Using longitudinal client and therapist working alliance ratings, previous research examined how alliance: average value, linear growth, variability, stability (autocorrelation), and partner responsiveness were associated with client outcome. However, no research simultaneously examined all of these dimensions. Omitting important variables in analyses could lead to overestimation of related effects. Therefore, the purpose of this study was to examine these effects simultaneously. Therapists (N = 45) and clients (N = 236) rated alliance after every session (N = 10,720) and clients completed a measure of psychological distress after every eighth session. We used dynamic structure equation modeling to model longitudinal ratings using the longitudinal actor-partner interaction and location-scale models. Across sessions, there were significant linear growth and significant variability in client and therapist alliance ratings. The variability indicates multiple "V" patterns, which have been associated with alliance ruptures. Both actor effects were significant, showing session-to-session stability for client and therapist alliance. In addition, client-partner effect was significant, indicating higher-than-usual client alliance in a session predicting an increase in therapist alliance in the subsequent session. Growth in neither client-rated nor therapist-rated working alliances was significantly associated with client improvement. Lower variabilities (fewer fluctuations) in both client- and therapist-rated working alliances were associated with better outcomes. Higher therapist-actor and partner effects were associated with client improvement, but client-actor and partner effects were not associated with client improvement. Average working alliances were not associated with client improvement. Implications for practice and research were discussed. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

中文翻译：

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治疗师和客户对工作联盟的看法：共同发展、线性增长、可变性和客户功能。


之前的研究使用纵向客户和治疗师工作联盟评级，研究了联盟：平均值、线性增长、可变性、稳定性（自相关）和合作伙伴响应性如何与客户结果相关联。然而，没有研究同时检验所有这些维度。在分析中忽略重要变量可能会导致相关影响的高估。因此，本研究的目的是同时检查这些影响。治疗师 (N = 45) 和客户 (N = 236) 在每次治疗后对联盟进行评分 (N = 10,720)，客户在每八次治疗后完成一项心理困扰测量。我们使用动态结构方程模型来使用纵向演员-合作伙伴交互和位置尺度模型来模拟纵向评级。在各个疗程中，客户和治疗师联盟评级存在显着的线性增长和显着的变化。变异性表明多种“V”模式，这与联盟破裂有关。两个演员的效果都很显着，显示了来访者和治疗师联盟的每次疗程的稳定性。此外，客户-合作伙伴效应显着，表明一次会议中的客户联盟高于平常，预示着后续会议中治疗师联盟的增加。来访者评价的工作联盟和治疗师评价的工作联盟的增长都与来访者的改善没有显着相关。客户和治疗师评价的工作联盟的较低变异性（较少的波动）与更好的结果相关。较高的治疗师-行动者和伴侣效应与来访者的改善相关，但来访者-行动者和伴侣效应与来访者的改善无关。 平均的工作联盟与客户的改进无关。讨论了对实践和研究的影响。 （PsycInfo 数据库记录 (c) 2024 APA，保留所有权利）。