A thematic analysis of therapists' perspectives on therapeutic alliance rupture moments

Abstract

This study aimed to qualitatively examine the perspectives of therapists using different theoretical orientations on rupture moments. The study features a qualitative research design. Six different therapy session segments were presented to the participants and questions were asked to gather their perspectives on the segments. The thematic analyses conducted on 20 therapists’ evaluations on the 6 rupture segments of 5 patients were based on two categories: i) the causes of the rupture moments, ii) the recommendations for resolution. Findings revealed that therapists are more likely to report patients’ negative contribution as the main cause of rupture moments. Participants attributed less importance to the negative contribution of the therapist or to the therapist-patient relationship in rupture moments, and therapists tended to suggest mostly technical resolutions to ruptures. This second-generation alliance research draws attention to relational aspects of the rupture resolution processes for a positive outcome. However, our findings yielded that there was a lack in therapists’ evaluations in addressing the contribution of the therapists and/or therapist-patient relationship to rupture moments. This highlights the importance of supervision training to foster therapists’ awareness of rupture moments and develop their skills for resolution in the context of the therapist-patient relationship.

Keywords

• Therapeutic alliance rupture
• Therapists’ perspectives
• Thematic analysis