Recognize, Repair, and Resolve: Understanding Ruptures within the Therapeutic Alliance

The therapeutic alliance, or the relationship between the therapist and patient, has been a popular research topic and is believed to play an important role in therapy, but what happens when the bond is broken and trust cannot be established? Unresolved ruptures are associated with deterioration in the alliance and may lead to poor outcome or patient dropout (Safran & Kraus, 2014). In order to recognize that a rupture has occurred, seven themed rupture markers are provided, six interventions are suggested to repair the rupture, and ten strategies are identified to assist clinicians resolve the rupture. To evaluate the understanding of mental health practitioners, an anonymous survey was distributed. Clinicians were asked to rate the frequency of observing when rupture markers have occurred within the relationship, the utilization of interventions to repair the rupture, and strategies to resolve the rupture. It was found that a relationship was determined between years of experience of the clinician and noticing compliance on the part of the client and with years of experience and linking the event to similar relational issues in a client\u27s life. Additionally, it was determined that the recognize stage of the rupture process was identified more frequently than the later stages of repairing and resolving the rupture according to matching responses of the quantitative and qualitative questions. Strengths of this study include a sample in which 44% of respondents indicated they had 16 years of experience or more in mental health and the use of a mixed-method design. Limitations include sample size, survey instrument, and lack of funding