The resolution of ruptures in the therapeutic alliance.
This article outlines some of the main features of a research program on ruptures in the therapeutic alliance and reports some of the major findings to date. A rupture in the therapeutic alliance is a deterioration in the quality of the relationship between patient and therapist; it is an interpersonal marker that indicates a critical opportunity for exploring and understanding the processes that maintain a maladaptive interpersonal schema. Following the task-analytic research paradigin, a preliminary model of the resolution process was developed and then tested and revised with 2 different data sets. A series of lag 1 sequential analyses were used to confirm the hypothesized sequences of events within resolution sessions and to demonstrate a difference between resolution and nonresolution sessions. This article describes the evolution of a model of rupture resolution and then discusses its implications for treatment development and evaluation.
Safran
J D
JD
Department of Psychology, New School for Social Research, Beth Israel Medical Center, New York, New York 10003, USA.
Muran
J C
JC
D000223:Adaptation, Psychological; D003220:Conflict, Psychological; D003674:Defense Mechanisms; D004644:Emotions; D006801:Humans; D008960:Models, Psychological; D010553:Personality Development; D011369:Professional-Patient Relations; D011613:Psychotherapy / Q000379:methods*; D016896:Treatment Outcome