OBJECTIVE Therapeutic alliance is one of the most stable predictors of outcome in psychotherapy, regardless of theoretical orientation. The alliance-outcome relationship in internet-based treatments has been investigated with mixed results. There is preliminary evidence that emotion regulation can work as a mediator for the alliance-outcome relationship. The present study aimed to investigate whether alliance predicted outcome session by session in two internet-based treatments for adolescent depression, and whether this relationship was mediated by emotion regulation. METHOD Two hundred and seventy-two participants aged 15-19 years and diagnosed with depression were randomized to 10 weeks of internet-based psychodynamic or cognitive behavioral treatment. Both therapists and patients rated the alliance weekly. Patients also rated depressive symptoms and emotion regulation weekly. Analyses were made using cross-lagged panel modeling. RESULTS Alliance, as rated by both therapist and patient, predicted depression scores the following week. Emotion regulation rated by the patient also predicted depression scores the following week. Furthermore, alliance scores predicted emotion regulation scores the following week, which in turn predicted depression scores the week after, supporting the hypothesis that alliance influences outcome partly through emotion regulation. There were no group differences in any of these relationships. CONCLUSION Alliance seems to play an important role in internet-based treatments, partly through emotion regulation. Clinicians working with text-based treatments should pay attention to the working alliance. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

中文翻译：

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治疗联盟正在镇定和治愈 - 联盟和情绪调节之间的相互作用作为基于互联网的青少年抑郁症治疗结果的预测指标。

目标 无论理论方向如何，治疗联盟都是心理治疗结果最稳定的预测因素之一。对基于互联网的治疗中的联盟-结果关系进行了调查，结果喜忧参半。有初步证据表明情绪调节可以作为联盟-结果关系的中介。本研究旨在调查联盟是否可以预测两种基于互联网的青少年抑郁症治疗的结果，以及这种关系是否由情绪调节介导。方法 272 名年龄在 15-19 岁并被诊断患有抑郁症的参与者被随机分配接受为期 10 周的基于互联网的心理动力学或认知行为治疗。治疗师和患者每周都会对该联盟进行评级。患者还每周评估抑郁症状和情绪调节。使用交叉滞后面板建模进行分析。结果 根据治疗师和患者的评分，Alliance 预测了接下来一周的抑郁评分。患者评价的情绪调节也可以预测接下来一周的抑郁评分。此外，联盟分数预测了下一周的情绪调节分数，这反过来又预测了下一周的抑郁分数，支持联盟部分通过情绪调节影响结果的假设。在任何这些关系中都没有群体差异。结论 Alliance 似乎在基于互联网的治疗中发挥着重要作用，部分是通过情绪调节。使用基于文本的治疗的临床医生应该注意工作联盟。