Therapeutic Alliance Ruptures

The conceptual and empirical literature on alliance ruptures and their resolution is a developing one that is receiving increasing attention, especially as clinicians and researchers continue to face the challenges of treatment resistance and failure across all treatment orientations. Alliance ruptures have been defined as negative patient communications and patient-therapist interactions. Rupture resolution has been defined as therapist corrective actions or collaborative explorations by therapist and patient that can lead to significant change events.

Contextualizing the Therapeutic Alliance

Any discussion of alliance ruptures must begin with an attempt to contextualize the alliance construct itself. The history of the construct dates back to Sigmund Freud’s original recommendation to make the patient a “collaborator” in the therapeutic process. Several ego psychologists advanced the alliance construct to counteract a ...

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