OBJECTIVE In this naturalistic study we aimed to investigate the relationships between two central change processes (affective and cognitive) and two common relationship factors ("Confidence in the therapist" and "Confidence in the treatment"), which have been shown to impact outcomes in a clinical context. We also investigated whether these interrelationships varied across treatment orientations (i.e., cognitive or psychodynamic focused). METHOD The sample consisted of 631 patients with a primary anxiety or depressive disorder who were admitted to an inpatient program and treated with psychotherapy. The data consisted of weekly measures of cognitive (i.e., "rumination") and affective (i.e., "problems with emotional clarity") change processes as well as scores on Confidence in the therapist and Confidence in the treatment and symptom distress. A multivariate version of the latent curve model with structured residuals was used to investigate the within-patient effects of week-to-week changes in all variables. RESULTS Initial analyses established that both problems with emotional clarity and rumination predicted symptom distress. Further, we found that higher Confidence in the therapist predicted higher emotional clarity (but not lower rumination) whereas higher Confidence in the treatment predicted lower rumination (but did not affect emotional clarity). Post hoc analyses found that these interrelationships varied across treatment orientation (i.e., cognitive vs. psychodynamic). DISCUSSION The results indicate that patients' experience of the therapist is associated with emotional change processes, and that patients' experience of the coherence and meaningfulness of treatment, on the other hand, is associated with cognitive change processes. Implications for clinical practice are discussed. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

中文翻译：

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心理治疗中的情绪和认知过程与治疗关系的不同方面有关。


目的 在这项自然主义研究中，我们旨在调查两个核心变化过程（情感和认知）和两个常见关系因素（“对治疗师的信心”和“对治疗的信心”）之间的关系，这已被证明会影响临床环境中的结果。我们还调查了这些相互关系是否因治疗取向而异（即，以认知或心理动力学为重点）。方法 样本包括 631 名患有原发性焦虑或抑郁症的患者，他们被收治在住院计划中并接受心理治疗。数据包括认知（即“反刍”）和情感（即“情绪清晰度问题”）变化过程的每周测量，以及对治疗师的信心和对治疗的信心和症状困扰的分数。使用具有结构化残差的潜在曲线模型的多变量版本来研究所有变量的每周变化对患者内部的影响。结果 初步分析确定，情绪清晰和反刍问题都预测了症状困扰。此外，我们发现，对治疗师的信心越高，情绪清晰度越高（但反刍程度不低），而对治疗的信心越高，反刍程度越高（但不影响情绪清晰度）。事后分析发现，这些相互关系因治疗取向而异（即认知与心理动力学）。讨论 结果表明，患者对治疗师的体验与情绪变化过程有关，另一方面，患者对治疗的连贯性和意义的体验与认知变化过程有关。 讨论了对临床实践的意义。（PsycInfo 数据库记录 （c） 2024 APA，保留所有权利）。