Rupture and Repair in Psychotherapy: A Critical Process for ChangeRuptures in the therapeutic alliance are common clinical experiences. If left unresolved, they often lead patients to drop out and to other poor outcomes. As a therapist and patient work together, their alliance can come under strain, often because of disagreements in how to work together and toward what goals or due to a lack of trust and respect. These moments of stress, where the relationship has ruptured, are challenges but also opportunities for