Client Perspectives on Therapeutic Ruptures in Psychotherapeutic Relationships

Abstract

The therapeutic relationship is a secure base and safe haven for clients undergoing psychotherapy. The current study uses an interpretive phenomenological design to explain the meaning-making process of clients during negative experiences of therapy and its effect on the therapeutic relationship. 11 participants from various parts of India have been recruited for the study. They were interviewed about their negative experiences in therapy, special emphasis was given to the client therapist relationship. Insight into the perception of therapy events can help therapists detect negative feelings before it leads to breakdown therapeutic relationships. Participants who face negative experiences in therapy showed low motivation to seek therapy in future. The findings suggest that ruptures can have multiple origins and that they have very important implications for psychotherapy practice.  The origins of such ruptures that emerge from different therapy events perceived by clients are explained in the current paper. The different therapy events are techniques, structure of sessions, tools, feedback and therapist presence.  Clinicians need to be more mindful of the clients’ perspective on techniques, assessments, therapeutic presence and power issues to avoid ruptures. Current research can inform protocols for rupture prevention, repair and termination.