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) 2023 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相关。

目的 在这项自然主义研究中，我们旨在调查两个中心变化过程（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，这些因素已被证明会影响治疗结果临床背景。我们还调查了这些相互关系是否因治疗方向（即以认知或心理动力学为重点）而变化。方法 样本由 631 名患有原发性焦虑症或抑郁症的患者组成，他们被收治入院并接受心理治疗。数据包括每周对认知（即“沉思”）和情感（即“情绪清晰度问题”）变化过程的测量，以及对治疗师的信心以及对治疗和症状困扰的信心的得分。使用具有结构化残差的多变量版本的潜在曲线模型来研究所有变量每周变化的患者内部影响。结果 初步分析表明，情绪清晰度和沉思问题都预示着症状困扰。此外，我们发现对治疗师的较高信心预示着较高的情绪清晰度（但不会降低沉思），而对治疗的较高信心则预示着较低的沉思（但不影响情绪清晰度）。事后分析发现，这些相互关系因治疗方向（即认知与心理动力学）而异。讨论 结果表明，患者对治疗师的体验与情绪变化过程相关，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相关。讨论了对临床实践的影响。（PsycInfo 数据库记录 (c) 2023 APA，保留所有权利）。