Developing a method for training clinical psychologists to recognize and repair alliance ruptures: a pilot study focusing on trainee experiences
Abstract Background Research in psychotherapy has underscored the importance of therapeutic relationships, especially alliances between therapists and clients, in predicting outcomes. A strong alliance enhances results and reduces dropout. We developed a training program to strengthen alliances, bas...
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BMC
2025-06-01
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| Series: | BMC Psychology |
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| Online Access: | https://doi.org/10.1186/s40359-025-02882-y |
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| author | Asaka Kawamura Mina Fukuda Shuntaro Aoki Ayane Jinnai |
| author_facet | Asaka Kawamura Mina Fukuda Shuntaro Aoki Ayane Jinnai |
| author_sort | Asaka Kawamura |
| collection | DOAJ |
| description | Abstract Background Research in psychotherapy has underscored the importance of therapeutic relationships, especially alliances between therapists and clients, in predicting outcomes. A strong alliance enhances results and reduces dropout. We developed a training program to strengthen alliances, based on a North American supervision model. Therapists' self-awareness, emotional regulation, and insight into client interactions are essential for maintaining this alliance and addressing potential ruptures. Methods A training program was formulated with three primary components: 1) observation of one's thoughts, feelings, and intentional behavioral control; 2) mindfulness training; and 3) reflection and classification of the three-term contingency of reinforcement in interactions during therapy sessions. This study focused on the program's practical implementation and examined the validity of its components through participant feedback. A pilot study was conducted with graduate students. Results Content analysis post training showed a notable reduction in respondents who felt "hooked" (pre1 65%, pre2 50%, post 17%) and a significant increase in those who felt "engaged well" (pre1 22%, pre2 36%, post 84%). Post-training feedback revealed that the most frequent positive responses were "noticing captivity objectively" (24%), "relating with intention" (21%), and "not being upset" (14%). Although the first two components of the program were deemed effective, the third component concerning three-term contingency requires further refinement. Conclusion The training program showed promise for promoting therapist awareness and preventing alliance ruptures. However, refinements are necessary, particularly for the third component. This study provides a preliminary foundation for refining and further evaluating the program in clinical practice settings. The study's limitations include not objectively measuring awareness frequency and the potential influence of social desirability bias in participants' feedback. |
| format | Article |
| id | doaj-art-d583b5e229f340b686e320c583089773 |
| institution | DOAJ |
| issn | 2050-7283 |
| language | English |
| publishDate | 2025-06-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Psychology |
| spelling | doaj-art-d583b5e229f340b686e320c5830897732025-08-20T03:21:05ZengBMCBMC Psychology2050-72832025-06-0113111110.1186/s40359-025-02882-yDeveloping a method for training clinical psychologists to recognize and repair alliance ruptures: a pilot study focusing on trainee experiencesAsaka Kawamura0Mina Fukuda1Shuntaro Aoki2Ayane Jinnai3Hokusho UniversityFaculty of Global Engagement, Kyoto University of Foreign StudiesCenter for Medical Education and Career Development, Department of Neuropsychiatry, Fukushima Medical University, Fukushima Medical UniversityWellness Boyo Hospital Otaru Sleep Disorder ClinicAbstract Background Research in psychotherapy has underscored the importance of therapeutic relationships, especially alliances between therapists and clients, in predicting outcomes. A strong alliance enhances results and reduces dropout. We developed a training program to strengthen alliances, based on a North American supervision model. Therapists' self-awareness, emotional regulation, and insight into client interactions are essential for maintaining this alliance and addressing potential ruptures. Methods A training program was formulated with three primary components: 1) observation of one's thoughts, feelings, and intentional behavioral control; 2) mindfulness training; and 3) reflection and classification of the three-term contingency of reinforcement in interactions during therapy sessions. This study focused on the program's practical implementation and examined the validity of its components through participant feedback. A pilot study was conducted with graduate students. Results Content analysis post training showed a notable reduction in respondents who felt "hooked" (pre1 65%, pre2 50%, post 17%) and a significant increase in those who felt "engaged well" (pre1 22%, pre2 36%, post 84%). Post-training feedback revealed that the most frequent positive responses were "noticing captivity objectively" (24%), "relating with intention" (21%), and "not being upset" (14%). Although the first two components of the program were deemed effective, the third component concerning three-term contingency requires further refinement. Conclusion The training program showed promise for promoting therapist awareness and preventing alliance ruptures. However, refinements are necessary, particularly for the third component. This study provides a preliminary foundation for refining and further evaluating the program in clinical practice settings. The study's limitations include not objectively measuring awareness frequency and the potential influence of social desirability bias in participants' feedback.https://doi.org/10.1186/s40359-025-02882-yTherapist trainingAlliance rupturesClinical psychologists |
| spellingShingle | Asaka Kawamura Mina Fukuda Shuntaro Aoki Ayane Jinnai Developing a method for training clinical psychologists to recognize and repair alliance ruptures: a pilot study focusing on trainee experiences BMC Psychology Therapist training Alliance ruptures Clinical psychologists |
| title | Developing a method for training clinical psychologists to recognize and repair alliance ruptures: a pilot study focusing on trainee experiences |
| title_full | Developing a method for training clinical psychologists to recognize and repair alliance ruptures: a pilot study focusing on trainee experiences |
| title_fullStr | Developing a method for training clinical psychologists to recognize and repair alliance ruptures: a pilot study focusing on trainee experiences |
| title_full_unstemmed | Developing a method for training clinical psychologists to recognize and repair alliance ruptures: a pilot study focusing on trainee experiences |
| title_short | Developing a method for training clinical psychologists to recognize and repair alliance ruptures: a pilot study focusing on trainee experiences |
| title_sort | developing a method for training clinical psychologists to recognize and repair alliance ruptures a pilot study focusing on trainee experiences |
| topic | Therapist training Alliance ruptures Clinical psychologists |
| url | https://doi.org/10.1186/s40359-025-02882-y |
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