The Collaborative Interactions Scale: A new transcript-based method for the assessment of therapeutic alliance ruptures and resolutions in psychotherapy

Colli, Antonello; Lingiardi, Vittorio

doi:10.1080/10503300903121098

Cited by 100 publications

(117 citation statements)

References 39 publications

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“…We used the single-rater ICC because 70% of our data was coded by only one rater. Considering recommendations from previous studies (Shrout & Fleiss, 1979;Colli & Lingiardi, 2009;Dimagio et al, 2008), the interreliability values were adequate (ICC = .73 for withdrawal global ratings, ICC = .96 for confrontation global ratings).…”

Section: Al/confrontation Rupture(s) Did Not Occur; Not Significant Fmentioning

confidence: 99%

The development of the therapeutic alliance and the emergence of alliance ruptures. [El desarrollo de la alianza terapéutica y la aparición de rupturas en la alianza]

et al. 2014

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Título: El desarrollo de la alianza terapéutica y la aparición de rupturas en la Alianza. Resumen: Objetivos: Este estudio evaluó el desarrollo de la alianza terapéutica y la aparición de rupturas de alianzas, en una muestra de pacientes con diferentes diagnósticos y resultados terapéuticos. Diseño: Se analizaron los datos longitudinales de 38 díadas terapéuticas que recibieran terapia cognitivo-conductual. La muestra incluyó a casos de abandonos, así como casos exitosos y no exitosos. La muestra incluyó a casos con trastornos del Eje I y Eje II. Método: Al final de cada sesión, los pacientes evaluaron la alianza mediante el Inventario de Alianza de Terapéutica (WAI). Seis jueces entrenados en la observación de los marcadores de ruptura de alianza con un sistema de observación de rupturas, codificaran 201 sesiones terapéuti-cas grabadas en vídeo. Se aplicaran modelos estadísticos longitudinales a los datos. Resultados: Se encontró que el patrón de desarrollo de la alianza de los casos de éxito era diferente de la de los casos sin éxito y abandonos. En media, los pacientes con trastornos de la personalidad iniciaran la terapia con una menor puntuación en el WAI que disminuyó con el tiempo, mientras que los pacientes con trastornos del Eje I iniciaran la terapia con una mayor puntuación en el WAI que aumentó con el tiempo. Palabras clave: dDesarrollo de la alianza terapéutica; rupturas en la alianza, trastornos del Eje I; trastornos del Eje II. Abstract:Objectives: This study evaluated the development of the therapeutic alliance and the emergence of alliance ruptures, in a sample of patients with different diagnosis and different therapeutic outcome. Design: We examined the longitudinal data of 38 therapeutic dyads receiving cognitive-behavioural therapy, including dropouts as well as successful and unsuccessful cases. The sample included cases with Axis I and Axis II disorders. Method: At the end of each session, patients evaluated the alliance using the Working Alliance Inventory (WAI). Six judges trained in the observation of alliance rupture markers with an observational system of ruptures, rated 201 videotaped sessions. Longitudinal statistical models were applied to the data. Results: We found that the pattern of alliance development of successful cases was different from the unsuccessful and dropouts cases. In addition on average, patients with personality disorders began therapy with a lower WAI score that decreased over time, whereas patients with Axis-I disorders began therapy with a higher WAI score that increased over time.

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Section: Al/confrontation Rupture(s) Did Not Occur; Not Significant Fmentioning

confidence: 99%

The development of the therapeutic alliance and the emergence of alliance ruptures. [El desarrollo de la alianza terapéutica y la aparición de rupturas en la alianza]

et al. 2014

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“…Beyond unveiling the impact of deferential behavior on psychotherapy process and outcome, indeed, our findings draw new attention to the need of a proper assessment of this elusive behavioral functioning for both clinical and research purposes (Colli & Lingiardi, 2009). In fact, deferential patients may be often treated as high functioning level patients, with the consequence of underestimating patient's resistance to therapeutic changing.…”

Section: Discussionmentioning

confidence: 99%

“…As a consequence, a deeper comprehension of the defensive functioning of the patient can inform about the relational and bi-personal meaning of ruptures in the alliance. Deference may represent, indeed, a very insidious problem for researchers and clinicians because it can negatively influence the inter-subjective dynamic of the therapy (Colli & Lingiardi, 2009). On these grounds, the present study aims to explore the dynamics of deferential behavior in relationship with other clinically relevant constructs (i.e., transference, defense mechanisms and alliance ruptures).…”

