Rupture Repair

Abstract

A strong therapeutic relationship provides the optimal context for CBT, and an important component of this relationship is the alliance. An alliance rupture is a difficulty or deterioration in the alliance manifested by a lack of collaboration on therapy tasks or goals or a strain in the bond. The process of rupture repair can facilitate the work of therapy by renewing collaboration and strengthening the bond. Rupture repair can also provide the opportunity for a corrective experience of successfully navigating interpersonal conflict. A review of research on rupture repair in CBT treatments highlights that ruptures are common, and that failure to repair ruptures is associated with poor outcome and premature dropout. Therapists can reduce the likelihood of contributing to ruptures by adhering to the principle of collaborative empiricism. Therapists can facilitate rupture repair by recognizing ruptures when they occur and employing repair strategies: immediate repair strategies such as modifying the treatment task, or expressive repair strategies such as metacommunicating about the rupture and exploring the interpersonal schemas that underlie it. Training in rupture repair has demonstrated benefits for CBT therapists, particularly trainees.