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Psykhe (Santiago)

On-line version ISSN 0718-2228


VALDES, Nelson; GOMEZ, Diana  and  REINEL, Mahaira. Moments of Rupture and Resolution of the Therapeutic Alliance in the Case of an Adolescent Diagnosed with Identity Diffusion: Their Impact on Psychotherapeutic Outcomes. Psykhe [online]. 2018, vol.27, n.2, pp.1-20. ISSN 0718-2228.

The therapeutic alliance is an important component of the therapeutic process; however, very few studies have explored how the therapeutic alliance is constructed with adolescent patients. A single case study with a mixed methodology was conducted to identify moments of rupture and attempts to resolve the therapeutic alliance, based on the microanalysis of the successful treatment of an adolescent with identity diffusion indicators and depressive symptomatology. The Youth Outcome Questionnaire-Self Report, the Assessment of Identity Development in Adolescence, the Beck Depression Inventory (BDI-I), and the Social Problem Solving Inventory-Revised were administered. Thirty-two sessions were analyzed using the Ruptures and Resolutions Coding System developed by Eubanks, Muran, and Safran (2015), in which 29 rupture moments were found (11 withdrawals and 18 confrontations). The frequency and characteristics of these relevant moments, as well as their relationship with therapeutic success at the end of the process, were analyzed through pre-post differences, using Z-ratio. The clinical implications of immediately resolving moments of rupture during the session are discussed.

Keywords : rupture; therapeutic alliance; adolescents; identity diffusion; case study.

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