ABSTRACT
Safran and Muran's classic theoretical framework of alliance rupture and repair suggests effective techniques for repairing alliance ruptures. Accumulating empirical evidence suggests that successful processes of rupture and repair result in better therapeutic outcome and reduced dropout rates. Although ruptures in the alliance in child psychotherapy are frequent, little is known about how to repair them. The present paper proposes a model for identifying and repairing ruptures in child psychotherapy based on Safran and Muran. It consists of four phases: i) identifying the rupture and understanding its underlying communication message, ii) indicating the presence of the rupture, iii) accepting responsibility over the therapists' part in the rupture and emphasizing the children's active role as communicators of their distress, and iv) resolving the rupture using change strategies and meta-communication by constructing a narrative story. The theoretical rationale of each phase is explained in detail, and practical clinical guidelines are provided. Empirical studies are needed to examine the effectiveness of the proposed framework.
ABSTRACT
The short-term mother-child and father-child psychoanalytic psychotherapy assumes that children develop specific types of relationships with each parent, as well as with the parenting couple. The model integrates an intra-psychic, object-relational view with an interpersonal perspective to the treatment of relational disturbances in childhood. The same therapist meets with the mother-child, father-child dyads on a weekly basis, along with regular meetings with the parental dyad. The model focuses on the developmentally prelatency child's need for the active participation of both parents in the here-and-now shared experiences of the therapeutic process. The participants express, in interactions and in enactments, various contents and meanings of their specific patterns of relations. The therapist addresses the behaviours as well as the meanings of relations, thus promoting reflective understanding and experiential changes in self, other, and self-other relations. The child's active and different participation with each parent is the main change-promoting factor. The child uses mainly the medium of play to express his/her needs and to mobilize the therapist's help. The therapist's access to the different dyads is utilized to better understand the explicit and implicit relational themes. The therapist supports the co-construction of new and different behaviour patterns and the co-creation of additional meanings to representations. The setup fosters the child's active participation in each dyad's growth-promoting changes.
