Psychotherapy Relationships That Work : Evidence-based Responsiveness (9780199930500) by Norcross John C. (EDT)

Author:Norcross, John C. (EDT)
Language: eng
Format: epub
Publisher: Oxford Univ Pr
Published: 2011-01-15T00:00:00+00:00

CHAPTER 11

Repairing Alliance Ruptures

Jeremy D. Safran, J. Christopher Muran, and Catherine Eubanks-Carter

One of the most consistent findings emerging from psychotherapy research is that the quality of the therapeutic alliance is a robust predictor of outcome across a range of different treatment modalities (e.g., Chapters 2, 3, and 4) and that, conversely, weakened alliances are correlated with unilateral termination by the patient (e.g., Horvath & Bedi, 2002; Martin, Garske, & Davis, 2000; Samstag, Batchelder, Muran, Safran, & Winston, 1998; Tryon & Kane, 1990, 1993, 1995). In the last two decades, there has emerged what we have characterized as a “second generation” of alliance research that attempts to clarify the factors leading to the development of the alliance, as well as those processes involved in repairing ruptures in the alliance when they occur (Safran & Muran, 2006; Safran et al., 2002). In this chapter, we provide a review of this research and meta-analyses of two different types of relevant studies. The first meta- analysis examines the association between the presence of rupture repair episodes and treatment outcome. The second examines the impact of rupture resolution training or supervision on patient outcome by assessing patient change from therapy intake to termination. We will also briefly review the task analytic studies investigating processes associated with alliance rupture repair.

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