Dwyer Hall, Holly; (2021) Exploring Alliance Rupture Resolution Processes in Psychotherapy with Adolescents. Doctoral thesis (D.Psych), UCL (University College London).

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Abstract

This thesis adds to a small but growing body of work exploring in session alliance rupture resolution processes with adolescents in psychotherapy using the Rupture Resolution Rating Scale (3RS). The reviewing of the theoretical and empirical literature shows important differences in how alliance rupture resolution processes might be conceptualised and further studied in work with adolescents from that of adult psychotherapy. Further factors specific to adolescence which are thought to impact on alliance development and how alliance rupture resolution processes are identified, will also be explored The findings from the empirical study suggest Withdrawal ruptures to be a common feature in psychotherapy with adolescents with depression, with patient confrontation marker behaviours slightly increasing in the middle and later therapy phases. Therapists respond less to Mixed Ruptures in the middle phases of treatment and use more Immediate resolution strategies such as Redirects and Changes Tasks and Goals in early treatment phases. Expressive/ Exploratory resolution strategies exploring the patient therapist relationship are most likely to be used in middle treatment phases and suggest a higher average degree of resolution, despite higher therapist contribution to ruptures. This exploratory study suggests the adolescent field would benefit from further qualitative study of the function of Withdrawal ruptures in adolescent psychotherapy.

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