Shir Rivka, Tishby Orya
Department of Psychology, Hebrew University of Jerusalem.
Psychotherapy (Chic). 2024 Sep;61(3):222-233. doi: 10.1037/pst0000532. Epub 2024 Jul 8.
The pattern of rupture and repair within therapeutic alliances has been associated with improved outcome. The present study adds to this body of research by examining rupture and repair from a perspective. First, we examined the relationship between mutual recognition of ruptures, rupture intensity, and client ratings of session helpfulness. We then examined client-therapist congruence regarding rupture and repair characteristics and their relation to client ratings of session helpfulness. Data were collected from 90 client-therapist dyads (providing two subsamples of 61 and 45 dyads) during 16 sessions of short-term psychodynamic therapy. Clients and therapists rated the occurrence of ruptures, rupture characteristics, and rupture repair following each session. Clients also rated session helpfulness following each session. We found a significant negative interaction effect, indicating that when clients rated ruptures as more intense, therapist rupture recognition was related to lower client ratings of session helpfulness. Client-therapist congruence in the perception of rupture intensity was positively related to client perceptions of the extent to which ruptures were discussed. Finally, we found a significant positive relationship between client-therapist congruence in their perception of rupture repair and client ratings of session helpfulness. This study demonstrates the significance of the dyadic view of the rupture/repair process. Therapist recognition of ruptures may not be enough to facilitate repair, specifically in ruptures with a high level of intensity. Nevertheless, congruence in intensity is valuable for addressing the rupture within the session, and congruence in repair is valuable for session helpfulness. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
治疗联盟中的破裂与修复模式与更好的治疗结果相关。本研究通过从一个视角审视破裂与修复，为这一研究领域增添了内容。首先，我们考察了对破裂的相互识别、破裂强度与来访者对治疗 session 帮助程度的评分之间的关系。然后，我们考察了来访者与治疗师在破裂及修复特征方面的一致性及其与来访者对治疗 session 帮助程度评分的关系。在短期心理动力治疗的 16 个疗程中，从 90 对来访者 - 治疗师二元组（提供了两个分别为 61 对和 45 对二元组的子样本）收集数据。来访者和治疗师在每个疗程后对破裂的发生、破裂特征和破裂修复进行评分。来访者还在每个疗程后对治疗 session 的帮助程度进行评分。我们发现了一个显著的负向交互作用效应，表明当来访者将破裂评为更强烈时，治疗师对破裂的识别与来访者对治疗 session 帮助程度的较低评分相关。来访者 - 治疗师在对破裂强度的感知上的一致性与来访者对讨论破裂程度的感知呈正相关。最后，我们发现来访者 - 治疗师在对破裂修复的感知上的一致性与来访者对治疗 session 帮助程度的评分之间存在显著的正相关关系。本研究证明了破裂/修复过程的二元视角的重要性。治疗师对破裂的识别可能不足以促进修复，特别是在强度较高的破裂中。然而，在强度上的一致性对于在疗程中处理破裂是有价值的，而在修复上的一致性对于治疗 session 的帮助程度是有价值的。（PsycInfo 数据库记录 (c) 2024 APA，保留所有权利）
