ArticlePsychology and psychotherapy2026
How recent psychological distress relates to session quality in psychotherapy: The mediating roles of the real relationship and working alliance.
Article in Psychology and psychotherapy, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
1 citing paper in PubMed.
- How recent psychological distress relates to session quality in psychotherapy: The mediating roles of the real relationship and working alliance.Psychology and psychotherapy · 2026Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
1 author.
Funding
Abstract
objectiveTo examine how clients' recent psychological distress (PD) relates to perceived psychotherapy session quality (SQ), and to test whether this association is statistically accounted for by clients' ratings of the real relationship (RR) and the working alliance (WA).
methodsSecondary analyses combined data from two studies of adults (N = 1175) receiving individual psychotherapy. Following a session, clients completed measures of anxiety and depressive symptoms (7-day recall), RR, WA (task, goal and bond), and SQ. A covariate-adjusted path model was performed.
resultsPD was associated with weaker RR and poorer task agreement, but not with goal or bond. RR was positively associated with all WA dimensions. When predicting SQ simultaneously, task showed the largest unique association, with smaller unique contributions from goal, bond, and RR; PD also retained a small direct association. Bootstrap decomposition indicated that indirect associations through task accounted for most of the distress-SQ link, with additional indirect associations through bond and an RR-only pathway. Task effects reflected both a direct distress-to-task pathway and a serial distress-to-RR-to-task pathway. DISCUSSION: This study suggested task agreement as a central correlate of SQ when clients are distressed but cannot establish temporal ordering or causality.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.