title: Therapeutic bond judgments: Congruence and incongruence.
abstract: OBJECTIVE
  The present study had 2 aims: (a) to implement West and Kenny's (2011) Truth-and-Bias model to simultaneously assess the temporal congruence and directional discrepancy between clients' and therapists' ratings of the bond facet of the therapeutic alliance, as they cofluctuate from session to session; and (b) to examine whether symptom severity and a personality disorder (PD) diagnosis moderate congruence and/or discrepancy.
  
  
  METHODS
  Participants included 213 clients treated by 49 therapists. At pretreatment, clients were assessed for a PD diagnosis and completed symptom measures. Symptom severity was also assessed at the beginning of each session, using client self-reports. Both clients and therapists rated the therapeutic bond at the end of each session.
  
  
  RESULTS
  Therapists and clients exhibited substantial temporal congruence in their session-by-session bond ratings, but therapists' ratings tended to be lower than their clients' across sessions. Additionally, therapeutic dyads whose session-by-session ratings were more congruent also tended to have a larger directional discrepancy (clients' ratings being higher). Pretreatment symptom severity and PD diagnosis did not moderate either temporal congruence or discrepancy at the dyad level; however, during sessions when clients were more symptomatic, therapist and client ratings were both farther apart and tracked each other less closely.
  
  
  CONCLUSIONS
  Our findings are consistent with a "better safe than sorry" pattern, which suggests that therapists are motivated to take a vigilant approach that may lead both to underestimation and to attunement to fluctuations in the therapeutic bond.
authors: Department of Psychology, Bar-Ilan University.
authors: Dana
authors: D
authors: Atzil-Slonim
authors: Department of Psychology, Bar-Ilan University.
authors: Eran
authors: E
authors: Bar-Kalifa
authors: Department of Psychology, Bar-Ilan University.
authors: Eshkol
authors: E
authors: Rafaeli
authors: Department of Psychology, University of Trier.
authors: Wolfgang
authors: W
authors: Lutz
authors: Department of Psychology, University of Trier.
authors: Julian
authors: J
authors: Rubel
authors: Department of Psychology, University of Trier.
authors: Ann-Kathrin
authors: AK
authors: Schiefele
authors: Department of Psychology, Bar-Ilan University.
authors: Tuvia
authors: T
authors: Peri
mesh_terms: D000328:Adult; D005260:Female; D006282:Health Personnel / Q000523:psychology*; D006801:Humans; D007600:Judgment; D008297:Male; D008875:Middle Aged; D010554:Personality Disorders / Q000523:psychology*; D011369:Professional-Patient Relations; D011613:Psychotherapy; D057566:Self Report