Objective: The association between alliance and therapy outcome is one of the most investigated factors in psychotherapy research. However, even studies using advanced methods estimate effects over a specific time period (interval) between measurement occasions. Thus, it remains unknown how the magnitude and direction of effects depend on the considered time interval, resulting in limited comparability across studies. The current study examines the influence of time on the within-person relationship between alliance and symptom severity. Method: Alliance (WAI-SR) and symptom severity (SCL-K11) were assessed every fifth session in N = 650 patients receiving up to 100 weekly sessions (mode = 55; M = 41.03; SD = 27.23) of individual psychotherapy in a German outpatient clinic. Bivariate continuous-time (CT) structural equation modeling (SEM) was used to estimate within-person cross- and auto-effects. Results: Analysis revealed significant reciprocal within-person cross-effects with stronger relative effects of SCL-K11 on WAI-SR (a₂₁) than vice versa (a₁₂). CT analysis showed that both cross-lagged effects increased for longer time intervals with strongest effects for time intervals of about 40 sessions (a₂₁ = -.47; a₁₂ = -.19). Conclusions: Alliance and symptom severity showed a reciprocal relationship. Expanding current evidence, our analysis showed how the magnitude of these effects depends on the considered time interval. Applying CT-SEM on longitudinal data of the alliance outcome association complements current cross-lagged panel analysis and allows to compare results of studies which are based on different time intervals between measurement occasions. Methodological, theoretical, and clinical implications are discussed. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

中文翻译：

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长期心理治疗中联盟与症状严重程度之间的个体内动态：为什么时间很重要。

目的：联盟与治疗结果之间的关联是心理治疗研究中研究最多的因素之一。然而，即使使用高级方法的研究也会估计测量时间之间特定时间段（间隔）内的影响。因此，影响的大小和方向如何取决于所考虑的时间间隔仍然未知，导致研究之间的可比性有限。目前的研究考察了时间对联盟和症状严重程度之间人际关系的影响。方法：在 N = 650 名患者中，每五次评估一次联盟 (WAI-SR) 和症状严重程度 (SCL-K11)，他们接受了多达 100 次每周一次的个体心理治疗（模式 = 55；M = 41.03；SD = 27.23）。德国门诊。双变量连续时间 (CT) 结构方程模型 (SEM) 用于估计人体内的交叉和自动效应。结果：分析表明，SCL-K11 对 WAI-SR (a₂₁) 的相对影响比反之 (a₁₂) 更强，存在显着的人内交互效应。CT 分析表明，交叉滞后效应在更长的时间间隔内增加，在大约 40 个会话的时间间隔内影响最强（a₂₁ = -.47；a₁₂ = -.19）。结论：联盟和症状严重程度呈相互关系。扩大现有证据，我们的分析表明这些影响的程度如何取决于所考虑的时间间隔。对联盟结果关联的纵向数据应用 CT-SEM 补充了当前的交叉滞后面板分析，并允许比较基于测量场合不同时间间隔的研究结果。讨论了方法论、理论和临床意义。（PsycInfo 数据库记录 (c) 2021 APA，保留所有权利）。