Negotiating the Therapeutic Alliance

A Relational Treatment Guide

Jeremy D. Safran and J. Christopher Muran

January 11, 2000
ISBN 9781572305120
Price: $85.00
260 Pages
Size: 6" x 9"
May 22, 2003
ISBN 9781572308695
Price: $35.00
260 Pages
Size: 6" x 9"

A half-century of psychotherapy research has shown that the quality of the therapeutic alliance is the most robust predictor of treatment success. This unique book provides a systematic framework for negotiating ruptures and strains in the therapeutic alliance and transforming them into therapeutic breakthroughs. Cutting-edge developments in psychoanalysis and other modalities are synthesized with original research and clinical wisdom gleaned from years of work in the field. The result is a practical and highly sophisticated guide that spells out clear principles of intervention while at the same time inspiring therapists toward greater creativity.

“The quality of the therapeutic alliance is the most powerful predictor of success in psychotherapy. Given the inevitability of stresses, strains, and breakdowns in that alliance, the identification and repair of these difficulties are among the most important skills for the psychotherapist to acquire....[This book] belongs in the library of every mental health professional who practices or teaches psychotherapy.”

American Journal of Psychiatry

“While clinical research has demonstrated the efficacy of a variety of psychotherapeutic procedures, what is often overlooked is the critical role played by the 'common factors' of psychotherapy. This important book details procedures for optimizing the therapeutic alliance and maximizing treatment effectiveness. It should be read by all clinicians.”

—David H. Barlow, PhD, Professor and Director Center for Anxiety and Related Disorders, Boston University

“This is a brilliant book. Informed by the authors' internationally recognized research program on ruptures in the therapeutic alliance, the book is enlightening in two major ways. First, its focus on ruptures opens a route to understanding the nature and utility of the therapeutic alliance. Second, the authors show how to negotiate ruptures, offering a veritable guide to moving from rupture to healing. Focusing on an important and neglected area of clinical training, this is an invaluable text for beginning and advanced psychotherapy courses.”

—Lester Luborsky, PhD

“An unparalleled achievement....Among the few comprehensive texts that truly integrates ongoing empirical research with cutting-edge developments in clinical psychoanalysis, as well as elements of other therapeutic modalities....This book will be used both as a classroom text and as a sourcebook for working clinicians, researchers, and theorists.”

—Lewis Aron, PhD

Table of Contents

1. The Therapeutic Alliance Reconsidered

2. Fundamental Assumptions and Principles

3. Understanding Alliance Ruptures and Therapeutic Impasses

4. Therapeutic Metacommunication: Mindfulness in Action

5. Stage-Process Models of Alliance Rupture Resolution

6. Brief Relational Therapy

7. A Relational Approach to Training and Supervision

About the Authors

Jeremy D. Safran, PhD, is Professor of Psychology at the New School for Social Research and Senior Research Scientist at New York's Beth Israel Medical Center. He maintains a private practice in New York City.

J. Christopher Muran, PhD, is Chief Psychologist and Director of the Brief Psychotherapy Research Program at Beth Israel Medical Center in New York City, where he also maintains a private practice.


Practicing psychotherapists; graduate-level students in clinical psychology, psychiatry, and social work; trainees within psychoanalytic institutes; psychotherapy researchers.

Serves as a text in graduate-level courses on psychodynamic theory and technique.

Course Use

Serves as a text in graduate-level courses on psychodynamic theory and technique.