Ambivalence, resistance, and alliance ruptures in psychotherapy: It’s complicated.

2019 ◽  
Vol 36 (2) ◽  
pp. 139-147 ◽  
Author(s):  
Adelya A. Urmanche ◽  
João Tiago Oliveira ◽  
Miguel M. Gonçalves ◽  
Catherine F. Eubanks ◽  
J. Christopher Muran
Keyword(s):  
Alliance Ruptures

Session-to-session effects of alliance ruptures in outpatient CBT: Within- and between-patient associations.

2018 ◽  
Vol 86 (4) ◽  
pp. 354-366 ◽  
Author(s):  
Julian A. Rubel ◽  
Sigal Zilcha-Mano ◽  
Viola Feils-Klaus ◽  
Wolfgang Lutz
Keyword(s):  
Alliance Ruptures

scholarly journals Beyond the mask of deference: exploring the relationship between ruptures and transference in a single-case study

2016 ◽  
Vol 19 (2) ◽  
Author(s):  
Francesca Locati ◽  
Pietro De Carli ◽  
Emanuele Tarasconi ◽  
Margherita Lang ◽  
Laura Parolin
Keyword(s):  
Sequential Analysis ◽  
Rating Scales ◽  
Rating Scale ◽  
Defense Mechanism ◽  
Single Case ◽  
Assessment Procedure ◽  
Single Case Study ◽  
Alliance Ruptures ◽  
The Relationship

The relationship between transference and therapeutic alliance has been long discussed. It is only recently, however, that empirical evidence has provided support for a tight correspondence between several transference dimensions and rupture and resolution processes. In the present single-case study, we used alliance ruptures as a key dimension to understand patient’s transference dynamics. This was achieved in a particular form of patient’s behavior, i.e., patient’s deference and acquiescent behavior, which describes a significant submission to assertions, skills, judgments and point of views of another person. Therapeutic process was measured by means of the Rupture Resolution Rating Scale, the Core Conflictual Relationship Theme and the Defense Mechanism Rating Scales, whereas therapeutic outcome was measured by means of the Shedler-Westen Assessment Procedure-200. Results of sequential analysis yielded a significant correspondence between rupture markers, characterized by avoidance and shifting of session’s topic, and patient’s narrations. Furthermore, a systematic correspondence between alliance ruptures and patient’s avoidant functioning, which emerged both in transference relationship and in the quality of the defense structure, was found. Together, these findings indicate that patient’s deference inhibits the expression of relational themes, with ruptures in alliance that seem to be supported by a strong defensive structure. In particular, patient’s avoidance played a double role in the treatment. On the one hand, avoidance was the main characteristic of her transference structure, based on extreme intellectualization and emotional closure. On the other hand, it contributed to create an impasse in the treatment, based on a withdrawal ruptures model and on obsessive level defences.

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

Nonverbal synchrony as a marker of alliance ruptures.

Psychotherapy ◽  
2021 ◽  
Vol 58 (4) ◽  
pp. 499-509
Author(s):  
Keren Deres-Cohen ◽  
Tohar Dolev-Amit ◽  
Galit Peysachov ◽  
Fabian T. Ramseyer ◽  
Sigal Zilcha-Mano
Keyword(s):  
Alliance Ruptures ◽  
Nonverbal Synchrony

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 Detecting alliance ruptures: the effects of the therapist’s experience, attachment, empathy and countertransference management skills

2019 ◽  
Vol 22 (1) ◽  
Author(s):  
Corinne Talbot ◽  
Rose Ostiguy-Pion ◽  
Esther Painchaud ◽  
Claudelle Lafrance ◽  
Jean Descôteaux
Keyword(s):  
Clinical Supervision ◽  
Clinical Experience ◽  
Mental Health Professionals ◽  
Personal Characteristics ◽  
Repair Process ◽  
Attachment Anxiety ◽  
Detection Ability ◽  
Negatively Associated ◽  
Alliance Rupture ◽  
Alliance Ruptures

Accurate alliance rupture detection is a prerequisite to any successful repair process. Despite its importance, however, rupture detection remains a struggle for most therapists. Supporting the existence of a therapist effect on therapy outcomes, rupture detection skills may rely on certain therapists’ personal characteristics. The aim of this study was to verify whether alliance rupture detection performance is related to therapists’ personal characteristics. One hundred and eight undergraduates, trainees and mental health professionals participated in an experimental task assessing their alliance rupture detection ability. Participants also completed attachment, empathy and countertransference management self-reported measures. Participants with clinical experience (trainees and professionals) reported more alliance ruptures, accurate or not, than those with no clinical experience (undergraduates). Trainees reported more accurate ruptures and less inaccurate ones than the two other groups. Attachment anxiety was positively associated with accurate ruptures detection for undergraduates, while this association proved negative for trainees and therapists. Perspective-taking, a cognitive dimension of empathy, was negatively associated with accurate rupture detection, whereas personal distress, an affective dimension of empathy, was negatively associated with accurate ruptures detection for trainees, and positively associated for undergraduates. Self-insight, a component of countertransference management, revealed a negative association with accurate rupture detection for trainees. These findings suggest that therapists vary as to their rupture detection ability and that this ability is related to certain personal characteristics. They also highlight the importance of specific training and clinical supervision for both trainees and experienced therapists in order to improve their detection ability.

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.

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