Abstract

Objective

The purpose of this study was to provide some definition of rupture repair in a cognitive–behavioral therapy (CBT) for personality disorders, specifically how treatment tasks or goals are renegotiated.

Method:

Following a task analysis, a rational model was developed with the support of an expert panel. An empirical analysis was conducted on six CBT cases sampled from a clinical trial that included personality disordered patients and treatment adherent therapists. Two sessions from each case indicating rupture repair were selected, based on patient and therapist ratings of the Working Alliance Inventory—12 item version (WAI-12) and rupture presence. A qualitative analysis of the sessions was conducted with the support of the observer-based Rupture Resolution Rating System (3RS—2022).

Results:

The empirical analysis provided some support for many of the stages defined in the rational model, but less support for the hypothesized sequences of stages. A rational-empirical synthesis yielded a revised model that suggested therapists combine various strategies in rupture repair in a variety of ways, not necessarily in consistent sequences.

Conclusions:

The renegotiation of tasks and goals in this CBT sample was variable. The importance of responsiveness and the need to validate the rational-empirical model were highlighted.

中文翻译：

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重新协商任务或目标作为破裂修复：人格障碍认知行为治疗中的任务分析

 抽象的

 客观的

本研究的目的是提供人格障碍认知行为疗法（CBT）中破裂修复的一些定义，特别是如何重新协商治疗任务或目标。

 方法：

经过任务分析后，在专家小组的支持下开发了一个合理的模型。对从临床试验中抽取的 6 个 CBT 病例进行了实证分析，其中包括人格障碍患者和坚持治疗的治疗师。根据患者和治疗师对工作联盟清单 12 项目版本 (WAI-12) 的评级以及是否存在破裂，从每个病例中选择了两个表明破裂修复的疗程。在基于观察者的破裂解决评级系统（3RS-2022）的支持下对会议进行了定性分析。

 结果：

实证分析为理性模型中定义的许多阶段提供了一些支持，但对假设的阶段顺序的支持较少。理性与经验的综合产生了一个修订后的模型，该模型建议治疗师以多种方式结合破裂修复的各种策略，而不必以一致的顺序进行。

 结论：

此 CBT 样本中任务和目标的重新协商是可变的。强调了响应能力的重要性以及验证理性经验模型的必要性。