The alliance is dyadic in its nature with both the patient and the therapist contributing. Relatively little is known about the effects of congruence between patient and therapist perception of alliance on treatment outcome. The current study investigated how patient and therapist agreement and disagreement about the alliance predict symptom severity over the course of long-term psychotherapy. We investigated N = 361 patients nested within N = 102 therapists longitudinally every 5th session across long-term treatment. Multilevel polynomial regression with response surface analysis was used to predict symptom severity five sessions later from congruence of the alliance ratings. Throughout treatment, patient and therapist agreement about stronger alliances significantly predicted lower subsequent patient-reported symptom distress. Patient and therapist disagreement was a marginally significant predictor of subsequent symptom distress. There was no significant difference in the effects of alliance agreement and disagreement on symptoms across time in long-term treatment. Findings support the importance of alliance agreement and disagreement as predictors of subsequent patient symptom severity. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

中文翻译：

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患者和治疗师在治疗过程中就其联盟达成一致和不一致对症状严重程度的影响：响应面分析。

该联盟本质上是二元的，患者和治疗师都做出了贡献。关于患者和治疗师对联盟的看法之间的一致性对治疗结果的影响知之甚少。目前的研究调查了患者和治疗师对联盟的一致和分歧如何预测长期心理治疗过程中的症状严重程度。我们在长期治疗中每第 5 个疗程纵向调查 N = 361 名患者嵌套在 N = 102 名治疗师中。具有响应面分析的多级多项式回归用于根据联盟评级的一致性预测五个会话后的症状严重程度。在整个治疗过程中，患者和治疗师就更强大的联盟达成一致显着预测了随后患者报告的症状困扰较低。患者和治疗师的分歧是随后症状困扰的一个边缘显着的预测因素。在长期治疗中，联盟同意和不同意对症状的影响没有显着差异。研究结果支持联盟一致和不一致作为后续患者症状严重程度的预测指标的重要性。（PsycINFO 数据库记录 (c) 2019 APA，保留所有权利）。