Rupture and Repair in Psychotherapy: A Critical Process for Change

Ruptures in the therapeutic alliance are common clinical experiences. If left unresolved, they often lead patients to drop out and to other poor outcomes.

As a therapist and patient work together, their alliance can come under strain, often because of disagreements in how to work together and toward what goals or due to a lack of trust and respect. These moments of stress, where the relationship has ruptured, are challenges but also opportunities for growth. Repairing these ruptures is an important change process that is relevant for all therapies.

This volume collects the work of 12 teams of scholars and clinicians, each expert in a different therapeutic context or theoretical approach, to describe clinical challenges that resonate with readers’ own experiences. The authors use case studies to describe realistic, complex clinical examples of rupture and provide strategies and principles therapists can readily integrate into their work to help them navigate these challenges more successfully with their patients.