Repairing the therapeutic alliance : the impact of therapists’ contributions to ruptures

Effectively repairing alliance ruptures has been associated with improved client outcomes and reduced dropout. Although ruptures and repairs are inherently dyadic processes, research has focused on clients’ contributions, leaving therapists’ contributions conceptually underdeveloped. Thus, little is known about how therapists’ contributions influence rupture repair. Because therapists are trained to focus on their clients, they may be less likely to recognize or address their own contributions to ruptures. Further, acknowledging their contributions may evoke greater distress than acknowledging clients’ contributions, further hindering repair. Therefore, the aim of the present study was to examine whether therapists’ contributions to alliance ruptures were associated with reduced repair effectiveness. Using the Rupture Resolution Rating System (3RS), 156 therapy sessions from 13 client-therapist dyads were coded for ruptures, repairs, and therapists’ contributions to ruptures. Our results indicated that therapists’ contributions to ruptures were negatively associated with repair at both the within-session and between-session levels. Further, exploratory analyses indicated that rupture intensity was negatively associated with repair, and that therapists’ contributions predicted repair effectiveness after controlling for rupture intensity. These findings provide novel evidence that therapists’ contributions to ruptures are associated with reduced repair and highlight a target for clinician and supervisor training.