Alliance ruptures refer to tensions and negative processes between therapist and patient. Identifying ruptures is important because research shows that ruptures play an important role in establishing therapeutic alliance and in promoting therapeutic changes. However, previous studies have not used within-person methodology to explore the dynamic and dyadic processes of interpersonal behaviors in ruptures and thus there is little evidence to guide clinicians in the identification of ruptures. The current study utilizes an intensive single-case analytic approach to examine how patients' and therapists' dominance, warmth, and interpersonal complementarity are associated with in-session confrontation ruptures and withdrawal ruptures in sixteen adult psychotherapy sessions from eight independent therapeutic dyads. Interpersonal behaviors and ruptures were coded and processed at a half-minute interval. Dynamic factor analysis models were fit to examine the relationships between interpersonal variables and ruptures for each single session. Generalizability was examined by comparing results within dyads and across dyads. Patient's increased cold or dominant behaviors, as well as the dyad's increased dominance complementarity, were related with confrontation ruptures in more than one third of the sessions. Therapist's decreased dominant behaviors and patient's increased dominant behaviors were related with withdrawal ruptures in more than one third of the sessions. The results also identified dyad- and session-specific patterns that did not generalize across cases but may be of clinical interest. These findings highlight the important roles of both therapists' and patients' behaviors as well as their synchronization on dominance in the development of alliance ruptures, extended our knowledge on within-person interpersonal dynamics associated with ruptures, and emphasized the need to examine both idiographic and nomothetic processes of alliance ruptures.
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