Mendelsohn,
Laurie (2/08) Evaluating alliance ruptures: assessment of learned skills,
trainee characteristics, and clinical experience (Lisa Samstag, Ph.D.; David
Castro Blanco, Ph.D.; Nicholas Papouchis, Ph.D.)
Few studies in the psychotherapy research
literature have directly addressed the issue of training psychology graduate
students to be effective observers of interpersonal process, even though
clinical raters are commonly included in psychotherapy research. The current
research investigated whether observers of psychotherapy process can be trained
to develop a clinical skill that has been found to be especially difficult to
attain, even for seasoned clinicians: the identification of alliance ruptures
between patients and therapists. This study also examined whether participant
characteristics such as interpersonal sensitivity, emotional awareness, and
intrapersonal introjects predict identification of aspects of alliance
ruptures. Fifty-four psychology graduate students were evaluated on their
ability to identify an alliance rupture (withdrawal type) in a taped therapy
segment, before and after a training intervention. Participants were assigned
to either the training group, which underwent training on defining features of
negative therapeutic process, or the read-only group, which was given an
article to read on negative therapeutic process. Participants' written
descriptions of the therapy segment were rated for sensitivity to patient
rupture markers, therapist precipitant of rupture events, and tension in the
therapeutic relationship on an observer scale developed for this study, adapted
from the Rupture Resolution Scale - Revised (Samstag, Safran, & Muran.
2006). Results revealed that the training group increased significantly more
than the read-only group on the amount of rupture behavior they identified on
their post intervention ratings. Further analyses revealed that participants'
with higher levels of emotional awareness improved significantly more from the
pre to post intervention in their ability to identify features of alliance
ruptures.
