Repairing alliance ruptures in emotionally focused therapy: A preliminary task analysis

Abstract

Prior research has shown the therapeutic alliance to be positively related to therapeutic outcome in couple therapy (Johnson & Talitman, 2007; Knoblock-Fedders, Pinsoff, & Mann, 2007). It is common for the therapeutic alliance to vary over the course of therapy. Alliance ruptures can be defined as "deteriorations in the relationship between therapist and patient" (Safran & Muran, 1996, p. 447). If managed successfully, these moments of alliance rupture can positively impact therapy (Safran & Muran, 1996; Sprenkle, Davis, & Lebow, 2009). As a result, researchers have begun to develop models of alliance rupture repair to help further our understanding of how this process is achieved in various therapeutic approaches (Aspland, Llewelyn, Hardy, Barkham, & Stiles, 2008; Binder, Holgerse, & Nielsen, 2008; Safran & Muran, 1996). The purpose of this study was to conduct a preliminary, discovery-oriented task analysis (Greenberg, 2007) in order to develop a model of alliance rupture repair in Emotionally Focused Therapy (EFT), a couple therapy approach which encourages emotional reconnection and restructuring of couple interactions developed by Susan Johnson and Les Greenberg (Johnson, 2004). By conducting a thought experiment with four experienced certified EFT therapists, a rational model of alliance rupture repair in EFT was formulated. The rational model was then compared with the analysis of alliance rupture repair sequences during the process of one couple's therapy with a certified EFT therapist to develop a rational-empirical model of alliance rupture repair in EFT. The final model and treatment implications are discussed.