Studies suggest that approximately half of clients leave therapy prematurely and fail to benefit from psychosocial interventions. One factor consistently associated with client retention and outcome is the quality of the therapeutic alliance. While strong alliances contribute to positive outcome, tensions or breaks in the client and therapist's collaborative relationship (i.e., alliance ruptures) contribute to poor outcome. Although ruptures are common in therapy, current treatments may not provide effective ways to manage alliance ruptures. A promising way to identify new strategies to address alliance ruptures is through clinician-informed approaches. This study is designed to systematically collect, categorize, and identify clinician-generated strategies to resolve situations in which alliance ruptures occur in adult individual therapy. The goals are 1) to compile and categorize typical therapeutic situations and associated resolution strategies concerning alliance ruptures that confront clinicians, and 2) to identify a set of intervention strategies to address alliance ruptures that can serves as potential therapeutic strategies to be evaluated through future psychotherapy outcome research. I predict that the resulting clinical strategies will correspond to Bordin's conception of the alliance and Safran's rupture and repair model.
Eubanks, Catherine F; Burckell, Lisa A; Goldfried, Marvin R (2018) Clinical Consensus Strategies to Repair Ruptures in the Therapeutic Alliance. J Psychother Integr 28:60-76 |