Examining the Roles of Goal, Task, and Bond in Therapeutic Alliance Ruptures

Date

2022

Authors

Dimmick, Andrew
Callahan, Jennifer

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Abstract

Strong support has been given for the importance of the therapeutic alliance and repairing therapeutic alliance ruptures in psychotherapy. The cause driving therapeutic alliance ruptures has yet to be fully explored. The aim of this study was to analyze the three facets of therapeutic alliance—goal, task, and bond—and their association with therapeutic alliance ruptures. We also investigated the presence and frequency of alliance ruptures as predictors of treatment outcomes. To accomplish this, we analyzed clinical records (N = 221) from clients in a training clinic who had previously received psychotherapy services. We found that a disagreement of the goals and tasks of treatment were both more likely to result in an alliance rupture than a deterioration of the relational bond. Furthermore, we found that the frequency of therapeutic alliance ruptures accounted for a significant amount of variability in treatment outcomes, with more ruptures being associated with poorer outcomes. These results highlight the importance of identifying when a rupture has occurred while underscoring that not all ruptures are equal. The implications of these findings are discussed.

Description

University of North Texas

Keywords

Clinical Psychology

Citation