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This study evaluated therapeutic progress in clients treated with FBIM at four time points: baseline (T0), 3\u2009months (T1), 12\u2009months (T2), and follow-ups at 3\u2009months post-therapy (T3). From April 2022 to July 2024, this longitudinal study was conducted at a community-based psychotherapy centre in Italy, enrolling 154 participants (\n                    <jats:italic toggle=\"yes\">M<\/jats:italic>\n                    <jats:sub>age<\/jats:sub>\n                    \u2009=\u200932.8\u2009years; 54.3% female) who completed baseline assessments, with sociodemographic and clinical data collected on symptom severity, WA, and client motivation. Symptom severity declined significantly from T0 to T2. Within the integrated approach employed, that combined psychodynamic and Cognitive Behavioural Therapy (CBT) components, CBT showed stronger Task subscale scores at T2. Resistance to change impacted WA at T1 but decreased by T2. Contextual differences in WA at T1 diminished over time. Client motivation had no effect on WA. Structured approaches like CBT foster early collaboration, while changes in the WA over time reflect the therapist\u2019s capacity to adapt to client needs and therapeutic challenges.\n                  <\/jats:p>","DOI":"10.1177\/01454455261416501","type":"journal-article","created":{"date-parts":[[2026,4,3]],"date-time":"2026-04-03T04:24:57Z","timestamp":1775190297000},"page":"251-285","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Working Alliance and Therapeutic Change in Integrated Psychotherapy: A Longitudinal Study"],"prefix":"10.1177","volume":"50","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0266-6386","authenticated-orcid":false,"given":"Eleonora","family":"Volpato","sequence":"first","affiliation":[{"name":"Universit\u00e0 Cattolica del Sacro Cuore, Milan, Italy"},{"name":"IRCCS Fondazione Don Carlo Gnocchi, Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-4203-4299","authenticated-orcid":false,"given":"Susanna","family":"Bergamaschi","sequence":"additional","affiliation":[{"name":"Institute for the Study and Research of Psychic Disorders (ISeRDiP), Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mattia","family":"Cis","sequence":"additional","affiliation":[{"name":"Institute for the Study and Research of Psychic Disorders (ISeRDiP), Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Davide","family":"Sattin","sequence":"additional","affiliation":[{"name":"Istituti Clinici Scientifici Maugeri IRCCS, Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Milena","family":"Ruffino","sequence":"additional","affiliation":[{"name":"Institute for the Study and Research of Psychic Disorders (ISeRDiP), Milan, Italy"},{"name":"ASST Valle Olona, Struttura Complessa di Neuropsichiatria Infantile, Saronno, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giacomo","family":"Tognasso","sequence":"additional","affiliation":[{"name":"Institute for the Study and Research of Psychic Disorders (ISeRDiP), Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Clotilde","family":"Gislon","sequence":"additional","affiliation":[{"name":"Institute for the Study and Research of Psychic Disorders (ISeRDiP), Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1612-4211","authenticated-orcid":false,"given":"Francesco","family":"Pagnini","sequence":"additional","affiliation":[{"name":"Universit\u00e0 Cattolica del Sacro Cuore, Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,4,2]]},"reference":[{"key":"e_1_3_4_2_1","doi-asserted-by":"crossref","unstructured":"Baldwin S. 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