Communication strategies and suggestive psychological interventions in individuals with behavioral dysregulation and emotional disorders: a clinical and psychological analysis

Abstract

Background. Emotion dysregulation and behavioral dysregulation are important transdiagnostic factors that adversely affect the therapeutic alliance, treatment adherence, and the effectiveness of psychotherapeutic care. Contemporary psychiatry and medical psychology increasingly emphasize person-centered, evidence-based approaches that integrate effective communication strategies and psychological interventions into comprehensive mental health care. Purpose – to investigate the application of communication strategies and suggestive psychological interventions in individuals with behavioral dysregulation and emotional disorders and to evaluate their impact on the therapeutic alliance, emotion regulation, and treatment adherence. Materials and Methods. A cross-sectional clinical psychological study was conducted involving 286 patients receiving either outpatient or inpatient treatment in healthcare institutions in Ukraine during 2024–2025. Standardized psychometric instruments, including the Difficulties in Emotion Regulation Scale (DERS-36), Hospital Anxiety and Depression Scale (HADS), Depression Anxiety Stress Scales (DASS-21), Working Alliance Inventory–Short Revised (WAI-SR), and Medication Adherence Rating Scale (MARS), were administered. Statistical analysis included descriptive statistics, the Shapiro–Wilk test, Pearsonʼs correlation analysis, Studentʼs t-test, one-way analysis of variance (ANOVA), multiple linear regression analysis, and thematic content analysis. Results. Significant negative correlations were identified between emotion dysregulation, therapeutic alliance, and treatment adherence (p < 0.001), whereas significant positive associations were found between anxiety, depressive symptoms, and psychological distress (p < 0.001). Inpatients demonstrated higher levels of emotion dysregulation and psychological distress together with lower therapeutic alliance and treatment adherence compared with outpatients. Multiple regression analysis showed that the therapeutic alliance was an independent positive predictor of treatment adherence, whereas emotion dysregulation, anxiety, and depression were independent negative predictors (R² = 0.54). The thematic content analysis identified empathic communication, active listening, psychological support, motivational interviewing, and suggestive psychological interventions as the most important components of effective therapeutic interaction. Conclusions. The integration of evidence-based communication strategies and suggestive psychological interventions into comprehensive psychotherapeutic care contributes to strengthening the therapeutic alliance, improving treatment adherence, enhancing emotion regulation, and optimizing psychosocial functioning in individuals with behavioral dysregulation and emotional disorders.