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. OBJECTIVE: 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. METHOD: 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. RESULTS: 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. CONCLUSION: 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.