Therapeutic alliance rupture and resolution in a brief psychiatric treatment for borderline personality disorder

IF 1.2 Q3 PSYCHOLOGY, CLINICAL

Counselling & Psychotherapy Research Pub Date : 2024-09-09 DOI:10.1002/capr.12819

Isabella Nadel, Sofia Glassier, Yves de Roten, Ueli Kramer

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Abstract

Background

The focus of this case study was to explore the development of the therapeutic alliance in relation to alliance rupture and resolution and the effect of motive-focussed psychotherapeutic techniques on this process in the treatment of borderline personality disorder (BPD).

Methods

Therapeutic alliance rupture and resolution processes were analysed in relation to outcomes over the course of a 10 week, short-term generalist psychiatric treatment for BPD in two patients, hereby referred to as Clara and Rebecca. Clara received treatment in the form of good psychiatric management (GPM) with the addition of motive-oriented therapeutic relationship (MOTR) techniques. Rebecca received treatment in the form of GPM.

Results

Both patients experienced a clinically significant reduction in symptoms. Ruptures and resolution processes occurred at low frequencies in Clara's treatment, while ruptures and resolution processes were numerous in Rebecca's treatment. The focus in Clara's treatment was on rupture prevention because of the added presence of MOTR techniques, while the focus in Rebecca's treatment was on rupture identification and resolution.

Discussion

Results support the hypothesis that symptom reduction was achieved through two distinct pathways of change as a function of the treatment condition, which suggests the potential presence of multiple effective psychotherapeutic techniques for alliance development. Limitations of this study and clinical implications for the treatment of BPD in psychotherapy, with a special focus on the therapeutic alliance, are discussed.

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来源期刊

Counselling & Psychotherapy Research PSYCHOLOGY, CLINICAL-

CiteScore

4.40

自引率

12.50%

发文量

期刊介绍： Counselling and Psychotherapy Research is an innovative international peer-reviewed journal dedicated to linking research with practice. Pluralist in orientation, the journal recognises the value of qualitative, quantitative and mixed methods strategies of inquiry and aims to promote high-quality, ethical research that informs and develops counselling and psychotherapy practice. CPR is a journal of the British Association of Counselling and Psychotherapy, promoting reflexive research strongly linked to practice. The journal has its own website: www.cprjournal.com. The aim of this site is to further develop links between counselling and psychotherapy research and practice by offering accessible information about both the specific contents of each issue of CPR, as well as wider developments in counselling and psychotherapy research. The aims are to ensure that research remains relevant to practice, and for practice to continue to inform research development.