chapter  9
28 Pages

Defining and Identifying Alliance Ruptures

WithLisa Wallner Samstag, J. Christopher Muran, Jeremy D. Safran

A compelling body of empirical evidence has established the therapeutic alliance as a core psychotherapy process that directly contributes to overall patient change across a range of theoretically diverse treatments (Horvath & Symonds, 1991; Martin, Garske, & Davis, 2000). There are numerous theoretical conceptualizations of the therapeutic alliance and several instruments have been developed to measure it. A common feature among them is a description of the general affective quality of the patient-therapist relationship, including the interaction of patient and therapist interpersonal characteristics (e.g., therapist’s capacity for empathy, patient’s degree of involvement in treatment) in their moment-to-moment collaboration toward agreed on treatment goals (Horvath & Greenberg, 1994).