Alliance ruptures and resolution during cognitive behaviour therapy with patients with borderline personality disorder.

OBJECTIVE

To explore the process of rupture resolution in cognitive behaviour therapy (CBT) with two good outcome clients with borderline personality disorder (BPD).

METHOD

This study employed task-analytic methods to investigate whether the existing CBT rupture resolution model for depression could be validated. Quantitative analyses identified rupture-repair sequences and 41 rupture resolution attempts were systematically analysed.

RESULTS

The final model shared similarities with the existing model although additional components, including an "external observer" were identified. Focus on affective experience was also hypothesized to be important.

CONCLUSIONS

The final theoretical rupture resolution model may be a useful tool when working with BPD clients in CBT. It is however recognized that further research on data from larger samples is needed. Clinical implications for managing alliance ruptures with BPD clients are discussed.