OBJECTIVE This study examined the reciprocal effects between therapeutic agency, working alliance, and symptoms during psychotherapy. We aimed to predict symptom improvement by previous changes in either agency or alliance. In addition, we examined whether alliance development was predicted by previous changes in agency. METHOD A sample of 386 patients in psychodynamic outpatient psychotherapy answered the Therapeutic Agency Inventory (TAI), the Working Alliance Inventory-SR (WAI-SR), and the Symptom Checklist-K11 (SCL-K11) after Sessions 1, 5, 10, 15, and 20. Dynamic panel models were estimated using structural equation modeling. Associations were tested while controlling for autoregressive effects and differentiating within-person changes over time from between-person differences. RESULTS Increases in agency predicted subsequent symptom improvement. Similarly, increases in alliance predicted subsequent symptom improvement. For agency and alliance, we found a more complex pattern with varying reciprocal effects over time. CONCLUSIONS Findings show evidence for agency and alliance as curative change factors in psychodynamic psychotherapy. The study supports the importance of both agency and alliance and further suggests that both mechanisms may need to be balanced in successful psychotherapies. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

中文翻译：

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代理和联盟作为心理治疗中的变化因素。

目的 本研究检验了心理治疗过程中治疗机构、工作联盟和症状之间的相互影响。我们旨在通过之前机构或联盟的变化来预测症状的改善。此外，我们研究了联盟的发展是否可以通过之前的代理变化来预测。方法 386 名接受心理动力学门诊心理治疗的患者样本在第 1、5、10 节后回答了治疗机构清单 (TAI)、工作联盟清单-SR (WAI-SR) 和症状清单-K11 (SCL-K11)， 15 和 20。使用结构方程模型估计动态面板模型。在控制自回归效应并区分人与人之间的差异随时间的变化的同时，对关联进行了测试。结果 代理的增加预测了随后的症状改善。同样，联盟的增加预测了随后的症状改善。对于代理和联盟，我们发现了一种更复杂的模式，随着时间的推移具有不同的相互影响。结论 研究结果显示了机构和联盟作为心理动力学心理治疗中治疗变化因素的证据。该研究支持代理和联盟的重要性，并进一步表明在成功的心理治疗中可能需要平衡这两种机制。（PsycInfo 数据库记录 (c) 2021 APA，保留所有权利）。结论 研究结果显示了机构和联盟作为心理动力学心理治疗中治疗变化因素的证据。该研究支持代理和联盟的重要性，并进一步表明在成功的心理治疗中可能需要平衡这两种机制。（PsycInfo 数据库记录 (c) 2021 APA，保留所有权利）。结论 研究结果显示了机构和联盟作为心理动力学心理治疗中治疗变化因素的证据。该研究支持代理和联盟的重要性，并进一步表明在成功的心理治疗中可能需要平衡这两种机制。（PsycInfo 数据库记录 (c) 2021 APA，保留所有权利）。