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如果你相信破裂是可能的,那么也要相信修复是可能的:儿童心理治疗中破裂与修复的框架。

If you believe that breaking is possible, believe also that fixing is possible: a framework for ruptures and repairs in child psychotherapy.

作者信息

Nof Aviv, Dolev Tohar, Leibovich Liat, Harel Judith, Zilcha-Mano Sigal

机构信息

Department of Psychology, University of Haifa, Haifa, Israel.

出版信息

Res Psychother. 2019 Apr 19;22(1):364. doi: 10.4081/ripppo.2019.364.

Abstract

Safran and Muran's classic theoretical framework of alliance rupture and repair suggests effective techniques for repairing alliance ruptures. Accumulating empirical evidence suggests that successful processes of rupture and repair result in better therapeutic outcome and reduced dropout rates. Although ruptures in the alliance in child psychotherapy are frequent, little is known about how to repair them. The present paper proposes a model for identifying and repairing ruptures in child psychotherapy based on Safran and Muran. It consists of four phases: i) identifying the rupture and understanding its underlying communication message, ii) indicating the presence of the rupture, iii) accepting responsibility over the therapists' part in the rupture and emphasizing the children's active role as communicators of their distress, and iv) resolving the rupture using change strategies and meta-communication by constructing a narrative story. The theoretical rationale of each phase is explained in detail, and practical clinical guidelines are provided. Empirical studies are needed to examine the effectiveness of the proposed framework.

摘要

萨夫兰和穆兰关于联盟破裂与修复的经典理论框架提出了修复联盟破裂的有效技巧。越来越多的实证证据表明,成功的破裂与修复过程会带来更好的治疗效果并降低脱落率。尽管儿童心理治疗中联盟的破裂很常见,但对于如何修复它们却知之甚少。本文基于萨夫兰和穆兰的理论提出了一个识别和修复儿童心理治疗中破裂的模型。它包括四个阶段:i)识别破裂并理解其潜在的沟通信息,ii)指出破裂的存在,iii)治疗师承担在破裂中应负的责任,并强调儿童作为痛苦传达者的积极作用,iv)通过构建一个叙事故事,使用改变策略和元沟通来解决破裂。每个阶段的理论依据都有详细解释,并提供了实际临床指导方针。需要进行实证研究来检验所提出框架的有效性。

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本文引用的文献

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Alliance rupture repair: A meta-analysis.联盟破裂修复:一项荟萃分析。
Psychotherapy (Chic). 2018 Dec;55(4):508-519. doi: 10.1037/pst0000185.
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Clinical Consensus Strategies to Repair Ruptures in the Therapeutic Alliance.修复治疗联盟破裂的临床共识策略。
J Psychother Integr. 2018 Mar;28(1):60-76. doi: 10.1037/int0000097. Epub 2017 Dec 21.
5
The alliance in adult psychotherapy: A meta-analytic synthesis.成人心理治疗中的联盟:一项荟萃分析综合研究。
Psychotherapy (Chic). 2018 Dec;55(4):316-340. doi: 10.1037/pst0000172. Epub 2018 May 24.
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Infancy research, infant mental health, and adult psychotherapy: Mutual influences.
Infant Ment Health J. 2012 Jul;33(4):339-349. doi: 10.1002/imhj.21330. Epub 2012 May 17.

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