Psych Central Reviews

Reviews Home » Book Review: Paraverbal Communication in Psychotherapy

Book Review: Paraverbal Communication in Psychotherapy

Communication is said to be only 7% what you say and 93% how you say it. In many ways, it’s all about what isn’t said—body language, eye contact, tone of voicebecause what isn’t said shows the true emotion behind the message.

In Paraverbal Communication in Psychotherapy: Beyond the Words, authors James Donovan, Kristin Osborn, and Susan Rice put nonverbal communication in psychotherapy under the microscope.

Through case studies and both qualitative and quantitative analysis, the authors present a clear case for the value of understanding and leveraging paraverbal communication for the betterment of the patient.

Paraverbal Communication in Psychotherapy is reminiscent of a research-paper-turned-book, yet with a readability often lost in the technicalities of scholastic writing. The structure establishes credibility and offers a delineated roadmap, making it clear that despite its accessible tone, this isn’t Sunday reading for the everyday psychology nut. Rather, it is a genuine primer and experiential evaluation of using paraverbal communication as a tool in psychotherapy.

The authors relied on tapes of themselves and of other clinicians, and a quantitative rating guide – the Achievement of Therapeutic Objectives Scale (ATOS) – to determine the communicable connectivity between the paraverbal signals and the course of the treatment session.

The authors used distinct case studies followed by evaluations of the treatment session as determined by the ATOS score, clinicians’ perspectives, and a notated “script” of each participant’s nonverbal communication. In doing so, they were able to demonstrate not only the role of paraverbal communication in the session, but best practices and opportunities for clinicians to learn from in their own work.

I am a student of communication, psychology, and public speaking, but I am not a licensed therapist. That being said, my review takes into account the established credibility and academic structure of the book. Despite my lack of professional experience in the field, the brief history of psychotherapy provided in the opening pages was truly educational and set a solid foundation for the case studies.

Because the authors took the time to summarize the practice as well as the current and historical research, I had a base understanding from which to contextualize the “experimental” portions and evaluations that followed. As the book followed the structure of a well-researched paper, the case study portion was presented as mini-experiments, tested over time and analyzed for this book. This lent an air of objectivity to the research, which was well-established and communicated in a way that was both academically sound and accessible.

What did surprise this reader was that the body language portion of communication – referred to as paraverbal communication in this context – seemed to be a less-discussed topic or an ancillary study, as opposed to a core.

In my study of leadership, public speaking, and relating to others in those roles, understanding where people are coming from based on their body language is foundational information and something you are trained to be constantly aware of. It is quantified well by the research both preceding this work and shown in the case studies, and the authors further prove its validity as an important component in psychotherapy.

One additional strength of this book, and part of what kept it from being too bogged down by academic thoroughness was the tone. As mentioned previously, it is both accessible and clear, but more than that, it is personal. The authors – notably James Donovan – maintained an intimate connection to the reader that grabbed my attention and gave me the perspective of sitting in a small classroom and learning directly from the source.

While it laid the concepts clearly, built a solid research framework, and presented in an accessible yet authoritative tone, I found myself lacking the action steps for application on a case-by-case basis. This is where the downfall of the academic structure is seen, as there is not as clear a focus on “what do we do with it now,” in direct, actionable terms.

While a licensed therapist might know what to do with the information presented, the accessible tone would be topped off perfectly with a more direct application. By providing readers with methodology to apply the principles learned, this would be stronger as a primer on the topic as opposed to just a presentation of research.

In closing, what Donovan, Osborn, and Rice have done is take the principles of non-verbal communication and demonstrated their value in psychotherapy sessions. Backed by research and experience, Paraverbal Communication in Psychotherapy is an excellent primer on the topic for licensed therapists eager to better understand and respond to what their patients are really feeling and walking through in the moment.

Though I speak from outside the field as a formal participant, I can see how this work could be transformational for the practices of those who read it.

Paraverbal Communication in Psychotherapy: Beyond the Words

James M. Donovan, Kristin A. R. Osborn, Susan Rice

Rowman & Littlefield

October 2016

Paperback, 262 pages

Book Review: Paraverbal Communication in Psychotherapy

Psych Central's Recommendation:
Worth Your Time! +++

Your Recommendation: (if you've read this book)
1 Star2 Stars3 Stars4 Stars5 Stars (No Ratings Yet)

Want to buy the book or learn more?
Check out the book on!
(All links to provide a small affiliate fee to us if you decide to purchase the book.)

Bethany Duarte

APA Reference
Duarte, B. (2017). Book Review: Paraverbal Communication in Psychotherapy. Psych Central. Retrieved on December 4, 2020, from
Scientifically Reviewed
Last updated: 29 Dec 2017
Last reviewed: By a member of our scientific advisory board on 29 Dec 2017
Published on Psych All rights reserved.