ABSTRACT
When ruptures in the therapeutic relationship occur, how the therapist handles them determines the outcome of therapy. The client may leave precipitously or stay, deepening the relationship. Therapists need to notice there is a problem, track the origin of the rupture, examine themselves for the activation of defensive structures, respond appropriately to the rupture, and repair the relationship. Effective therapeutic apology and other reparative strategies are presented for ruptures of attachment in trauma therapy. Session rating metrics are presented as a way to monitor mini-ruptures in therapy, since ruptures can remain unnoticed until they are too big to repair.
