The emotional quality of the therapeutic relationship has the highest and most consistent effect sizes on therapeutic outcomes found in meta-analyses on psychotherapeutic processes. In the current study, the facial-emotional (micro-) behaviors of patients and therapists are analyzed to obtain a better understanding of how relationship patterns are established in the beginning of psychotherapies and how they constitute the emotional quality of the relationship. The results provide evidence for the importance of dyadic emotional microprocesses in the psychotherapeutic process. Several significant correlations were found between the individual and more expressed dyadic emotional behavior in the first session and the therapeutic outcome reported at the end of the treatment. In particular, dyadic emotional process patterns, detected with Theme (Magnusson, 1996), correlated negatively with all outcome perspectives.