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Rupture Patterns and Outcomes: The Moderating Role of Interpersonal Functioning.

L Igra¹, C F Jacobsen¹, F Falkenström²

¹Department of Psychology, University of Copenhagen, Copenhagen, Denmark.

Clinical Psychology & Psychotherapy

|November 22, 2025

Summary

This summary is machine-generated.

Clients with more impaired interpersonal functioning experience greater symptom improvement when psychotherapy alliance ruptures are repaired. This finding highlights the importance of addressing ruptures for personalized mental healthcare.

Keywords:

alliance ruptures interpersonal functioning psychotherapy outcomes rupture–repair working alliance

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Area of Science:

Psychology
Psychotherapy Research
Clinical Psychology

Background:

The therapeutic alliance is crucial for psychotherapy outcomes.
Alliance ruptures, or disagreements, can hinder progress if not resolved.
Understanding how client characteristics interact with rupture resolution is key.

Purpose of the Study:

To investigate if clients with impaired interpersonal functioning benefit more from repaired alliance ruptures.
To examine the moderating role of interpersonal functioning on the relationship between alliance rupture patterns and psychotherapy outcomes.

Main Methods:

Analysis of data from 514 adult outpatient psychotherapy cases.
Classification of treatments into 'no rupture,' 'unrepaired rupture,' or 'repaired rupture' patterns.
Multilevel modeling to assess the interaction between rupture patterns and interpersonal functioning on symptom change.

Main Results:

A significant interaction was found between repaired ruptures and interpersonal functioning.
Clients with more impaired interpersonal functioning showed greater symptom improvement after repaired ruptures.
This benefit was observed primarily in longer treatments (over seven sessions).

Conclusions:

Repaired alliance ruptures are particularly beneficial for clients with significant interpersonal difficulties.
Therapeutic alliance dynamics can be personalized based on client functioning levels.
Addressing ruptures effectively contributes to personalized treatment approaches in psychotherapy.