Why the model matters ...
​A therapist may experience discomfort, which could cause them to react
poorly rather than respond skillfully.
In turn, their reaction might cause a
rupture in the client-therapist relationship.
The client may lose motivation for treatment, drop out, and
not get the help they need.
The MCW Model is derived from Buddhist psychology principles and is informed by research on therapeutic alliance, alliance rupture, rupture repair, and premature termination.
What the research says ...
Read below to learn about:
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therapeutic alliance
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alliance rupture
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rupture repair
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premature termination
Therapeutic Alliance
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The therapeutic alliance refers to three main features within psychotherapy:
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the bond between therapist and client
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agreed-upon goals for treatment
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agreed-upon tasks to achieve the goals
The bond, or therapeutic relationship, is said to contribute to therapeutic success as much as, if not more than, the mode of intervention (Norcross & Lambert, 2018).
Research has shown that the client-therapist connection is primarily established in the initial therapy session (Sexton et al., 2005), and it is during this session that a client tends to determine whether they will return for subsequent sessions. A study revealed that therapists’ involvement, support, hope, and empathy eased clients’ initial doubts and concerns about psychotherapy and was perceived as the foundation for future work together (MacFarlane et al., 2015).
You should expect to experience client-therapist ruptures, as this is a normal part of therapy. Ruptures can vary in intensity and involve a strain in the relationship or disagreement about tasks and goals of treatment.
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Acknowledging and exploring a rupture early in therapy can lead a client to experience a positive emotion. As a result, the client’s emotion can be linked with an overall positive feeling toward the therapist and the exploratory process, motivating willingness to explore other challenges in therapy (Fitzpatrick et al., 2006).
Alliance Rupture
Rupture Repair
When a rupture occurs, a therapist can:
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notice subtle indications of a rupture and initiate a discussion
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give clients space to discuss negative feelings about the therapy
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acknowledge their part in the rupture in a nondefensive way
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empathize with the client and validate the client’s feelings
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help the client explore the impasse
(Safran & Kraus, 2014, Safran & Muran, 2000, Safran et al, 2011)
Approximately 20% of psychotherapy clients end treatment prematurely, that is, without completing treatment and without getting significant relief from their problems
(Swift et al., 2012).
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It is well known in 'performance under pressure' research that stress causes judgement and decision making to be more rigid and fixed. Meaning, therapists may strictly adhere to a theorhetical model during a difficult interaction, rather than pause and listen to the client's concerns, which has been linked with poor therapy outcome and premature termination from therapy
(Schut et al., 2005).
Premature Termination