OBJECTIVE During treatment, the therapeutic alliance is characterized by rupture and repair episodes, which in turn are associated with psychotherapy outcome. It would be important to have a parsimonious tool to identify ruptures in psychotherapy sessions to provide therapists with meaningful feedback about when they occur. The present study thus aims to establish whether measuring self-reported alliance dynamics can function as a measure of alliance ruptures. METHOD The sample consisted of 58 depressed patients, who received 22 sessions of cognitive therapy for depression in an outpatient setting. The observer-rated Rupture Resolution Rating System (3RS) was applied to 58 sessions where the self-reported Working Alliance Inventory (WAI) completed by patients after each therapy session indicated that alliance ratings declined more than 2 SDs from that patient's individual mean. For comparison purposes, the 3RS was also applied to 58 randomly chosen sessions from the same treatment phase (early, middle, late). RESULTS Results showed significant differences between sessions where the WAI indicated a drop in the alliance and randomly chosen sessions of the same treatment phase with regard to the frequency and impact of ruptures. CONCLUSION This speaks for the construct validity of the 3RS. Session-by-session alliance ruptures may reliably be measured using a case-sensitive approach to identify meaningful drops in alliance self-report (WAI). (PsycInfo Database Record (c) 2024 APA, all rights reserved).

中文翻译：

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自我报告的联盟评分逐个疗程的变化能否作为治疗联盟破裂的衡量标准？


目的 在治疗过程中，治疗联盟的特点是破裂和修复事件，而这又与心理治疗的结果相关。重要的是要有一个简洁的工具来识别心理治疗过程中的破裂，以便为治疗师提供有关破裂何时发生的有意义的反馈。因此，本研究旨在确定衡量自我报告的联盟动态是否可以作为联盟破裂的衡量标准。方法 样本由 58 名抑郁症患者组成，他们在门诊接受了 22 次抑郁症认知治疗。观察员评级的破裂解决评级系统 (3RS) 应用于 58 个疗程，其中患者在每次治疗后完成的自我报告工作联盟清单 (WAI) 表明联盟评级较患者的个人平均值下降了 2 个标准差以上。出于比较目的，3RS 还应用于同一治疗阶段（早期、中期、晚期）中随机选择的 58 个疗程。结果结果显示，在破裂频率和影响方面，WAI 表明联盟下降的疗程和同一治疗阶段随机选择的疗程之间存在显着差异。结论 这说明了 3RS 的结构有效性。可以使用区分大小写的方法可靠地测量逐个会话的联盟破裂，以识别联盟自我报告（WAI）中有意义的下降。 （PsycInfo 数据库记录 (c) 2024 APA，保留所有权利）。