To optimise the effects of cognitive behaviour therapy (CBT) for anxiety disorders, research has increasingly focussed on understanding mechanisms of change. Specifically, the therapeutic relationship has been identified as a potential “active ingredient” of therapy. The evidence for the effects of eleven elements of the therapeutic relationship (alliance, collaboration, goal consensus, group cohesion, empathy, positive regard, feedback, emotional expression, outcome expectations, treatment credibility, alliance rupture-repair) on treatment outcomes in CBT for anxiety disorders was systematically reviewed. Fifty unique studies were included, and findings were qualitatively reviewed and summarised. Results revealed consistent and sizeable evidence for the cohesion-outcome and expectation-outcome relationships. There was emerging evidence for the effects of collaboration, empathy, and alliance rupture-repair on outcomes. However, the evidence for goal consensus and credibility on outcomes was limited. Notably, review of the alliance literature revealed substantial inconsistencies across studies. No studies were identified for positive regard, feedback, and emotional expression. Overall, further research is needed to clarify the role of the therapeutic relationship in CBT for anxiety disorders. These findings will contribute to the conceptual integration of therapeutic relationship constructs in cognitive behavioural models, and help to improve treatments and outcomes for individuals.

为了优化对焦虑症的认知行为疗法（CBT）的效果，研究越来越集中在理解变化的机制上。具体而言，治疗关系已被确定为治疗的潜在“活性成分”。证明治疗关系的11个要素（联盟，协作，目标共识，小组凝聚力，同理心，积极关心，反馈，情感表达，结果期望，治疗信誉，联盟破裂修复）对CBT的治疗效果有影响的证据焦虑症得到系统地审查。包括五十项独特的研究，并对结果进行定性审查和总结。结果揭示了凝聚力结果和期望结果关系的一致且可观的证据。越来越多的证据表明合作，移情和联盟破裂修复对结果的影响。但是，关于目标共识和结果可信度的证据有限。值得注意的是，对联盟文献的审查显示，各研究之间存在重大矛盾。尚无针对积极关注，反馈和情感表达的研究。总的来说，需要进一步的研究来阐明治疗关系在焦虑症CBT中的作用。这些发现将有助于认知关系模型中治疗关系构建的概念整合，并有助于改善个体的治疗方法和结果。对联盟文献的审查显示，各研究之间存在重大矛盾。尚无针对积极关注，反馈和情感表达的研究。总的来说，需要进一步的研究来阐明治疗关系在焦虑症CBT中的作用。这些发现将有助于认知关系模型中治疗关系构建的概念整合，并有助于改善个体的治疗方法和结果。对联盟文献的审查显示，各研究之间存在重大矛盾。尚无针对积极关注，反馈和情感表达的研究。总的来说，需要进一步的研究来阐明治疗关系在焦虑症CBT中的作用。这些发现将有助于认知关系模型中治疗关系构建的概念整合，并有助于改善个体的治疗方法和结果。