The melody of ruptures: identifying ruptures through acoustic markers

Tohar Dolev-Amit, Aviv Nof, Amal Asaad, Amit Tchizick, Sigal Zilcha-Mano

Research output: Contribution to journalArticlepeer-review


Ruptures in the alliance have a potential to either undermine the treatment, leading to its premature termination, or to enhance it, leading to its success. Detecting ruptures is a critical step in therapy, especially concerning withdrawal ruptures that often go unnoticed because of the indirect expression of negative emotions. The present study explored whether acoustic data of a particular patient can serve as markers for ruptures, particularly withdrawal ruptures. Given the pioneering nature of the study, an exploratory approach based on a case study was chosen. The case-study showed that acoustic data can serve as markers of withdrawal ruptures (characterized by higher F0-span, pause proportion, and shimmer, and lower articulation rate than neutral speech) and of confrontation ruptures (characterized by higher F0-span and pause proportion than neutral speech). The limitations of a case study design are discussed. These findings add to previous knowledge and help to open the door to using feedback to assist clinicians in identifying the occurrence of ruptures and prevent deterioration in alliance and dropout.

Original languageEnglish
Pages (from-to)724-743
Number of pages20
JournalCounselling Psychology Quarterly
Issue number4
StatePublished - 2020

Bibliographical note

Publisher Copyright:
© 2020 Informa UK Limited, trading as Taylor & Francis Group.


  • F0
  • Therapeutic Relationship
  • acoustic markers
  • alliance
  • ruptures

ASJC Scopus subject areas

  • Clinical Psychology
  • Applied Psychology
  • Psychiatry and Mental health


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