Chapter 4 focused on two formidable impasses to therapeutic progress: resistance and ambivalence. Chapter 5 focused on two other potential impasses: transference and countertransference. This chapter emphasizes another formidable impasse: alliance ruptures. Alliance strains and ruptures can and do occur in all forms of therapy. This chapter addresses the essential competency of resolving alliance strains and ruptures. First, alliance ruptures will be described. Then different strategies for resolving this major threat to client engagement and cause of premature termination are presented. Finally, these points are illustrated with case material.

As described in Chapter 2, the therapeutic alliance has been conceptualized in terms of three interdependent variables: an agreement on the therapeutic tasks, an agreement on goals, and the quality of the interpersonal bond between therapist and client (Bordin, 1979). An effective therapeutic alliance is a therapeutic relationship that is mutual and collaborative. Alliance ruptures are basically tensions or breakdowns in the collaborative relationship between client and therapist. Safran, Muran, Samstag, and Stevens (2002) conceptualize ruptures as either disagreements about the tasks and goals of treatment or as breaches in the therapeutic bond.