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

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

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.

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.

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.