Perspective Chapter: Therapeutic Alliance, Rupture and Repair in Group Therapy

Abstract

This chapter contains an overview of the therapeutic alliance including the purpose and importance of therapeutic alliance as well as recent research that provides knowledge on therapeutic alliance within the group therapy context. This chapter will also take a deep dive into understanding the rupture-repair model, its’ connections with therapeutic alliance, and provide clinical examples of what a rupture and repair may look like in group therapy. Finally, this chapter discusses cultural considerations and includes clinical examples on rupture and repairs where individual and cultural differences are important. In conclusion, therapeutic alliance has been identified as a key contributor to positive outcomes for group therapy clients. While ruptures are expected to occur during therapy, It is important to note that both the rupture and the repair equally effect the therapeutic alliance as well as the outcome of treatment. Outcomes to therapy that align with a strong therapeutic alliance include reduced symptoms, client retention, improved outlook on life, and an improved occupational and interpersonal functioning. Outcomes of therapy associated with a successful repair involve a decrease in anxiety and depressive symptoms, increase in daily living activities, an increase in empathy for their group members, and stronger therapeutic alliance among the group.