Benefits of difficult moments between therapist and client highlighted by research

Moments of difficulty in this therapeutic alliance are called ruptures, while subsequent attempts to fix the alliance are called repairs. Alliance might rupture when a therapist makes a mistake, such as a failure of empathy. It could rupture in couple or family therapy when the therapist spends too much time and energy on one client's issues, at the expense of the others' needs. It could rupture when the therapist pushes too hard or too quickly in a difficult area, leaving the client feeling exposed or misunderstood.

New research from The Family Institute at Northwestern University, conducted by researchers including Jacob Goldsmith, PhD, Assistant Clinical Director at The Epstein Center, studies these alliance ruptures and repairs.

"When alliance ruptures, it must be repaired for therapy to continue," says Dr. Goldsmith. "Evidence suggests that clients who experience a successfully repaired rupture actually do better in therapy than those who do not. The act of facing and working through problems in the alliance may make the relationship stronger. These moments are also a chance to learn new ways of navigating conflict."

The Epstein Center for Psychotherapy Change at The Family Institute is dedicated to understanding the change process in therapy and to developing empirical tools for research and practice. The Epstein Center recently conducted the first study of rupture-repair in individual, couple and family therapy. The research found that different sorts of ruptures occurred with different frequency in various types of therapy but overall, ruptures posed a significant threat in all types of therapy. They occurred in the beginning, middle, and end of treatment. But the vast majority of ruptures were successfully repaired.

These findings have a direct impact on clinical service and training at The Family Institute. Data on alliance is not only collected but also presented to the therapists throughout the course of treatment. A better understanding of the processes of rupture and repair shows therapists not only how to look for them but also how to fix them, allowing for an enhanced therapeutic relationship.