The concept of the therapeutic alliance originated in Freud’s basic premise, stating that the therapeutic relationship can be differentiated into a positive component, a negative component, and an unobjectionable, friendly component that constitutes the conscious bond between therapist and patient. The latter being conceived of as the vehicle of therapeutic success in all kinds of psychotherapies. In subsequent years, the field moved away from such psychoanalytic perspectives towards a pan-theoretical view that encompasses different therapeutic approaches. In this movement, Bordin’s concept of the working alliance was most prominent. It focuses on the collaboration between therapist and patient with regard to three central aspects: agreement on therapeutic goals, consensus on tasks, and an emotional bond between patient and therapist. In the last decades, the theoretical view on the alliance shifted from a static to a dynamic perspective. This new view involved the development of psychotherapy process measures, assessing the alliance at different time points during therapy and/or during sessions, and focusing on the inevitable rupture and repair processes within the alliance.
This study aims to assess the most promising candidate for measuring rupture and repair processes in the therapeutic alliance – the revised version of the Rupture Resolution Rating System (3RS v2022; Eubanks & Muran, 2022) – with regard to reliability and validity. For this rating system, studies on interrater reliability for video recordings as well as predictive validity have already shown satisfactory results. Tests of convergent validity, however, as of yet did not. Furthermore, although first attempts to use the 3RS with audio recordings were promising, interrater reliability for audio recordings has yet to be established.
The study consists of a re-analysis of n = 242 audio-recorded psychotherapy sessions from a psychotherapy study using two observer-rated instruments (3RS v2022, Experiencing Scale) and one therapist-rated instrument (session quality). Foremost, we aim to test the hypotheses that the 3RS v2022 is reliable and has convergent validity with regard to rupture occurrence, rupture repair, and alliance quality. Additionally, we want to explore whether other variables from the 3RS v2022 might also be systematically related to session quality and patient levels of emotional experiencing.
Original Language: German, English