Repairing alliance ruptures using supportive techniques in telepsychotherapy during the COVID-19 pandemic

ABSTRACT

The COVID-19 pandemic shifted many traditional face-to-face treatments to telepsychotherapy, forcing many therapists worldwide to adapt effective techniques developed in face-to-face treatment to telepsychotherapy. These include supportive techniques that may be particularly important at a time of rising anxiety, loneliness, helplessness, and depression. The present paper provides detailed guidelines for therapists on how supportive techniques developed in traditional face-to-face treatment can be effectively used in telepsychotherapy to resolve alliance ruptures. To this end, we used the conceptual framework of the core conflictual relationship theme (CCRT) formulation, making adjustments for identifying and resolving ruptures in the therapeutic alliance in telepsychotherapy. We demonstrated the proposed techniques for identifying and repairing ruptures with a case study of a patient participating in an ongoing RCT, whose treatment shifted in mid-therapy to telepsychotherapy because of the COVID-19 pandemic. The techniques presented and illustrated in this article may be used in the transition to remote therapy for a range of reasons, including patient or therapist relocation and more.

KEYWORDS:

• Therapeutic Relationship
• alliance ruptures
• supportive Techniques
• core conflictual relationship theme

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

The research was supported by a grant from the Israel Science Foundation (Grant no. 186/15).

Notes on contributors

Tohar Dolev-Amit

Tohar Dolev-Amit is a Doctoral Candidate on a president’s scholarship in the University of Hafia, Israel, and a researcher and lab manager in Dr. Sigal Zilcha-Mano’s lab. Her research focuses on processes of therapeutic change, and more specifically on the effect of the patient’s interpersonal style on the alliance, ruptures and resolutions and outcome of treatment.

Liat Leibovich

Dr. Liat Leibovich is a licensed clinical psychologist and supervisor in Israel, working in “Ahava” children’s home and in private practice, and lecturing at the Department of Clinical Psychology, in Ruppin Academic Center. Her research focuses on psychodynamic techniques and especially on the role of supportive techniques in enhancing the alliance and contributing to interpretive techniques in psychodynamic psychotherapy for depression.

Sigal Zilcha-Mano

Dr. Sigal Zilcha-Mano is an Associate Professor of Clinical Psychology and heads the Psychotherapy Research Lab in the Department of Psychology, University of Haifa. She is Associate Editor of the Journal of Counseling Psychology, and on the editorial board of Journal of Consulting and Clinical Psychology, Journal of Clinical Psychology, Psychotherapy, and Psychotherapy Research. She is a licensed clinical psychologist.Dr. Zilcha-Mano is the recipient of several career awards, including the International Society for Psychotherapy Research Outstanding Early Career Achievement Award, the American Psychological Foundation’s 2019 Division 29 Early Career Award, the International Society for the Exploration of Psychotherapy Integration New Researcher Award, and the Dusty and Ettie Miller Fellowship for Outstanding Young Scholars. She has received many research grants to support her work, including three research and equipment grants from the Israel Science Foundation, the U.S.-Israel Binational Science Foundation Grant (BSF), the JOY Ventures: Innovative Nero Wellness Grant, the MIT-Israel Zuckerman Award, the Society of Psychotherapy Research Grant, the Norine Johnson Psychotherapy Research Early Career Grant, Society for the Advancement of Psychotherapy, APA, and the Charles J. Gelso Grant, Society for the Advancement of Psychotherapy, APA. Dr. Zilcha-Mano has published over 85 peer reviewed papers in the past 6 years focusing on psychotherapy research and precision medicine in leading journals in these fields.