Challenge Your Exam Readiness With Our Free EPPP Practice Questions

Alliance ruptures—tensions or breakdowns in the therapeutic bond, goals, or tasks—are common and clinically meaningful. Markers include withdrawal (missed sessions, short answers) and confrontation (irritability, criticizing the therapist). Empirically supported rupture-repair strategies emphasize metacommunication: openly exploring the client’s moment-to-moment experience of the therapist and therapy, validating emotions, taking responsibility for misattunements, and renegotiating goals/tasks. Option C captures this approach—slowing down, naming the strain, inviting feedback, and collaborating on repairs. Option A risks escalating defensiveness by imposing an interpretation without first restoring safety. Option B can be helpful later, but premature focus on structure may feel invalidating. Option D is premature; referral is considered only if repeated, good-faith repair attempts fail or scope/fit issues emerge. Effective repair strengthens the alliance, predicts better outcomes across modalities, and models healthy relational problem-solving. Skills include reflective listening, curiosity, responsiveness to cultural/contextual factors, and a stance of humility. Documenting repair efforts and monitoring alliance (e.g., session ratings) supports high-quality care.