A Therapist’s Guide to Repairing Ruptures in the Working Alliance

The authors discuss the phenomena of “misattunements,” or ruptures, in the working alliance. They present a set of skills and tools that aim to help therapists recognize and identify when ruptures occur, and they introduce a model for managing these moments. Albeit difficult, ruptures in the working alliance are common, and research shows that a therapist’s ability to recognize and attend to these ruptures has a positive relationship with client improvement at the end of therapy. Strategies that have been successful in rupture repair (the therapist’s attempts to address the rupture and restore the alliance with the client) include the therapist’s exploration of the client’s experience of the rupture and the acknowledgment of the client’s perspective. Finally, they present real-world, clinical examples of their rupture repair model, which consists of strategies that can help therapists negotiate difficult therapeutic moments by employing the technique of mindfulness and demonstrating genuineness and authenticity in the therapist–client relationship.