Weakenings and Repairs of the Working Alliance in Short-Term Psychotherapy

The purpose of this study was to investigate how the weakening and repair of the working alliance in short-term psychotherapies relate to change in therapy. In six short-term, time-limited therapies, weakenings and repairs were identified with a unitized process ratings scale. Though the data must be considered preliminary, interesting relations emerged. Patients with greater ego strength had a higher initial quality of alliance with their therapist and were better able to work to repair any weakenings. These patients also exhibited a growing use of observing ego in their increasing ability to initiate talk about weakenings. Highest levels of patient alliance were preceded by high levels of therapist repair action. The success with which weakenings and repairs were handled was predictive of the general outcome of therapy. Surprisingly, more frequent interpretations of transference allusions were associated with poor outcome.