Interpersonal Problems and Their Impact on Alliance Ruptures in Psychotherapy

Area of Science:

• Psychology
• Psychotherapy Research
• Clinical Psychology

Background:

• Alliance ruptures are common in psychotherapy and impact outcomes.
• Interpersonal theory suggests interpersonal problems contribute to alliance ruptures.
• Maladaptive relational patterns can cause interpersonal misattunements during therapy.

Purpose of the Study:

• To investigate how specific interpersonal problems predict alliance rupture frequency.
• Focus on the first three sessions of cognitive-behavioural therapy (CBT).

Main Methods:

• 64 outpatients completed the Inventory of Interpersonal Problems (IIP-32).
• Therapy sessions were coded using the Rupture and Resolution Rating System (3RS).
• Multilevel Bayesian hurdle models analyzed rupture likelihood and frequency.

Main Results:

• Withdrawal ruptures were more common than confrontation ruptures.
• Affiliation and friendly-submissive tendencies related to fewer withdrawal ruptures but higher likelihood.
• Hostile-submissive tendencies predicted more frequent withdrawal ruptures but lower occurrence probability.
• High dysfunction and self-sacrificing tendencies predicted fewer confrontation ruptures.

Conclusions:

• Interpersonal problems offer insights into subtle alliance ruptures.
• Therapists can use this understanding to better recognize and address ruptures.
• Improved rupture management can enhance the overall therapeutic process.