“…In relation to instruments employed to assess TR, in 55% of the included studies (Culina et al, 2022;Elkin et al, 2014;Richards et al, 2013;Snyder & Aafjes-van Doorn, 2016;Snyder & Silberschatz, 2016;Zalaznik et al, 2021) the authors adopted tools aimed at directly measure TR [i.e., the therapist responsiveness scale (TRS), the patient's experience of attunement and responsiveness (PEAR) scale, and the adherence responsiveness measure], while in the remaining 45%, TR was assessed indirectly, through: i) the use of instruments to measure related constructs [e.g., aesthetic relational knowledge scale (ARKS) or processing-content-relationship scale] ( Kramer et al, 2016;Spagnuolo Lobb et al, 2022); ii) the integration of different constructs and methodologies, as in the case of discrepancy between working alliance inventory short form and real relationship inventory, or in the case of co-presence of the comprehensive psychotherapeutic interventions rating scale (C-PIRS) and the assimilation of problematic experiences scale (APES) (Kivlighan et al, 2017;Meystre et al, 2014); iii) the adoption of an atheoretical approach (i.e., the motive-oriented therapeutic relationship) (Kramer et al, 2014). Among the included studies, the only instruments used in more than one article were the PEAR scale (27%) (Snyder & Aafjes-van Doorn, 2016;Snyder & Silberschatz, 2016;Zalaznik et al, 2021) and the TRS (18%) (Culina et al, 2022;Elkin et al, 2014).…”