Identifying therapies to effectively reduce alexithymia: A systematic review and meta-analysis

Alexithymia is a multi-faceted construct that refers to difficulties with noticing and describing one's own emotional states, an externally oriented thinking style and constricted imaginal capacity. Here, we present a systematic review and meta-analysis of whether psychological interventions can reduce alexithymia compared to control conditions, and which intervention types are most effective. Following PRISMA guidance, this extensive search of databases resulted in 59 included studies, of which 53 effect sizes (N = 3368) were analysed with meta-analytic techniques. Overall, interventions significantly reduced levels of alexithymia compared with control conditions (g = -0.52 [SE = 0.09]), representing a medium-sized, average effect. Furthermore, moderation analyses indicated that integrative interventions had the largest effects, with minimal heterogeneity, with no differences found between psychological interventions that directly targeted alexithymia versus those that measured it as a secondary outcome. Included studies were mostly of good methodological quality. These findings increase theoretical and clinical knowledge of interventions for reducing alexithymia. Recommendations herein include conducting higher powered studies, recruiting more diverse groups, and developing a deeper understanding of the processes through which these interventions work.