Effects of preference alignment and client-rated attachment style on therapy: The moderating role of interpersonal synchrony

The study suggests that preference alignment provides unique insights into symptom improvement beyond client-rated attachment style alone. Counselor-guided behavioral synchrony amplifies the effect of preference differences on symptom improvement, whereas client-guided brain synchrony reduces attachment avoidance's impact on the working alliance. These findings highlight that behavioral and brain synchrony impact therapeutic outcomes differently based on who guides the process, emphasizing the need to consider both interpersonal dynamics and alignment factors in counseling.