The therapeutic relationship is often cited as a key factor in positive treatment outcomes for clients, including with youth and families. This dissertation will look at how psychotherapists approach ruptures and repairs in the relationship with adolescent clients so that more will be known about what promotes or hinders therapeutic work with teenagers. A hermeneutic literature review will be conducted to identify meaningful and practical elements in rupture-repair processes within therapeutic relationships or alliances. The main data will come from existing literature related to psychotherapy with young people and additional data will come from the writer’s own reflection of practice.

The findings of the literature review presented that ruptures are inevitable and are understood to be normal in interactions with adolescents given their developmental stage and conflicting needs however if not addressed, ruptures can lead to significant disengagement and early termination of therapy. Repairs (like ruptures) are co-constructed between the client and therapist, and the aim is to have a meaningful, corrective relational experience for better treatment outcomes. There has been growing interest and evidence on rupture-repair processes and strategies with teenagers that link with a range of relevant theories including from developmental, psychodynamic, attachment and neuroscience literatures. These understandings may support other psychotherapists and mental health practitioners in considering rupture resolution as interventions when working with youth. Ideas of further research are discussed at the end.