The therapeutic alliance has been reliably associated with outcome across psychotherapies. We investigated the alliance–outcome relationship in the early sessions of cognitive behavioral therapy of depression using a model that disaggregates within- and between-persons variance while estimating the reciprocal relation between variables. We used this model in a combined data set from two studies totaling 191 patients. In our primary model, we found evidence for a predictive within-patients relationship between alliance and symptoms such that symptoms predicted regressed change in alliance and alliance predicted regressed change in symptoms. In a more conservative detrended model, these relationships were not significant. Given that (a) most of the variability in alliance scores is between patients, (b) the size of the alliance–outcome relationship is modest, and (c) the alliance–outcome relationship is not robust to detrending, our findings suggest that alliance plays at most a small role in improving patient outcomes in cognitive behavioral therapy of depression.

治疗联盟已经与各种心理治疗的结果可靠地相关联。我们在抑郁症的认知行为疗法的早期阶段使用模型来研究人际和人际差异的模型，同时估计变量之间的相互关系，从而研究了结局与结局的关系。我们在来自191名患者的两项研究的组合数据集中使用了该模型。在我们的主要模型中，我们发现了联盟与症状之间存在可预测的患者内部关系的证据，使得症状预示了联盟中的回归变化，而联盟预测了症状中的回归变化。在更保守的趋势模型中，这些关系并不重要。鉴于（a）联盟得分的大部分差异都在患者之间，