OBJECTIVE The relationship between the therapeutic alliance and outcome has been supported consistently over time. More recently, studies have examined therapist effects in the alliance-outcome relationship and came up with somewhat mixed findings. The purpose of this study was to replicate and extend previous meta-analytic work using a much larger data set, permitting not only the verification of the overall impact of the therapists' contribution but, at the same time, controlling for several potential covariates effecting this relationship. METHOD We conducted two- and three-level mixed-effects meta-analyses (k = 152; 827 total effect sizes) to examine the significance of several potential moderators of the alliance-outcome correlation. These moderators included (a) Patient-Therapist Ratio (PTR; Patient N divided by therapist N to test therapist effects), (b) Alliance and Outcome Rater's contribution (patient, therapist, observer, and other), (c) Alliance Measures, (d) Research Design (RCT, Other) and (e) Personality Disorder. RESULTS The PTR, an index of the therapist's contribution to the alliance, was a significant moderator of the alliance-outcome correlation in both the two- and three-level models. When several potential confounds were simultaneously tested in a three-level multipredictor metaregression, including rater of alliance and outcome, research design, alliance measure, and personality disorder, PTR remained a significant moderator of the alliance-outcome correlation. CONCLUSION Replicating and extending previous research, this study supported the significance of therapists' impact in the alliance-outcome relationship. These results remained significant even when, using three-level metaregressions, several potential covariates were simultaneously controlled. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

中文翻译：

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检查联盟-结果关系中的治疗师效果：多层次荟萃分析。

目的 治疗联盟与结果之间的关系一直得到支持。最近，研究检查了治疗师对联盟-结果关系的影响，并得出了一些混合的结果。本研究的目的是使用更大的数据集复制和扩展先前的元分析工作，不仅允许验证治疗师贡献的整体影响，而且同时控制影响这一点的几个潜在协变量关系。方法 我们进行了两级和三级混合效应荟萃分析（k = 152；827 个总效应量）来检查联盟-结果相关性的几个潜在调节因素的重要性。这些主持人包括 (a) 患者-治疗师比率 (PTR; 患者 N 除以治疗师 N 以测试治疗师效果），（b）联盟和结果评估者的贡献（患者、治疗师、观察者和其他），（c）联盟措施，（d）研究设计（RCT，其他）和（e） ） 人格障碍。结果 PTR 是治疗师对联盟贡献的指标，在​​两级和三级模型中都是联盟-结果相关性的重要调节因素。当在三级多预测变量元回归中同时测试几个潜在的混杂因素时，包括联盟和结果的评估者、研究设计、联盟测量和人格障碍，PTR 仍然是联盟-结果相关性的重要调节因素。结论 本研究复制和扩展先前的研究，支持治疗师的重要性。对联盟-结果关系的影响。即使使用三级元回归同时控制几个潜在的协变量，这些结果仍然显着。（PsycInfo 数据库记录 (c) 2021 APA，保留所有权利）。