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Chapter 13 - Managing Ruptures in Therapeutic Alliance

Published online by Cambridge University Press:  14 April 2022

Andrew C. Page
Affiliation:
University of Western Australia, Perth
Werner G. K. Stritzke
Affiliation:
University of Western Australia, Perth
Peter M. McEvoy
Affiliation:
Curtin University, Perth
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Summary

The chapter describes how to manage ruptures in the therapeutic alliance. It opens by outlining a conceptual model to understand the ruptures and proceeds to consider the ways that ruptures may manifest at different points in psychotherapy. One way to respond to some ruptures in alliance in via enhancing motivation and therefore the technique of Motivational Interviewing is described in detail; outlining the steps of expressing empathy, developing discrepancies (between actual and desired outcomes), avoiding argumentation, rolling with resistance and supporting self-efficacy. The chapter reviews ways to manage the assignment and review of homework exercises so that they are a productive element in clinical psychology practice. The chapter concludes with a close examination of psychotherapeutic process; defining what “process” is, and how to work with transference and countertransference.

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Clinical Psychology for Trainees
Foundations of Science-Informed Practice
, pp. 217 - 244
Publisher: Cambridge University Press
Print publication year: 2022

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