Therapeutic Alliance and Clients’ Experiences of Ruptures and Repairs in Virtual Group Therapy

Abstract

Therapeutic alliances often include cycles of rupture and repair. Ruptures are tension or disagreement that occur during therapy. The therapeutic alliance in group therapy operates on three levels: member-to-member, member-to-therapist, and member-to-group, and ruptures may occur at any level. The aim of the present research was to explore clients’ experiences of rupture and repairs and the effect these cycles have on the alliance in virtual group therapy. 10 youth and 11 parents participating in virtual group therapy (VGT) at three community mental health and addictions agencies in Eastern Ontario were recruited and semi-structured interviews were conducted with these clients. Interviews focused on (1) their experience of participating in VGT, (2) ruptures and repairs in VGT sessions, and (3) their effects on the client and group. Data were analyzed using thematic analysis to determine overarching themes in the data. Thematic analysis suggests that unresolved ruptures were associated with poor therapeutic outcome, but repaired ruptures had a positive effect on the therapeutic alliance. Understanding how clients and therapists experience alliance ruptures in online psychotherapy has significant clinical implications for intervention strategies (i.e., weaving in conflict resolution with group therapeutic goals). These results will be helpful in training therapists to recognize and address alliance ruptures at different levels in the group, which may improve the therapeutic alliance and ultimately, client outcomes.