Journal of Psychotherapy Integration, Vol 35(4), Dec 2025, 223-239; doi:10.1037/int0000369
While extensive research has investigated alliance rupture–repair processes in adult psychotherapy, there is a need for a better understanding of rupture–repair and its association with outcome in child and adolescent psychotherapy. This study aims to fill this gap and provide the first systematic narrative synthesis of the existing empirical research on the association between alliance rupture–repair processes and therapeutic outcomes among adolescents. This systematic review included six studies. The findings from these studies indicate that successful rupture–repair processes are associated with improved therapeutic outcomes and reduced dropout rates. These results should be interpreted with caution because of the limited number of studies, small sample sizes, methodological limitations, and observed heterogeneity. This review also highlights a significant research gap in child therapy on this topic. Despite these limitations, it underscores the association between successful rupture–repair and improved therapeutic outcomes and treatment retention, particularly in adolescent psychotherapy. Further research, especially in child therapy, is essential to deepen our understanding of this relationship. (PsycInfo Database Record (c) 2025 APA, all rights reserved)