Section: Introductionmentioning

confidence: 99%

Beyond the mask of deference: exploring the relationship between ruptures and transference in a single-case study

Locati

Carli

Tarasconi

et al. 2016

ResPsy

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The relationship between transference and therapeutic alliance has been long discussed. It is only recently, however, that empirical evidence has provided support for a tight correspondence between several transference dimensions and rupture and resolution processes. In the present single-case study, we used alliance ruptures as a key dimension to understand patient's transference dynamics. This was achieved in a particular form of patient's behavior, i.e., patient's deference and acquiescent behavior, which describes a significant submission to assertions, skills, judgments and point of views of another person. Therapeutic process was measured by means of the Rupture Resolution Rating Scale, the Core Conflictual Relationship Theme and the Defense Mechanism Rating Scales, whereas therapeutic outcome was measured by means of the Shedler-Westen Assessment . Results of sequential analysis yielded a significant correspondence between rupture markers, characterized by avoidance and shifting of session's topic, and patient's narrations. Furthermore, a systematic correspondence between alliance ruptures and patient's avoidant functioning, which emerged both in transference relationship and in the quality of the defense structure, was found. Together, these findings indicate that patient's deference inhibits the expression of relational themes, with ruptures in alliance that seem to be supported by a strong defensive structure. In particular, patient's avoidance played a double role in the treatment. On the one hand, avoidance was the main characteristic of her transference structure, based on extreme intellectualization and emotional closure. On the other hand, it contributed to create an impasse in the treatment, based on a withdrawal ruptures model and on obsessive level defences.Key words: Therapeutic alliance; Transference; Deferent behavior; Single-case study.Correspondence: Francesca Locati, Department of Psychology, University of Milano-Bicocca, Piazza dell'Ateneo Nuovo 1, Edificio U6, 20126 Milan, Italy. E-mail: francesca.locati@unimib.it Contributions: FL developed the study concept; ET performed data collection and scoring; FL and PDC performed the data analysis and interpretation under the supervision of LP; FL drafted the manuscript, and ML and LP provided critical revisions. All authors contributed to the study design and approved the final version of the manuscript for submission.

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“…This way of conceptualizing and working on the relationship is in line with Horvath's (2011) proposal about the necessity to "discover and docu- The investigation of how the patient and therapist construct the therapeutic alliance, to depict "the idiosyncratic interactional patterns that unfold between patient and therapist" (Charmann, 2004, p. 18), suggests promoting studies based on the evaluation of micro processes between patient and therapist (Colli & Lingiardi, 2009).…”

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confidence: 94%

Returning to the roots. A Comment on the Paper Alliance in Common Factor Land: A View through the Research Lens

Colli

2011

ResPsy

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In his interesting paper “Alliance in Common Factor Land: A View through the Research Lens” Horvath (2011) takes us through the critical aspects of therapeutic alliance researches and the challenges that researchers still have to face. The author discusses several complex issues from the historical background of the construct to the critical aspects of its measurement, and concluding with the proposal of a research agenda. The key topic of Horvath’s (2011) paper is the necessity for a better definition of <em>therapeutic alliance construct</em>, one that would (a) recognize the similarities and differences among the different kinds of therapeutic alliance definitions; and (b) differentiate the components of the therapeutic relationship. As Horvath reminds us in his paper, the problem of differentiation between therapeutic alliance and other components of the relationship originates from Greenson’s (1965) tripartition of therapeutic relationship in transference, working alliance, and real relationship.

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The Collaborative Interactions Scale: A new transcript-based method for the assessment of therapeutic alliance ruptures and resolutions in psychotherapy

Cited by 100 publications

References 39 publications

The development of the therapeutic alliance and the emergence of alliance ruptures. [El desarrollo de la alianza terapéutica y la aparición de rupturas en la alianza]

The development of the therapeutic alliance and the emergence of alliance ruptures. [El desarrollo de la alianza terapéutica y la aparición de rupturas en la alianza]

Beyond the mask of deference: exploring the relationship between ruptures and transference in a single-case study

Returning to the roots. A Comment on the Paper Alliance in Common Factor Land: A View through the Research Lens

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