Types of Ruptures and Repairs in the Therapeutic Relationship : A Scoping Review

Background: Ruptures in the therapeutic relationship are defined as tensions or breakdowns and repair is needed to continue the relationship. In order to create an overview of the different views on what causes ruptures and what is needed for repair, an integrative study is needed. Objectives: This scoping review provides an answer to the question: “What are reasons for ruptures between therapist and client to occur and in what way may they be repaired?” Methods: A scoping review was chosen as a methodology. Literature search which delivered 36 articles. A hybrid thematic analysis was carried out, meaning deductive and inductive coding were used. There were two deductive codes for the repair of ruptures: general steps for rupture resolution and based on type of rupture – withdrawal/confrontation. These were based on previous literature. The other codes and themes were found inductively. Results: Within the overarching theme reasons for ruptures, the following themes were found: incompatibility therapist-client, client challenges, and therapist’s contributions. The second overarching theme is ways to repair, with themes therapist’s guideline, insight into client, personal relationship repair, and therapist actions. Discussion: Concluding, ruptures could be due to a mismatch in the therapist-client relationship, problems caused by the client and problems caused by the therapist. For repair, there was a general, always applicable, solution, a way to learn more about the client, a method focusing on personal relationship repair, and some techniques therapists can use.