Antonello Colli, Vittorio Lingiardi, Giancarlo Dimaggio, Donatella Fiore & Daniela Petrilli
University of Rome 'La Sapienza' / Centro di Psicoterapia Cognitiva, Rome, Italy

E-mail:antonellocolli@tiscali.it

 

PATIENT'S ALLIANCE RUPTURES, THERAPIST'S INTERVENTIONS AND COGNITIVE INTERPERSONAL CYCLES:
A SINGLE CASE ANALYSIS WITH THE THERAPEUTIC ALLIANCE CODING SYSTEM (TACS)

 

The Therapeutic Alliance Coding System (TACS) has been created in order to rate and evaluate Therapeutic Alliance (TA) in transcripts of psychotherapy sessions. Until today, available instruments such as the Working Alliance Inventory or the California Psychotherapy Alliance Scale provided TA evaluation by means of personal questionnaires (therapist's, patient's and observer's versions). The TACS is theoretically based on Bordin's definition of TA as an interactive dimension between patient and therapist with respect to their ability to develop a genuine relationship based on trust, respect and collaboration in the common work of dealing with the patient's problems and difficulties. We also refer to Bordin's TA tripartition in tasks, goals and bond. To select the rupture and resolution markers of the alliance (for both patient and therapist) we referred to Safran and Muran's stage process model of impasses and to the cognitive interpersonal cycle as theorized by Safran and Segal. We present the analysis of a psychotherapy session using TACS. The patient is a 28 years old female with a borderline personality disorder. This single case study shows how the therapist recognizes the patient's alliance ruptures and how, focusing his attention on interpersonal cognitive cycles, he works to re-establish TA. In particular, thanks to a microanalysis of the transcription, we found a correspondence between Safran's conceptualizations and our therapist's working style in the session.