ArticleCogent mental health2026
Whose alliance shapes whose appraisal? Longitudinal actor-partner associations between therapeutic alliance and session quality, clinical severity, and global improvement among Filipino client-therapist dyads.
Article in Cogent mental health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
This study examined longitudinal actor-partner associations between client- and therapist-rated alliance and three appraisal domains: session quality, clinical severity, and global improvement. Using an intensive longitudinal dyadic design, 54 unique Filipino client-therapist dyads were followed across eight to ten psychotherapy sessions. Longitudinal actor-partner interdependence models tested whether each dyad member's alliance rating at session t predicted their own and the other member's appraisal at session t + 1, controlling for prior appraisal, observed session number, and between-dyad alliance means. Descriptive trajectories showed that alliance ratings were relatively stable, session quality fluctuated across sessions, clinical severity declined over time, and global improvement increased across observed treatment sessions. Actor effects were supported primarily for session quality: stronger-than-usual client-rated alliance predicted higher subsequent client-rated session quality, and stronger-than-usual therapist-rated alliance predicted higher subsequent therapist-rated session quality. Therapist-rated alliance also predicted lower subsequent therapist-rated clinical severity. Partner effects were not statistically significant across the primary models. Cross-domain comparisons indicated that actor effects were most evident for session quality, whereas partner effects did not vary meaningfully across appraisal domains. Findings suggest that alliance fluctuations are most consistently associated with each dyad member's own subsequent session appraisal and highlight the value of bidirectional alliance monitoring in psychotherapy practice.
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