Testing the alliance rupture repair model on two cases with successful and unsuccessful rupture repair: a task analytic validation study.

OBJECTIVE

This study aimed to test and refine the complete alliance rupture repair model (RRM), consisting of three pathways, in short-term psychodynamic psychotherapy.

METHOD: The validation phase of task analysis was applied in a multi-method case study design to compare therapeutic strategies in a successful repair case (SRC) and an unsuccessful repair case (URC). The Working Alliance Inventory - Short was utilized to select cases and sessions, while the revised Rupture Resolution Rating System (3RS) provided the framework for analyzing the six selected sessions.

RESULTS

The study found that pathway 1 strategies (acceptance, validation, curiosity, and engagement) were more frequently utilized in the SRC. These strategies were also linked to repair segments in both cases. Conversely, pathway 2 strategies (renegotiating tasks and goals) were employed less frequently in both cases and did not lead to successful repair. Pathway 3 strategies (exploring the rupture experience) were particularly effective in repairing the rupture in the SRC. However, in the URC, these strategies appeared to exacerbate the rupture.

CONCLUSION

Pathway 1 strategies are crucial, serving both as an independent approach and as a foundational element for effectively implementing strategies in pathway 3, and likely in pathway 2 as well.