PMC

Patterns of dyadic alliance change over time. Panel A shows a therapy dyad with a convergent alliance process and high alliance levels, in which the patient rated the alliance higher than the therapist. Ratings were more divergent early in psychotherapy, and became more similar as psychotherapy progressed. This was the most common pattern found in this study, as indicated by fixed effects results from the convergence model (). Panel B shows a convergent but low alliance, with the therapist rating slightly higher than the patient. Panel C shows a divergent alliance process, in which the patient rated the alliance lower and the discrepancy between the ratings increased. Panel D shows a divergent dyadic alliance process, in which the patient and therapist viewed their alliance relatively similarly at the beginning of treatment (low discrepancy), but became more divergent over time (divergence). Here, the therapist saw the alliance as poorer, while the patient rated it highly and also reported increased alliance as the therapy progressed. Exemplars are drawn from the Empirical Bayes coefficients of dyadic alliance discrepancy and dyadic alliance level output from the first step of HLM analyses.

Typical alliances of five vertical vegetation belts. (A–C), lower montane seasonal rainforest belt; (A), Terminalia myriocarpa forest alliance; (B), Altingia excels forest alliance; (C), the “slash-and-burn” farming method; (D–F), lower montane evergreen broadleaf forest belt; (D), Castanopsis indica forest alliance; (E), Castanopsis ceratacantha forest alliance; (F), Macaranga denticulate forest alliance; (G–J), middle montane semi-evergreen broadleaf forest belt; (G), Cyclobalanopsis kiukiangensis forest alliance; (H), Cyclobalanopsis lamellose forest alliance (April); (I), Exbucklandia populnea forest alliance; (J), Pinus bhutanica forest alliance; (K,L), subalpine evergreen needleleaf forest belt; (K), Tsuga dumosa forest alliance; (L), Abies delavayi var. motuoensis forest alliance; (M–O), alpine shrubland and meadow belt; (M), Salix annulifera deciduous broadleaf shrubland alliance; (N), Rhododendron chamaethomsonii evergreen broadleaf shrubland alliance; (O), Bergenia purpurascens alpine meadow grassland alliance.

The results have been enhanced relative to the default Sequence Server results page by the addition of links to Alliance JBrowse and to the corresponding gene page (in this case, C. elegans abi-1) at the Alliance website for each BLAST hit.

Change in depressive symptomatology as a function of alliance convergence, displayed at the 10^th percentile of discrepancy change (i.e., divergent alliance patterns) and 90^th percentile values of the change in alliance discrepancy over time (i.e., highly convergent alliance patterns). Therapy dyads who became more similar in their views of the working alliance showed stronger improvement in depression (as measured by the QIDS) than those who became more discrepant over time. Follow-up analyses indicated that patients with divergent alliance patterns had higher depression levels at follow-up, even when controlling for prior depression and alliance levels.