Repairing Alliance Ruptures

In this article, we review the existing empirical research on the topic of therapeutic alliance ruptures in psychotherapy. Ruptures in the therapeutic alliance are defined as episodes of tension or breakdown in the collaborative relationship between patient and therapist. Two meta-analyses were cond...

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Bibliographic Details
Published in:Psychotherapy (Chicago, Ill.) Ill.), 2011-03, Vol.48 (1), p.80-87
Main Authors: Safran, Jeremy D, Muran, J. Christopher, Eubanks-Carter, Catherine
Format: Article
Language:English
Subjects:
Breakdown
Clinical outcomes
Collaboration
Cooperative Behavior
Human
Humans
Mental Disorders - therapy
Professional-Patient Relations
Psychotherapeutic Processes
Psychotherapy
Psychotherapy - methods
Therapeutic Alliance
Therapeutic alliances
Therapist-Client relationships
Treatment Outcome
Treatment Outcomes
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Summary:In this article, we review the existing empirical research on the topic of therapeutic alliance ruptures in psychotherapy. Ruptures in the therapeutic alliance are defined as episodes of tension or breakdown in the collaborative relationship between patient and therapist. Two meta-analyses were conducted. The first reviewed studies examining the relation between rupture-repair episodes and treatment outcome ( r = .24, z = 3.06, 95% CI [.09, .39], p = .002, k = 3, N = 148). The second meta-analysis reviewed the research examining the impact on treatment outcome of training therapists in the use of alliance rupture intervention principles (prepost r = .65, z = 5.56, 95% CI [.46, .78], p < .001, k = 8, N = 376). Both meta-analyses provided promising evidence regarding the relevance of alliance rupture-repair processes to therapeutic outcome. The limitations of the research reviewed are discussed as well as practice implications for repairing the inevitable alliance ruptures in psychotherapy.
ISSN:0033-3204
1939-1536
DOI:10.1037/a0022140