Responsiveness to ruptures and repairs in psychotherapy.

Eubanks, Catherine F.; Sergi, Joey; Muran, J. Christopher

doi:10.1037/0000240-005

Cited by 13 publications

(9 citation statements)

References 37 publications

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“…Engagement includes clients overcoming early fears of exposure and difficulty to trust. This may be related to studies that show that processing ruptures in the alliance is one of the catalysts of therapeutic change (Eubanks et al., 2019, 2021). In Danny and Sara’s narratives, we have a glimpse into such a rupture that appeared in both narratives during the second interviews.…”

Section: Discussionmentioning

confidence: 92%

Client–therapist closeness–distance dynamics as a pathway for understanding changes in the alliance during psychodynamic therapy

Egozi

Tishby

Wiseman

2021

Couns and Psychother Res

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This study examines how changes in clients’ and their therapists’ perceptions of the therapeutic distance relate to changes in their reported alliance. Alliance is commonly measured using self‐report questionnaires that provide information regarding the partners’ bond and collaboration, but do not reflect the interactions or events underlining them. We developed the Observer Version of the Therapeutic Distance Scale (TDS‐O; Egozi et al., 2020) to assess components of the therapeutic relationship, including closeness–distance dynamics, autonomy and engagement. Sixty‐seven clients and their 27 therapists completed the Working Alliance Inventory (WAI) and underwent Relationship Anecdote Paradigm (RAP) interviews in which they related narratives about their experiences with each other three times during psychodynamic therapy (after sessions 5, 15 and 28). The clients’ and their therapists’ narratives were rated on the TDS‐O. Clients’ and therapists’ decrease in their sense that the partner was too distant correlated with WAI increase, as did therapists’ decrease in their opinion that the client was too close. Increases in both partners’ engagement was also related to WAI increase. A clinical example of a successful case demonstrates these changes and highlights significant moments that might contribute to positive change. The study establishes the relationship between the alliance and therapeutic distance, and reveals discrepancies in the experiences of clients and therapists. Tracking therapeutic distance has the potential to refine therapists’ attunement to their clients’ emotional needs.

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Section: Discussionmentioning

confidence: 92%

Client–therapist closeness–distance dynamics as a pathway for understanding changes in the alliance during psychodynamic therapy

Egozi

Tishby

Wiseman

2021

Couns and Psychother Res

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“…Safran and Kraus suggest that repairing a rupture requires therapists to be responsive in order to identify its occurrence and to determine the best way to repair it, taking account of all the salient information available about the dyad in the moment. Sensitive moment-to-moment responsiveness to alliance ruptures is essential, as these are often not overt or extreme but rather reflect subtle misattunements that accumulate over the course of therapy and negatively impact treatment outcomes (Eubanks et al, 2021). A number of studies have found evidence suggesting that therapists' recognition of ruptures is related to subsequent improvements in alliance or outcome (e.g., Chen et al, 2018;Rubel et al, 2018;Zilcha-Mano et al, 2019).…”

Section: Interpersonal Signalsmentioning

confidence: 99%

“…Eubanks and colleagues (2018) meta-analytic review pointed to a growing number of studies that have found a relationship between rupture repair and positive treatment outcomes, including symptom improvement and less premature dropout. Eubanks et al (2021) concluded: "Appropriate responsiveness is beneficial to a treatment at any stage; however, when a rupture occurs in the alliance, it becomes a crucial element for success. In fact, the process of successfully repairing a rupture not only explicitly values responsiveness, it also requires it" (p. 84).…”

Section: Interpersonal Signalsmentioning

confidence: 99%

Responsiveness: Can psychotherapies and psychotherapists adapt effectively to participant and clinical contexts?

Watson,

Wiseman

2024

APA Handbook of Psychotherapy: Evidence-Based Practice, Practice-Based Evidence, and Contextual Participant-Driven Practice (Vo

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“…The second AFT supervisor principle is to be responsive. Appropriate responsiveness (Stiles et al, 1998;Stiles & Horvath, 2017), that is, tailoring treatment appropriately to the individual patient, is a key component of good therapy and is essential for successful rupture repair (Eubanks, Sergi, & Muran, 2021). Similarly, supervisor responsiveness is essential when helping trainees navigate alliance ruptures (Friedlander, 2015).…”

Section: Supervisor-focused Principlesmentioning

confidence: 99%

Alliance-focused training: Teaching therapists to navigate alliance ruptures.

Eubanks¹,

Muran²,

Samstag³

2023

Becoming Better Psychotherapists: Advancing Training and Supervision.

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O ur rupture research program can be traced back to the Clarke Institute of Psychiatry in Toronto, where Jeremy Safran directed a team of clinical researchers in the late 1980s that included Lisa Wallner Samstag and Chris Muran. Since 1990, it has been situated at Mount Sinai Beth Israel (MSBI) in New York under the directorship of Chris Muran (principal investigator) with Jeremy Safran (senior consultant), Lisa Wallner Samstag, and subsequently Catherine Eubanks (joining in 2007) as primary collaborators and coinvestigators, and with support from the MSBI Department of Psychiatry (chair, Arnold Winston, until 2015) and the National Institute of Mental Health.As evidence of what we have described as a "second generation" of alliance research, there has been a burgeoning of empirical literature on ruptures and their repair (Muran, 2019), including meta-analytic evidence that rupture repair is associated with good treatment outcome (Eubanks et al., 2018). When we look back at the history of our rupture research program, it becomes clear that to a great extent our study of ruptures has always been, at its heart, the study of training therapists to navigate ruptures-specifically, alliance-focused training (AFT). In this chapter, we describe AFT and present the existing empirical support for this approach to training. We also illustrate AFT with data from an AFT session, as well as propose promising future directions.

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Responsiveness to ruptures and repairs in psychotherapy.

Abstract: Responsiveness to Ruptures and Repairs in Psychotherapy • 85THERAPIST: Yes, I just read an interesting article about that. I can send it to you.

Cited by 13 publications

References 37 publications

Client–therapist closeness–distance dynamics as a pathway for understanding changes in the alliance during psychodynamic therapy

Client–therapist closeness–distance dynamics as a pathway for understanding changes in the alliance during psychodynamic therapy

Responsiveness: Can psychotherapies and psychotherapists adapt effectively to participant and clinical contexts?

Alliance-focused training: Teaching therapists to navigate alliance ruptures.

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