Ruptur er esolution in cognitiv ea nalytic therap y for adolescents with borderline personality disorder

Background. Ruptures are potential change events in therapythat might result inpositive or negative consequences for the therapeutic alliance and outcome .Allianceruptures and prematuredro p-out arecommon with clients diagnosed with borderlinepersonality disorder,limiting treatment effectiveness.Objective. To test anine stage model of ruptureresolution in cognitiveanalytictherapy(CAT) with adolescents.Method. The validation phase of task analysis was employed to test the ruptureresolution model and to relate handling of ruptures to outcome using quantitative andqualitative analysis of transcripts. Eighteen ruptures and resolution attempts wereintensively examined across three good and two poor outcome sessions, as rated byclients. The number of model stages employed by therapists was relatedtooutcome.Results. Sessions evaluated as poor or good by clients could be distinguishedaccording to the extent to which therapists used model stages. Tr eatment outcome wassignificantly associated with number of model stages included by therapists.Conclusion. Competent resolution of ruptures in CATisdependent on therapists’inclusion of stages of the model, providing validation for the model, and demonstratingthat effective rupture resolution might be related to treatment outcome .Ruptures andtheir resolution arelikely to be ke yeve nts in psychotherapypro cess.