Nof Aviv, Dolev Tohar, Leibovich Liat, Harel Judith, Zilcha-Mano Sigal
Department of Psychology, University of Haifa, Haifa, Israel.
Res Psychother. 2019 Apr 19;22(1):364. doi: 10.4081/ripppo.2019.364.
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.
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。
