University of Oxford, UK.
Psychol Psychother. 2010 Sep;83(Pt 3):273-88. doi: 10.1348/147608309X481036. Epub 2010 Jan 28.
Ruptures are potential change events in therapy that might result in positive or negative consequences for the therapeutic alliance and outcome. Alliance ruptures and premature drop-out are common with clients diagnosed with borderline personality disorder, limiting treatment effectiveness.
To test a nine stage model of rupture resolution in cognitive analytic therapy (CAT) with adolescents.
The validation phase of task analysis was employed to test the rupture resolution model and to relate handling of ruptures to outcome using quantitative and qualitative analysis of transcripts. Eighteen ruptures and resolution attempts were intensively examined across three good and two poor outcome sessions, as rated by clients. The number of model stages employed by therapists was related to outcome.
Sessions evaluated as poor or good by clients could be distinguished according to the extent to which therapists used model stages. Treatment outcome was significantly associated with number of model stages included by therapists.
Competent resolution of ruptures in CAT is dependent on therapists' inclusion of stages of the model, providing validation for the model, and demonstrating that effective rupture resolution might be related to treatment outcome. Ruptures and their resolution are likely to be key events in psychotherapy process.
破裂是治疗中潜在的变化事件，可能对治疗联盟和结果产生积极或消极的影响。与被诊断患有边缘型人格障碍的客户一起，联盟破裂和过早退出很常见，这限制了治疗的效果。
用认知分析疗法（CAT）检验九个阶段的破裂解决模型在青少年中的应用。
采用任务分析的验证阶段来检验破裂解决模型，并通过对转录本的定量和定性分析，将破裂的处理与结果联系起来。在客户评定的三个良好和两个不良治疗效果的疗程中，对 18 个破裂和解决尝试进行了深入检查。治疗师采用的模型阶段数量与治疗效果相关。
根据治疗师使用模型阶段的程度，可以区分出客户评定为良好或不良的疗程。治疗效果与治疗师采用的模型阶段数量显著相关。
在 CAT 中熟练地解决破裂取决于治疗师对模型阶段的包含，为模型提供了验证，并表明有效的破裂解决可能与治疗效果有关。破裂及其解决可能是心理治疗过程中的关键事件。
