A systematic review of interoception and therapeutic outcome research: Implications for psychotherapeutic practice

Interoception has been recognized as a key process linking bodily regulation, emotional experience and psychological well-being, yet its role within psychotherapy remains theoretically and empirically fragmented. Beyond outcome variability, this fragmentation reflects differences in how interoception is conceptualized and operationalized in psychotherapy research.

This systematic review examined associations between interoceptive processes and psychotherapeutic outcomes-including interoception as a pre-therapy client factor, as a pre-post change measure and as a therapeutic outcome in itself-and identified intervention protocols promoting interoceptive abilities, while evaluating how interoception is defined and measured within psychotherapy.

Following PRISMA 2020 guidelines and PROSPERO registration, searches were conducted in PubMed, PsycINFO, CINAHL, Web of Science and Scopus. Eligible studies involved adults undergoing psychotherapy, assessed interoception using validated self-report or physiological measures, and reported therapeutic outcomes. Twenty-one studies were synthesized using thematic analysis and the PICO framework.

Improvements in interoceptive functioning, particularly interoceptive awareness, bodily trust and self-regulation, were associated with reductions in psychological symptoms, including eating disorder pathology, depression, anxiety and distress. Interoception emerged as a transdiagnostic process across diagnostic groups.

Interoception is clinically relevant in psychotherapy, yet evidence is shaped by predominantly top-down conceptualizations. Integrating behavioural and psychophysiological measures may clarify bottom-up mechanisms of therapeutic change. This integration can inform assessment strategies and support more embodied, process-oriented psychotherapeutic research in practice.