Use of Repair Strategies and Therapeutic Alliance in Child Psychotherapy: Therapists' Reports.

OBJECTIVE:This study examined rupture-repair processes in child psychotherapy, focusing on therapist-reported repair strategies and their relation to child therapeutic alliance. The role of parental alliance and child's diagnostic profile in shaping rupture type and severity was also examined. METHODS:Ninety-four child psychotherapists attended workshops on rupture and repair strategies adapted for children and reported on a single therapy session with children aged 3-13. Therapists completed measures of child and parent alliance, rupture type and intensity, and reported interventions based on 3RS repair strategies adapted for children. ANOVAs were used to assess group comparability; multiple linear regressions tested associations among child alliance, rupture intensity, repair strategies, parental alliance, and diagnostic group; and chi-square tests examined the association between diagnostic group and rupture type. RESULTS:Parental alliance was the strongest predictor of child alliance. Repair strategy frequency was positively associated with child alliance. Unexpectedly, rupture intensity was positively associated with child alliance. More intense ruptures elicited a greater number of therapist interventions. Confrontation ruptures were more common in externalizing disorders, whereas withdrawal ruptures predominated among internalizing disorders. CONCLUSION:Findings highlight parental alliance and frequency of developmentally adapted rupture-repair strategy use as important correlates of therapeutic alliance in child psychotherapy.