This commentary highlights common principles shared across the diverse clinical case examples featured in this In Session issue on Rupture Repair in Practice. We discuss the importance of therapists recognizing subtle signs of rupture and responding to ruptures with curiosity and compassion. We also consider how therapists can use repair strategies responsively to facilitate a corrective experience for the patient. We explore the ways in which the specific resolution strategy of linking a rupture to larger interpersonal patterns can benefit the therapeutic process, and the ways in which it can constitute a form of avoidance. We conclude by noting promising future directions and celebrating the generosity evidenced by these insightful authors' willingness to share and explore challenging moments in therapy.
Responsiveness to Ruptures and Repairs in Psychotherapy • 85THERAPIST: Yes, I just read an interesting article about that. I can send it to you.
The current study explored trainee therapists' experiences in alliance-focused training (AFT), a form of group supervision focused on training therapists to recognize and negotiate alliance ruptures. We analyzed interviews with 36 former trainees who received AFT during their predoctoral psychology internships. Findings centered on trainees' views of the central AFT tasks of videotape analysis, awareness-oriented role-plays, and mindfulness training; the supervisor's stance, including the provision of support and validation and the extent to which the supervisor served as a positive role model; and the impact of AFT on trainees' clinical skills. Many trainees reported that AFT increased their awareness, acceptance, and comfort with navigating ruptures, but some trainees reported that AFT supervisory tasks were anxiety-provoking and that AFT made them less comfortable in session. The findings underscore the challenges that AFT presents for trainees, who are asked to take risks in supervision, and for supervisors, who need to create a safe space for trainees and model sensitivity to supervisory ruptures. The findings also point to the potential benefits for trainees who feel safe and supported enough to explore the most challenging therapeutic moments in the context of a group supervision.
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