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Negotiating the Therapeutic Alliance : A Relational Treatment Guide - Jeremy D. Safran

Negotiating the Therapeutic Alliance

A Relational Treatment Guide


Published: 11th January 2000
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A half-century of psychotherapy research has shown that the quality of the therapeutic alliance is the most robust predictor of treatment success. This practical, theoretically sophisticated book provides a systematic framework for negotiating ruptures in the alliance and transforming them into therapeutic breakthroughs. The book is grounded in recent developments in relational psychoanalysis, as well as findings from the authors' highly regarded research program. Chapters spell out clear principles of intervention illustrated with extensive clinical vignettes and transcript material. Particular attention is given to the therapist's inner processes and the role they play in resolving alliance ruptures. Other topics covered include the use of therapist self-disclosure and metacommunication; interactional patterns of successful therapist-patient dyads; applications to short-term treatment; and guidelines for training and supervision.

"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

The Therapeutic Alliance Reconsideredp. 1
Overview of the Bookp. 5
A Brief History of the Therapeutic Alliancep. 6
A Reconceptualization of the Therapeutic Alliancep. 12
A Taxonomy of Interventions for Addressing Alliance Rupturesp. 15
Fundamental Assumptions and Principlesp. 30
Agency versus Relatednessp. 31
Constructivism and Realismp. 34
Beginner's Mind: The Dangers of Reificationp. 36
One-Person and Two-Person Psychologiesp. 38
Interventions as Relational Actsp. 41
Motivation and Emotionp. 42
Affective Appraisal and Communicationp. 45
Understanding and Experiencing/Insight and Awarenessp. 47
Participant-Observation and Observing-Participationp. 51
Intersubjectivityp. 52
Mindfulness: The Therapist's Observational Stance and Inner Workp. 55
Circles, Cycles, and Matricesp. 59
Beyond Countertransferencep. 62
Multiple Selvesp. 67
The Paradox of Acceptancep. 69
Understanding Alliance Ruptures and Therapeutic Impassesp. 72
Hope and Despairp. 73
Resistance: Intrapsychic, Characterological, and Relationalp. 77
Will and Responsibilityp. 81
Impasses as Windows into Core Organizing Principlesp. 85
Restructuring the Patient's Relational Schemasp. 88
Affective Miscoordination and Repairp. 90
Recovering a Split-Off Part of the Selfp. 92
Transitional Experiencep. 94
Optimal Disillusionmentp. 98
Subjects and Objectsp. 101
Need versus Needinessp. 103
Surviving and Containingp. 105
Therapeutic Metacommunication: Mindfulness in Actionp. 108
Clinical Vignettesp. 110
Principles of Metacommunicationp. 114
Clinical Illustrationp. 130
Stage-Process Models of Alliance Rupture Resolutionp. 140
A Resolution Model for Withdrawal Rupturesp. 142
A Resolution Model for Confrontation Rupturesp. 154
Brief Relational Therapyp. 175
The Dynamic Focusp. 177
Awareness and the Focus on the Present Momentp. 178
Termination and Optimal Disillusionmentp. 181
Case Illustrationp. 183
A Relational Approach to Training and Supervisionp. 204
Explicitly Establishing an Experiential Focusp. 207
Mindfulness Trainingp. 209
Self-Explorationp. 210
The Relational Context of Supervisionp. 213
Audio- and Videotapingp. 215
Awareness-Oriented Role Playsp. 217
Supervisors as Modelsp. 220
Training Illustrationp. 222
Afterwordp. 233
Referencesp. 239
Indexp. 255
Table of Contents provided by Ingram. All Rights Reserved.

ISBN: 9781572305120
ISBN-10: 1572305126
Audience: Professional
Format: Hardcover
Language: English
Number Of Pages: 260
Published: 11th January 2000
Publisher: Guilford Publications
Country of Publication: US
Dimensions (cm): 22.9 x 15.2  x 2.54
Weight (kg): 0.56