The Effects of Oxytocin Administration to Patients and Therapists on Physiological Synchronization
Status:
Not yet recruiting
Trial end date:
2023-07-01
Target enrollment:
Participant gender:
Summary
Introduction: Oxytocin (OT) is a nine-amino acid neuropeptide, known to have a fundamental
role in social communication. In a recent randomized, double-blind, placebo-controlled study
carried out in Shalvata Mental Health Center, OT was administrated to patients suffering from
severe mental health illness. The results indicated that OT has a clear beneficial effect on
therapeutic outcomes. However, to our knowledge, the effect of OT administration to both
patients and therapists on the therapeutic process was never tested. Substance administration
to caregivers is therefore possible, and could, in some cases, provide further knowledge
about the caregiving dynamics. Since we know the therapist's characteristics effect the
therapeutic alliance and that OT is associated with the therapeutic alliance,
patient-therapist bond, and therapy outcome, we are led to ask if OT administration to
patients and therapists could allow for a deeper understanding of OT's effects on the
therapeutic process.
Another variable found to be associated with the therapeutic process is Physiological
Synchronization. Physiological Synchronization (PS) is a primarily interpersonal phenomenon
which includes coordination of physiological signals between two or more interacting
individuals. Despite the rising number of studies examining PS, its physiological and
psychological mechanisms are yet to be fully understood. Based on literature indicating
associations between OT and PS, and associations each of them has with the therapeutic
process and its facilitators, in this study we wish to examine the influence of OT on PS
through intranasal OT administration to patients alone and to patients and therapists
together.
Research Hypotheses:
1. Patients receiving OT will demonstrate higher levels of PS during the measured session
compared to patients receiving placebo.
2. Patients receiving OT will report higher levels of perceived therapist empathy as
compared to patients receiving placebo.
3. These associations will be stronger when both patient and therapist receive OT in
comparison to patient alone.
4. Changed in PS and empathy will be associated with OT even after controlling for patient
rated alliance and session impact.
5. These findings will sustain after controlling for severity of symptoms and attachment
patterns.
Method:
Participants. Sixty patients and their therapists will be recruited for the pilot study.
Patients will be recruited from the inpatient adult psychiatric wards at Shalvata Mental
Health Center. Therapists in this study will be comprised of psychologists, psychiatrists,
and social workers, in different stages of seniority and training.
Instruments. Attachment patterns, symptom severity, side effects and therapeutic process
measurements - working alliance, perceived empathy and session impact - will be assessed
using self-report questionnaires. PS will be measured by recordings of the electrodermal
activity (EDA) measured by skin conductance signals, using a galvanic skin response (GSR)
device. Oxytocin Administration will be performed intranasally using a spray containing 24U.
Procedure. Sixty patients meeting inclusion criteria and their therapists will be recruited
for the pilot study. Dyads will be randomized and double-blindly allocated to receive
intra-nasal oxytocin or placebo. Dyads will be followed for two consecutive sessions,
approximately at their fourth and fifth sessions. After signing informed consent forms,
patients and therapists will complete therapeutic process measurements, and patients will be
assessed for the severity of their symptoms and attachment patterns. Prior to the first
session, patients will be administrated with either IN-OT or PLC and will wait for 30 minutes
before the beginning of the session. Skin conductance synchrony will be measured during the
session. At the end of the session, therapeutic process measurements will be assessed in both
patients and therapists, and patients will complete a side-effect questionnaire. Prior to the
second session, both patients and therapists will receive either IN-OT or PLC (each dyad will
receive the same substance) and will wait for 30 minutes before the beginning of the session.
Skin conductance synchrony will then be measured during the session. At the end of the
session, therapeutic process measurements will be assessed in both patients and therapists
alongside with a side-effect questionnaire.
The uniqueness of the proposed study is rooted in the view of the psychotherapy dyad as
undetached, by focusing on the dyad and not on the patient alone. Focusing on
patient-therapist synchronization lies on the understanding of the patient-therapist bond as
co-dependent and co-affected. Such research could increase our understanding of PS between
patient and therapist and its meaning in psychotherapy research and practice.