Exploring the therapeutic alliance
At present, there is a lack of research on how the rupture and repair process transpires within the context of interpersonal trauma discussion in psychotherapy. Therefore, this study employed a case study approach to qualitatively understand Safran and Muran's (1996; 2000) model of rupture and repair with a 28 year-old African-American, Christian female client who discussed her interpersonal traumatic experiences in individual psychotherapy at a community counseling clinic. The treatment lasted 21 sessions and of the 15 videotaped sessions, six contained discussions of childhood sexual abuse and workplace psychological harassment. Safran and Muran's (1996; 2000) model of rupture and repair and select Inventory of Countertransference Behavior (Friedman & Gelso, 2000) items were used to develop a coding system to identify the occurrence of ruptures and repairs in those sessions and examine their relationship with the client's and therapist's Working Alliance Inventory (Horvath & Greenberg, 1989) ratings. Other assessment measures and qualitative themes and subthemes, were analyzed to further understand the context of interpersonal trauma discussion as it related to the dynamics between the client and therapist, and overall treatment. Consistent with rupture and repair research, this study found a sizable amount of ruptures occurring within the context of trauma discussions, with high rates of the therapist-participant imposing too much structure, not providing validation, and being critical of the client-participant. Although there is a lack of research on the comparison between ruptures and repairs, this study found that the majority of ruptures were not repaired; 33 ruptures and only three repairs were identified over the course of therapy. The therapist-participant did not follow the repair model, and instead appeared to notice certain ruptures by laughing, changing topics, or taking back her statements or intentionally apologizing. Given data limitations, associations between ruptures and repairs and WAI ratings could not be identified. However, both participants rated their therapeutic alliance as strong. Future studies should develop a rupture and repair model more suitable to working with clients presenting with trauma histories, specifically focusing on how cultural factors enhance or hamper therapists' and clients' abilities to successfully engage in repairs. Such studies could use procedures created in this dissertation, including its operational definitions of ruptures, which may make their identification and repair easier. Results can also be used to inform therapists working with trauma survivors that ruptures and therapists' ability to successfully repair them can be opportunities for meaningful dialogue, and growth (Joseph & Linley, 2008) within an interpersonal context (Seligman, 2005; Seligman, Rashid, & Parks, 2006; Seligman & Csikszentmihalyi, 2000).
Library of Congress Subject Headings
Dissertations (PsyD) -- Psychology; Psychic trauma -- Treatment; Psychotherapy
Date of Award
Graduate School of Education and Psychology
Campos, Karina G., "Exploring the therapeutic alliance and rupture repair within the context of trauma discussion: a case study" (2011). Theses and Dissertations. 161.