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

Abstract

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.