Exercise 9. Responding to therapeutic alliance ruptures.

2022 ◽  
pp. 113-121
Author(s):  
James F. Boswell ◽  
Michael J. Constantino
Keyword(s):  
Therapeutic Alliance ◽  
Alliance Ruptures

scholarly journals Resolution Process of Therapeutic Alliance Ruptures: A Review of the Literature

Psychology ◽  
2012 ◽  
Vol 03 (12) ◽  
pp. 1049-1058 ◽  
Author(s):  
Pierre Baillargeon ◽  
Robert Coté ◽  
Lyne Douville
Keyword(s):  
Therapeutic Alliance ◽  
Review Of The Literature ◽  
Resolution Process ◽  
Alliance Ruptures

Repairing Ruptures in the Therapeutic Alliance

2019 ◽  
pp. 208-218
Author(s):  
Brian A. Sharpless
Keyword(s):  
Therapeutic Alliance ◽  
Premature Termination ◽  
Therapy Outcome ◽  
Rupture Resolution ◽  
Alliance Ruptures ◽  
Stage Process

:Ruptures (i.e., deteriorations or strains in the therapeutic alliance) are an inevitable part of any psychotherapy. They are not only common but are also clinically meaningful. If not adequately attended to, ruptures are associated with poor therapy outcome and premature termination. Fortunately, a strong research base is available that provides clinically useful guidance for identifying and resolving alliance ruptures. After a brief review of the theoretical and empirical literatures, a list of “markers” used to identify the two subtypes of ruptures (i.e., withdrawal and confrontation) is provided. Proper assessment of the subtype is critical, as they each require slightly different rupture resolution techniques across a four-stage process. Finally, a list of specific rupture resolution techniques is provided.

scholarly journals Ruptures and repairs of group therapy alliance. An untold story in psychotherapy research

2019 ◽  
Vol 22 (1) ◽  
Author(s):  
Gianluca Lo Coco ◽  
Giorgio A. Tasca ◽  
Paul L. Hewitt ◽  
Samuel F. Mikail ◽  
Dennis M. Kivlighan, Jr.
Keyword(s):  
Group Therapy ◽  
Therapeutic Alliance ◽  
Group Intervention ◽  
Psychotherapy Research ◽  
Substantial Contribution ◽  
Clinical Vignettes ◽  
Group Treatments ◽  
Alliance Ruptures ◽  
Group Members ◽  
Suitable Framework

Although previous studies investigated the characteristics of therapeutic alliance in group treatments, there is still a dearth of research on group alliance ruptures and repairs. The model by Safran and Muran was originally developed to address therapeutic alliance in individual therapies, and the usefulness of this approach to group intervention needs to be demonstrated. Alliance ruptures are possible at member to therapist, member to member, member to group levels. Moreover, repairs of ruptures in group are quite complex, i.e., because other group members have to process the rupture even if not directly involved. The aim of the current study is to review the empirical research on group alliance, and to examine whether the rupture repair model can be a suitable framework for clinical understanding and research of the complexity of therapeutic alliance in group treatments. We provide clinical vignettes and commentary to illustrate theoretical and research aspects of therapeutic alliance rupture and repair in groups. Our colleague Jeremy Safran made a substantial contribution to research on therapeutic alliance, and the current paper illustrates the enduring legacy of this work and its potential application to the group therapy context.

scholarly journals The Impact of Clients’ and Therapists’ Characteristics on Therapeutic Alliance and Outcome

2021 ◽  
Author(s):  
Volker Tschuschke ◽  
Margit Koemeda-Lutz ◽  
Agnes von Wyl ◽  
Aureliano Crameri ◽  
Peter Schulthess
Keyword(s):  
Treatment Outcome ◽  
Therapeutic Alliance ◽  
Attachment Styles ◽  
Naturalistic Study ◽  
Working Alliances ◽  
Alliance Ruptures ◽  
Vantage Points ◽  
The Impact

AbstractThis article investigates distances between therapists and their clients in their experience of the therapeutic alliance across the duration of the psychotherapeutic treatments in a naturalistic study. We looked at the working alliances from different vantage points—rupture, repair of ruptures, distances in the alliance impressions of both clients and therapists—and their correlation with treatment outcome. The only predictive variable of alliance ruptures was the inability of therapists to bond sufficiently with their clients regarding a sustainable working atmosphere, which could be identified through a continuous distant alliance rating by the therapists. Alliance ruptures in turn significantly predicted premature termination of treatments, whereas alliance ruptures per se did not necessarily predict treatment outcome. The paper discusses the possible role of the quality of therapists’ attachment styles as a potentially crucial variable in an effective working alliance in psychotherapy.

scholarly journals Trajectories of alliance ruptures in the psychotherapy of adolescents with borderline personality pathology: timing, typology and significance

2019 ◽  
Vol 22 (2) ◽  
Author(s):  
Nathalie Schenk ◽  
Ronan Zimmermann ◽  
Lukas Fürer ◽  
Mariane Krause ◽  
Sindy Weise ◽  
...  
Keyword(s):  
Therapeutic Alliance ◽  
Treatment Time ◽  
Clinical Sample ◽  
Borderline Personality ◽  
Personality Pathology ◽  
Mixed Effect ◽  
Identity Diffusion ◽  
Mixed Effect Models ◽  
Rupture Resolution ◽  
Alliance Ruptures

Jeremy Safran and his research group suggest that rupture-repair processes are important for the therapeutic change in patients with personality disorders. In this exploratory study, we describe alliance ruptures and resolutions on a session-by-session basis in a clinical sample of adolescents with Borderline Personality Pathology (BPP). Three research questions are addressed: i) Is there a typical trajectory of alliance ruptures over treatment time? ii) Which rupture and resolution markers occur frequently? iii) Which rupture markers are most significant for the therapeutic alliance? Ten patients who presented with identity diffusion and at least three Borderline Personality Disorder criteria were studied and treated with Adolescent Identity Treatment. Alliance ruptures and resolutions were coded in 187 therapy sessions according to the Rupture Resolution Rating System. Mixed-effect models were used for statistical analyses. Findings supported an inverted U-shaped trajectory of alliance ruptures across treatment time. The inspection of individual trajectories displayed that alliance ruptures emerge non-linearly with particular significant alliance ruptures appearing in phases or single peak sessions. Withdrawal rupture markers emerged more often compared to confrontation markers. However, confrontation markers inflicted a higher impact or strain on the immediate collaboration between patient and therapist compared to withdrawal markers. Clinicians should expect alliance ruptures to occur frequently in the treatment of adolescents with BPP. The findings support the theory of a dynamic therapeutic alliance characterised by a continuous negotiation between patients and therapists.

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