Should we feel the same? Mutual recognition and congruence between therapist and client regarding ruptures and repairs.

Abstract

The pattern of rupture and repair within therapeutic alliances has been associated with improved outcome. The present study adds to this body of research by examining rupture and repair from a dyadic perspective. First, we examined the relationship between mutual recognition of ruptures, rupture intensity, and client ratings of session helpfulness. We then examined client-therapist congruence regarding rupture and repair characteristics and their relation to client ratings of session helpfulness. Data were collected from 90 client-therapist dyads (providing two subsamples of 61 and 45 dyads) during 16 sessions of short-term psychodynamic therapy. Clients and therapists rated the occurrence of ruptures, rupture characteristics, and rupture repair following each session. Clients also rated session helpfulness following each session. We found a significant negative interaction effect, indicating that when clients rated ruptures as more intense, therapist rupture recognition was related to lower client ratings of session helpfulness. Client-therapist congruence in the perception of rupture intensity was positively related to client perceptions of the extent to which ruptures were discussed. Finally, we found a significant positive relationship between client-therapist congruence in their perception of rupture repair and client ratings of session helpfulness. This study demonstrates the significance of the dyadic view of the rupture/repair process. Therapist recognition of ruptures may not be enough to facilitate repair, specifically in ruptures with a high level of intensity. Nevertheless, congruence in intensity is valuable for addressing the rupture within the session, and congruence in repair is valuable for session helpfulness. (PsycInfo Database Record (c) 2024 APA, all rights reserved).