caa a22 4500 569335515 20200331060123.0 cr unu---uuuuu 190729e201904 xx s 000 0 eng 1050-3307 10.1080/10503307.2018.1502897 doi (BORIS)oai:boris.unibe.ch:120857 610 ddc 30047304 pmid Impact of confrontations by therapists on impairment and utilization of the therapeutic alliance [Elektronische Daten] [Laura Möseneder, Eugénia Ribeiro, John Christopher Muran, Franz Caspar] publishedVersion openAccess eu-repo OBJECTIVE Striking the balance between creating challenge through confrontation (drawing attention to discrepancies) to encourage change and offering support through the therapeutic relationship to ensure safety for patients represents a central issue for psychotherapists. The aim of the present study was to assess immediate effects of confrontations by therapists on the therapeutic alliance. METHOD We rated video recordings of 77 therapies to measure incidences of alliance ruptures/resolution attempts as well as confrontations by therapists. Change in the therapeutic alliance and therapy outcome were measured through questionnaires filled out by patients. RESULTS Confrontations were significantly associated with ruptures/resolution attempts on the micro level. Changes in the therapeutic alliance moderated the association between confrontations and alliance ruptures on the macro level: The bigger the fraction of a session containing confrontations, the larger the fraction containing ruptures, given a prior positive change in the therapeutic alliance. Therapists' use of confrontation during a resolution attempt was associated with significantly better therapy outcomes than no use of confrontation during or no resolution attempt. CONCLUSIONS Confrontations by therapists may temporarily impair the therapeutic alliance, but might also lead to better therapy outcomes when used to make an alliance rupture explicit as part of a resolution attempt. Möseneder Laura joint author Ribeiro Eugénia joint author Muran John Christopher joint author Caspar Franz joint author Psychotherapy research 29(3), pp. 293-305 1050-3307 268138605 https://boris.unibe.ch/120857/1/Postprint.pdf text/html WWW-Backlink auf das Repository 1 info:eu-repo/semantics/article boris PeerReviewed boris peerstatus BORIS 856 40 https://boris.unibe.ch/120857/1/Postprint.pdf text/html WWW-Backlink auf das Repository BORIS 700 1- Möseneder Laura joint author BORIS 700 1- Ribeiro Eugénia joint author BORIS 700 1- Muran John Christopher joint author BORIS 700 1- Caspar Franz joint author BORIS 773 0- Psychotherapy research 29(3), pp. 293-305 1050-3307 268138605 BK010053 XK010053 XK010000 BORIS BORIS BORIS info:eu-repo/semantics/article openAccess