Fanny Alexandra Dietel, Ivo Georgiev, Julia Müller, Tanja Andor, Isabelle Drenckhan, Julienne Seidemann, Heinz Holling, Nexhmedin Morina, Ulrike Buhlmann
{"title":"感知工作联盟品质与一致性对自然主义心理治疗结果的影响:反应面分析。","authors":"Fanny Alexandra Dietel, Ivo Georgiev, Julia Müller, Tanja Andor, Isabelle Drenckhan, Julienne Seidemann, Heinz Holling, Nexhmedin Morina, Ulrike Buhlmann","doi":"10.1080/10503307.2025.2553636","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>Patient- and therapist-reported (i.e., dyadic) working alliance evaluations have been identified as robust predictors of psychotherapy outcome. However, it remains unclear how their congruence relates to outcome and how treatment duration, a variable factor in naturalistic psychotherapy, influences this relationship. This study examined the effects of dyadic alliance judgments and their congruence on multidimensional outcomes, further assessing the role of treatment duration.</p><p><strong>Method: </strong><i>N</i> = 353 outpatients undergoing cognitive behavioral therapy and their <i>N</i> = 95 therapists provided alliance ratings at treatment onset, with patients reporting distress, depression, and quality of life pre- and post-treatment. Polynomial regressions with response surface analyses were used to examine the relationships between alliance, congruence, and outcome, further controlling for session count.</p><p><strong>Results: </strong>Dyadic alliance ratings were moderately correlated, with patient-reported ratings exceeding those of therapists. Therapist-reported but not patient-reported alliance predicted greater reductions in depression and distress. Higher levels of jointly high alliance ratings, but not congruence, were associated with improvements in distress and depression. There were no incongruence effects. Controlling for session count yielded identical result patterns.</p><p><strong>Conclusion: </strong>These findings highlight the value of alliance ratings and their alignment in predicting psychotherapy outcome, emphasizing the need to consider their interplay, regardless of treatment duration.</p>","PeriodicalId":48159,"journal":{"name":"Psychotherapy Research","volume":" ","pages":"1-14"},"PeriodicalIF":3.0000,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Effects of perceived working alliance quality and congruence on naturalistic psychotherapy outcome: A response surface analysis.\",\"authors\":\"Fanny Alexandra Dietel, Ivo Georgiev, Julia Müller, Tanja Andor, Isabelle Drenckhan, Julienne Seidemann, Heinz Holling, Nexhmedin Morina, Ulrike Buhlmann\",\"doi\":\"10.1080/10503307.2025.2553636\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>Patient- and therapist-reported (i.e., dyadic) working alliance evaluations have been identified as robust predictors of psychotherapy outcome. However, it remains unclear how their congruence relates to outcome and how treatment duration, a variable factor in naturalistic psychotherapy, influences this relationship. This study examined the effects of dyadic alliance judgments and their congruence on multidimensional outcomes, further assessing the role of treatment duration.</p><p><strong>Method: </strong><i>N</i> = 353 outpatients undergoing cognitive behavioral therapy and their <i>N</i> = 95 therapists provided alliance ratings at treatment onset, with patients reporting distress, depression, and quality of life pre- and post-treatment. Polynomial regressions with response surface analyses were used to examine the relationships between alliance, congruence, and outcome, further controlling for session count.</p><p><strong>Results: </strong>Dyadic alliance ratings were moderately correlated, with patient-reported ratings exceeding those of therapists. Therapist-reported but not patient-reported alliance predicted greater reductions in depression and distress. Higher levels of jointly high alliance ratings, but not congruence, were associated with improvements in distress and depression. There were no incongruence effects. Controlling for session count yielded identical result patterns.</p><p><strong>Conclusion: </strong>These findings highlight the value of alliance ratings and their alignment in predicting psychotherapy outcome, emphasizing the need to consider their interplay, regardless of treatment duration.</p>\",\"PeriodicalId\":48159,\"journal\":{\"name\":\"Psychotherapy Research\",\"volume\":\" \",\"pages\":\"1-14\"},\"PeriodicalIF\":3.0000,\"publicationDate\":\"2025-09-22\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Psychotherapy Research\",\"FirstCategoryId\":\"102\",\"ListUrlMain\":\"https://doi.org/10.1080/10503307.2025.2553636\",\"RegionNum\":1,\"RegionCategory\":\"心理学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"PSYCHOLOGY, CLINICAL\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Psychotherapy Research","FirstCategoryId":"102","ListUrlMain":"https://doi.org/10.1080/10503307.2025.2553636","RegionNum":1,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"PSYCHOLOGY, CLINICAL","Score":null,"Total":0}
Effects of perceived working alliance quality and congruence on naturalistic psychotherapy outcome: A response surface analysis.
Objective: Patient- and therapist-reported (i.e., dyadic) working alliance evaluations have been identified as robust predictors of psychotherapy outcome. However, it remains unclear how their congruence relates to outcome and how treatment duration, a variable factor in naturalistic psychotherapy, influences this relationship. This study examined the effects of dyadic alliance judgments and their congruence on multidimensional outcomes, further assessing the role of treatment duration.
Method: N = 353 outpatients undergoing cognitive behavioral therapy and their N = 95 therapists provided alliance ratings at treatment onset, with patients reporting distress, depression, and quality of life pre- and post-treatment. Polynomial regressions with response surface analyses were used to examine the relationships between alliance, congruence, and outcome, further controlling for session count.
Results: Dyadic alliance ratings were moderately correlated, with patient-reported ratings exceeding those of therapists. Therapist-reported but not patient-reported alliance predicted greater reductions in depression and distress. Higher levels of jointly high alliance ratings, but not congruence, were associated with improvements in distress and depression. There were no incongruence effects. Controlling for session count yielded identical result patterns.
Conclusion: These findings highlight the value of alliance ratings and their alignment in predicting psychotherapy outcome, emphasizing the need to consider their interplay, regardless of treatment duration.
期刊介绍:
Psychotherapy Research seeks to enhance the development, scientific quality, and social relevance of psychotherapy research and to foster the use of research findings in practice, education, and policy formulation. The Journal publishes reports of original research on all aspects of psychotherapy, including its outcomes, its processes, education of practitioners, and delivery of services. It also publishes methodological, theoretical, and review articles of direct relevance to psychotherapy research. The Journal is addressed to an international, interdisciplinary audience and welcomes submissions dealing with diverse theoretical orientations, treatment modalities.