Thinking Transtheoretically About Alliance and Rupture: Implications for Practice and Training

Sigal Zilcha-Mano, J. Christopher Muran

Research output: Contribution to journalArticlepeer-review


Repairing alliance ruptures has the potential to serve as a powerful mechanism of change in psychotherapy. In this article, a transtheoretical individual-specificframework for repairing alliance ruptures is proposed. According to the proposed framework, at the intake session, the therapist evaluates the trait-like tendencies of individual patients to face ruptures in interpersonal relationships. We propose a typology based on which patients are assigned to one of the following therapeutic strategies: (a) a treatment where alliance rupture and repair is the main mechanism of change (Type A), (b) an added module that augments another treatment, focusing on rupture and repair (Type B), or (c) treatment where no rupture resolution work is carried out (Type C). The proposed framework is based on cumulative clinical knowledge, and its validity and utility need to be assessed in future research.

Original languageEnglish
JournalClinical Psychology in Europe
Issue numberSpecial Issue
StatePublished - 2024

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  • alliance
  • mechanism of change
  • rupture and repair
  • state-like
  • trait-like

ASJC Scopus subject areas

  • Clinical Psychology
  • Psychiatry and Mental health


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