Interpersonal Problems and Their Impact on Alliance Ruptures in Psychotherapy

IF 3.2 3区 心理学 Q1 PSYCHOLOGY, CLINICAL
Flavio Iovoli, Marie Baranowski, Leonie S. Sander, Julian A. Rubel
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Abstract

Introduction

Alliance ruptures are frequent occurrences in psychotherapy. Understanding the factors that contribute to these ruptures is important for optimizing therapeutic outcomes. From the perspective of interpersonal theory, the experience of interpersonal problems may play a significant role in the occurrence of alliance ruptures, as maladaptive relational patterns can trigger momentary interpersonal misattunements. This study aimed to investigate how specific interpersonal problems predict the frequency of alliance ruptures in the first three sessions of cognitive–behavioural therapy.

Methods

Sixty-four patients completed the Inventory of Interpersonal Problems (32 items) (IIP-32) as part of their routine outcome monitoring in an outpatient clinic. Subsequently, the first three regular therapy sessions were coded using the Rupture and Resolution Rating System (3RS). Multilevel Bayesian hurdle models were estimated, simultaneously modelling (1) the likelihood of experiencing at least one rupture and (2) the frequency of rupture occurrences among patients who had at least one.

Results

Withdrawal ruptures were more frequent than confrontation ruptures. Higher affiliation and friendly–submissive tendencies were associated with fewer withdrawal ruptures but increased the likelihood of experiencing at least one withdrawal rupture. In contrast, hostile–submissive tendencies predicted more frequent withdrawal ruptures but were associated with a lower probability of at least one occurrence. For confrontation ruptures, the overall level of dysfunction and self-sacrificing tendencies predicted fewer confrontation ruptures.

Conclusion

These findings suggest that specific interpersonal problems can provide therapists with crucial insights into subtle rupture occurrences. By understanding these dynamics, therapists can better recognize and address ruptures, ultimately enhancing the therapeutic process.

心理治疗中人际关系问题及其对联盟破裂的影响
联盟破裂是心理治疗中的常见现象。了解导致这些破裂的因素对于优化治疗效果非常重要。从人际关系理论的角度来看,人际关系问题的经历可能在联盟破裂的发生中发挥重要作用,因为不适应的关系模式会引发短暂的人际失调。本研究旨在探讨特定的人际关系问题如何预测认知行为治疗前三个疗程中联盟破裂的频率。方法对64例门诊患者进行人际关系问题量表(IIP-32),并对其进行结果监测。随后,使用破裂和消退评分系统(3RS)对前三次常规治疗进行编码。估计多层贝叶斯障碍模型,同时建模(1)经历至少一次破裂的可能性和(2)至少有一次破裂的患者发生破裂的频率。结果后撤性破裂发生率高于对抗性破裂。较高的隶属关系和友好顺从倾向与较少的戒断破裂相关,但增加了经历至少一次戒断破裂的可能性。相反,敌对-顺从倾向预示着更频繁的戒断破裂,但至少发生一次的可能性较低。对于对抗破裂,功能障碍和自我牺牲倾向的总体水平预示着更少的对抗破裂。结论这些发现表明,特定的人际关系问题可以为治疗师提供对微妙破裂发生的重要见解。通过了解这些动态,治疗师可以更好地识别和处理破裂,最终提高治疗过程。
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来源期刊
Clinical psychology & psychotherapy
Clinical psychology & psychotherapy PSYCHOLOGY, CLINICAL-
CiteScore
6.30
自引率
5.60%
发文量
106
期刊介绍: Clinical Psychology & Psychotherapy aims to keep clinical psychologists and psychotherapists up to date with new developments in their fields. The Journal will provide an integrative impetus both between theory and practice and between different orientations within clinical psychology and psychotherapy. Clinical Psychology & Psychotherapy will be a forum in which practitioners can present their wealth of expertise and innovations in order to make these available to a wider audience. Equally, the Journal will contain reports from researchers who want to address a larger clinical audience with clinically relevant issues and clinically valid research.
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