Journal of Modern Foreign Psychology, 2024. Vol. 13, no. 1, pp. 10–20. DOI: 10.17759/jmfp.2024130101. (In Russ., аbstr. in Engl.)


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Information About the Authors

Galina V. Oreshina, PhD Student, Junior Researcher, Sirius University of Science and Technology, Sochi, Russia, ORCID:, e-mail:

Marina A. Zhukova, PhD in Psychology, Postdoctoral Fellow, Boston Children’s Hospital, Harvard Medical School, Boston, USA, ORCID:, e-mail:



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