Assessing alliance ruptures and resolutions: Reliability and validity of the Collaborative Interactions Scale-revised...

Area of Science:

• Psychotherapy Research
• Clinical Psychology
• Psychological Assessment

Background:

• The Collaborative Interactions Scale (CIS) is an observer-rated measure for assessing therapeutic alliance ruptures and resolutions.
• Previous use identified limitations including time consumption, low item occurrence, and insufficient detail in capturing patient-therapist interactions.

Purpose of the Study:

• To describe the revision process of the CIS.
• To evaluate the interrater reliability and validity of the revised CIS (CIS-R).
• To compare alliance dynamics in patients with and without personality disorders (PDs).

Main Methods:

• A revised scale (CIS-R) was developed based on criticisms of the original CIS.
• Three raters evaluated 60 psychotherapy sessions (180 segments) from 30 patients (15 with PDs, 15 without).
• Evaluations involved blind assessment of narrative units within sessions.

Main Results:

• Interrater reliability for the CIS-R was acceptable to excellent, comparable to the original scale.
• Patients with PDs exhibited more alliance ruptures and fewer collaborative processes than those without PDs.
• Therapists used more negative interventions with patients with PDs.

Conclusions:

• The revised CIS-R is a reliable and valid rating system for psychotherapy research and clinical assessment.
• The CIS-R effectively identifies rupture and resolution processes, aiding clinical practice and therapist training.
• The scale facilitates reflection on therapeutic actions for managing ruptures.