We examined how client working alliance (CWA) and therapist working alliance (TWA), and client-rated functioning (Outcome Rating Scale, ORS) related to client-perceived Cultural Humility (CH) of their therapist across the course of open-ended psychodynamic psychotherapy for 118 clients and 17 therapists. Clients and therapists completed measures of the WA after every session and clients completed the ORS prior to every session. Clients also judged their therapists' CH at Session 3, 8, and then every 8th session. CH data was partitioned into within-client, within-therapist, and between-therapists components and used to predict CWA, TWA, and ORS in a 4-level Hierarchical Linear Modeling (HLM) growth model. Between-therapist differences in CH were not related to next session CWA, TWA, or ORS, nor were these differences related to growth in CWA, TWA, and ORS. Within-therapist differences in CH were only related to the next session's CWA. At the within-client level, time-periods with higher CH, compared to clients' average CH, were associated with stronger next session (i.e., the immediate subsequent session) CWA and TWA, and time periods with lower CH, compared to clients' average CH, were associated with linear increase in CWA and TWA. Time-periods with high CH, compared to clients' average CH, were associated with significant increase in client functioning. Results suggest that lower CH weakens CWA and TWA in the next session but both CWA and TWA strengthen subsequently. By contrast, greater CH has no immediate effect on outcome but with greater CH psychological functioning increased over time. Implications for practice and research are discussed. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

中文翻译：

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心理动力学心理治疗中的文化谦逊、工作联盟和结果评定量表：治疗师之间、治疗师内部和客户内部的影响。

我们检查了客户工作联盟 (CWA) 和治疗师工作联盟 (TWA) 以及客户评级功能（结果评级量表，ORS）如何与他们的治疗师在开放式心理动力学过程中的客户感知文化谦逊 (CH) 相关为 118 名客户和 17 名治疗师提供心理治疗。客户和治疗师在每次治疗后完成 WA 测量，客户在每次治疗前完成 ORS。客户还在第 3 次、第 8 次和每第 8 次会议上评判他们的治疗师的 CH。CH 数据被划分为客户内部、治疗师内部和治疗师之间的组件，并用于预测 4 级分层线性建模 (HLM) 增长模型中的 CWA、TWA 和 ORS。CH 治疗师之间的差异与下一次 CWA、TWA 或 ORS 无关，这些差异也与 CWA 的增长无关，TWA 和 ORS。CH 的治疗师内部差异仅与下一个疗程的 CWA 有关。在客户内部层面，与客户的平均 CH 相比，具有较高 CH 的时间段与更强的下一个会话（即紧邻的后续会话）CWA 和 TWA 相关，而与客户的平均 CH 相比，具有较低 CH 的时间段平均 CH，与 CWA 和 TWA 的线性增加有关。与客户的平均 CH 相比，CH 高的时间段与客户功能的显着增加有关。结果表明，较低的 CH 在下一个会话中削弱了 CWA 和 TWA，但随后 CWA 和 TWA 都增强了。相比之下，更大的 CH 对结果没有直接影响，但更大的 CH 心理功能会随着时间的推移而增加。讨论了对实践和研究的影响。