Supportive-expressive (SE) psychodynamic treatment is based on the identification of and working through the patient's signature core conflictual relationship theme. According to the SE framework, when termination is anticipated, separation conflict arises, and the actualization of the patient's interpersonal wish in the relationship with the therapist is no longer possible. The disactualization of the patient's wish in the relationship with the therapist may cause patients to regress to their maladaptive prototype responses (Nof, Leibovich, & Zilcha-Mano, 2017), which may manifest as a rupture in the therapeutic alliance. The present work integrates constructs based on the SE framework, specifically the disactualization of the patient's wish at the end of treatment, with the framework of alliance ruptures and their resolution (Safran & Muran, 2000). We propose a conceptual clinical model to guide therapists in the successful resolution of alliance ruptures, which are the result of the disactualization of the patient's interpersonal wish. We propose a two-stage process to achieve successful resolution of termination ruptures: (a) identification of termination ruptures and (b) addressing and resolving termination ruptures. For each stage, we propose practice-based guidelines and steps to follow. We demonstrate the proposed guidelines based on the case study of a patient with major depressive disorder. We used three sources of information from the case study: verbal transcripts of the therapy sessions, questionnaires, and semistructured posttreatment interviews. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

中文翻译：

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“我们可以解决”：解决终止破裂的问题。

支持-表达 (SE) 心理动力学治疗基于识别并解决患者标志性的核心冲突关系主题。根据 SE 框架，当终止预期时，分离冲突就会出现，并且患者在与治疗师的关系中的人际愿望的实现不再可能。在与治疗师的关系中患者愿望的不现实化可能会导致患者回归到他们适应不良的原型反应 (Nof, Leibovich, & Zilcha-Mano, 2017)，这可能表现为治疗联盟的破裂。目前的工作整合了基于 SE 框架的结构，特别是在治疗结束时患者愿望的非现实化，与联盟破裂的框架及其解决方案（Safran 和 Muran，2000 年）。我们提出了一个概念性的临床模型来指导治疗师成功解决联盟破裂，这是患者人际关系愿望不现实化的结果。我们提出了一个两阶段的过程来成功解决终止破裂：（a）识别终止破裂和（b）解决和解决终止破裂。对于每个阶段，我们都提出了基于实践的指导方针和要遵循的步骤。我们展示了基于重度抑郁症患者案例研究的拟议指南。我们使用了案例研究中的三个信息来源：治疗过程的口头记录、问卷和半结构化的治疗后访谈。（PsycInfo 数据库记录 (c) 2020 APA，