Antioppressive approaches to alliance rupture and repair: A critical–cultural–relational model of rupture resolution.

Abstract

In this chapter, we describe the critical-cultural-relational model of rupture and repair, which builds on Safran, Muran, and colleagues' (Muran et al., 2010;Safran & Muran, 2000) classic model to explicitly contextualize ruptures within the historically and culturally constructed dynamics of power that shape all social interactions. We detail how cultural and social distance may increase the occurrence of ruptures and create challenges to repair, as well as how therapists can improve their capacity to bridge barriers to deepen client self-understanding and foster ethnocultural empathy, connection, and healing. We illustrate the approach with a case example. We conclude the chapter with reflections on how essential therapist skills of wise affect, critical self-awareness, and antioppressive interpersonal engagement may help disrupt entrenched dynamics of oppression as clinicians (imperfectly) work toward greater racial justice and equity in clinical care.Across the globe, increasing migration and mobility is bringing us in contact with more people from different cultures, belief systems, and perspectives about what is good, what is just, and what we owe each other as fellow citizens. Because humans naturally fear what is unfamiliar, we prefer to seekCopyright American Psychological Association. Not for further distribution. • Chang, Omidi, and Dunncompany with those who look, sound, and act like us (Stephan & Stephan, 1985). While understandable, our inclination for avoidance fails to provide us the experience and the tools to empathically connect with others who are different (Cameron et al., 2019;Stephan & Finlay, 1999). We struggle to understand how someone could believe what they believe, say the things they say, live the ways they live. And worse, we fail to see how systems of oppression shape each of our life trajectories and perpetuate inequities that are too easily blamed on individual choices (McNamee, 2018;Sears & Henry, 2003).Within the therapeutic context, these failures of empathy and understanding often lead to ruptures in the relationship. Safran and Muran (1996) defined a rupture as a deterioration in the therapeutic alliance or a difficulty in establishing the relationship that may be expressed through disagreements about the tasks or goals of therapy or through tensions in the affective bond between therapist and client (Bordin, 1979;Eubanks-Carter et al., 2010;Safran & Muran, 2000). Ruptures and conflicts in the relationship are unavoidable given that we can never be fully attuned to our clients; furthermore, therapeutic work necessarily involves challenging clients and helping them to navigate places of discomfort, disappointment, and anxiety in relation to others. Ruptures have been classified according to two types of markers: confrontation-for example, when the patient moves against the therapist or therapy process by expressing dissatisfaction, aggression, hostility, and so on-and withdrawal-for example, when the patient disengages or moves away from the therapist, the therapy process, or ...