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Background: Estimating the prevalence of depressive and anxiety symptoms among older adults with different health conditions can inform mental health services for this population during the corona virus disease-2019 (COVID-19) pandemic. Method: A search of 12 scientific databases identified 17 studies with 11,237 Chinese older adults who were infected by COVID-19, were generally healthy, or had chronic illnesses. Meta-analysis was used to estimate the overall prevalence of depressive and anxiety symptoms in these three groups. Assessment criteria, region, and time phase of the pandemic were tested as sources of heterogeneity. Results: With an average risk of bias score of 6.71 (range = 6–8), the majority of included studies employed appropriate statistical methods, used validated measurement tools, and had adequate response rates; however, they might have deficiencies in sample frame, sampling method, and sample size. Within the COVID-19, general, and chronic illness groups, the prevalence of depressive symptoms was 27%, 26%, and 61%, respectively, and the prevalence of anxiety symptoms was 14%, 23%, and 85%, respectively. Among generally healthy older adults, anxiety was more prevalent during the Phase 2 (March–April 2020) of the pandemic compared with other time phases. Conclusions: The results have implications for addressing the mental health problems of Chinese older adults, especially those with chronic illnesses, during the COVID-19 pandemic.

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The present study was conducted to (a) identify the clients and therapists' perceptual directional discrepancy and temporal congruence in different aspects of working alliance (i.e., goals/tasks and bond), (b) examine the moderating effect of therapists' client-specific self-efficacy on the directional discrepancy and congruence, (c) clarify the relationship between specific working alliance aspects congruence and the next-session symptom, and (d) test the relationship between the congruence of goals/tasks or bond and the psychotherapy outcome under different levels of therapists' self-efficacy. Clients (n ϭ 87, 80.9% female, average age ϭ 21.78 [1.90]) and therapists (n ϭ 43, 65% female) in a Chinese university mental health center evaluated the working alliance session by session. Clients self-reported session-level symptom severity were assessed at the beginning of every session and therapists' self-efficacy for a specific client were assessed at the end of the first session. The truth-and-bias approach was used to analyze the perceptual directional discrepancy and temporal congruence in goals/tasks and bond, and examine the moderating effect of therapists' self-efficacy. Multilevel polynomial regression and response surface analysis were used to clear the relationship between congruence/incongruence and client symptom level in the next session. (a) Clients and therapists temporally agreed on both the goals/tasks and bond dimensions of the working alliance. Averagely, therapists tended to rate goals/tasks agreement lower than clients but did not rate more or less intense bond than clients. (b) Therapists with low or medium self-efficacy for specific client underrated goals/tasks and bond more than therapists with high client-specific efficacy, and among the therapist-client dyads, the higher therapists' client-specific self-efficacy, the higher temporal congruence in bond rather than goals/tasks. (c) For both goals/tasks and bond, when clients and therapists were in agreement, client symptoms decreased as the congruent combinations of therapists' and clients' goals/tasks increased. Clients' symptom level increased more sharply as the degree of discrepancy increases for goals/tasks, not affected by the direction. (d) However, for therapists with high client-specific self-efficacy, their underestimations were more associated with the less severe next-session symptoms of their clients than their overestimations. This association was not found among clients whose therapists' self-efficacies for them were low. The findings provide a deeper insight into the congruence of the working alliance. Public Significance StatementIn the context of Chinese culture, the therapists tend to underestimate goals/tasks rather than the bond, so they need to make more clarification of goals/tasks. At the same time, the therapists should be aware of the evaluation bias caused by their self-efficacy, which will be associated with the treatment outcome.

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