Therapist interpretation, alliance ruptureresolution and outcome

Abstract

There is some evidence that in psychodynamic psychotherapy the quality of the therapist interventions, and especially interpretations, is related to the level of therapeutic alliance and to outcome. This exploratory study follows up this idea by studying the role played by quality of interpretations during sequences of rupture and resolution of alliance. Using the empirical concept of interpersonal accuracy developed by Paul Crits- Christoph and Lester Luborsky (2003), we compared two successive sessions, one showing a rupture in the alliance and the other a resolution, to one control session in 11 brief psychodynamic psychotherapies. We assessed interpersonal accuracy by rating the congruence between each patient's core conflictual relationship themes and the components of the patient-specific interpersonal theme expressed in therapist interpretations. Results showed that a higher interpersonal accuracy during resolution sessions was related to better outcome. These results confirm the link between therapeutic technique and alliance process in psychodynamic psychotherapy.