Are we on the same page? Examining client-therapist alliance congruence and psychological well-being.

Abstract

This study examined client-therapist alliance congruence as a predictor of psychological well-being among 104 Filipino psychotherapy dyads. Descriptive analysis showed that although most dyads had non-identical ratings, 55.8% fell within the conservative broad agreement band; among dyads outside this band, therapist-higher discrepancies were more common. Client- and therapist-rated alliances were analyzed using polynomial regression with response surface analysis (RSA) to model both congruent and incongruent alliance effects on client psychological well-being. Treatment length, treatment interval, therapist professional maturity, and client symptom severity were included as covariates. Results indicated a significant positive linear effect along the line of alliance congruence, such that a mutually perceived alliance was associated with greater psychological well-being. In contrast, significant curvature along the line of incongruence (LOIC) showed that discrepancies between therapist and client alliance ratings were associated with lower well-being, with increasing mismatch predicting progressively poorer outcomes. The findings suggest that therapist and client alliance perceptions should not be treated as interchangeable and that their dyadic alignment provides clinically meaningful information beyond either perspective alone. These results are discussed in relation to alliance monitoring, client feedback, and culturally responsive psychotherapy practice in the Filipino context.