Patients' higher psychotherapy outcome expectation (OE) correlates with improvement. Thus, it seems important that therapists attune to this belief, both in the moment and over time, to capitalize on its value when higher or respond to its potential risk when lower. Conceptually, attunement can have different guises, including the extent to which therapists (a) accurately estimate their patients' momentary OE level (low directional discrepancy), (b) become more accurate in estimating OE over time (convergence), (c) accurately track shifts in their patients' OE (temporal congruence), and (d) become more temporally congruent over time (alignment). To date, though, little is known empirically about therapist attunement to patient OE. Thus, we examined the presence of attunement indices and their relation to posttreatment outcome. Data derived from a randomized trial that compared cognitive-behavioral therapy (CBT; n = 43) to CBT plus motivational interviewing (n = 42) for patients with generalized anxiety disorder. After each session, patients rated their OE, and therapists estimated their patients' OE. Patients rated worry at baseline and posttreatment. Dyadic multilevel modeling revealed that across both treatments, therapists were directionally discrepant in that they underestimated patients' OE (p < .001), which did not change over time (no average convergence/divergence pattern; p = .43). Additionally, therapists exhibited temporal congruence with patients' OE (p < .001) and became more aligned with this rating over time (p = .008). Only greater OE convergence, when it occurred, predicted lower worry (p = .04). A therapist's increasingly accurate empathy about their patients' OE may be therapeutic. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

中文翻译：

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治疗师对患者结果期望的协调与两种广泛性焦虑症疗法中忧虑减少之间的关联。

患者较高的心理治疗结果期望（OE）与改善相关。因此，治疗师在当下和一段时间内适应这种信念似乎很重要，以便在较高时利用其价值，或在较低时应对其潜在风险。从概念上讲，协调可以有不同的形式，包括治疗师 (a) 准确估计患者瞬时 OE 水平（低方向差异）、(b) 随着时间的推移，在估计 OE 方面变得更加准确（收敛）、(c) 准确程度跟踪患者 OE（时间一致性）的变化，以及 (d) 随着时间的推移变得更加时间一致（对齐）。然而，迄今为止，我们对治疗师对患者 OE 的协调了解甚少。因此，我们检查了协调指数的存在及其与治疗后结果的关系。数据来源于一项随机试验，该试验对广泛性焦虑症患者的认知行为疗法（CBT；n = 43）与 CBT 加动机访谈（n = 42）进行了比较。每次治疗结束后，患者对他们的 OE 进行评分，治疗师也会评估患者的 OE。患者在基线和治疗后评估担忧程度。二元多级模型显示，在两种治疗中，治疗师在方向上存在差异，因为他们低估了患者的 OE (p < .001)，而 OE 不会随时间变化（没有平均收敛/发散模式；p = .43）。此外，治疗师表现出与患者 OE 的时间一致性 (p < .001)，并且随着时间的推移，与该评级更加一致 (p = .008)。只有更大的 OE 收敛（当发生时）才能预测更低的担忧 (p = .04)。治疗师对患者的 OE 越来越准确的同理心可能具有治疗作用。（PsycInfo 数据库记录 (c) 2020 APA，保留所有权利）。