Negotiating the therapeutic alliance : a relational treatment guide

Includes bibliographical references (p. 239-254) and index.

The Therapeutic Alliance Reconsidered. A Brief History of the Therapeutic Alliance -- A Reconceptualization of the Therapeutic Alliance -- A Taxonomy of Interventions for Addressing Alliance Ruptures -- Fundamental Assumptions and Principles. Agency versus Relatedness -- Constructivism and Realism -- Beginner's Mind :The Dangers of Reification --One Person and Two Person Psychologies -- Interventions as Relational Acts -- Motivation and Emotion -- Affective Appraisal and Communication -- Understanding and Experiencing/Insight and Awareness -- Participant-Observation and Observing-Participation -- Intersubjectivity -- Mindfulness :The Therapist's Observational Stance and Inner Work -- Circles, Cycles, and Matrices -- Beyond Countertransference -- Multiple Selves -- The Paradox of Acceptance -- Understanding Alliance Ruptures and Therapeutic Impasses. Hope and Despair-- Resistance : Intrapsychic, Characterological, and Relational -- Will and Responsibility -- Impasses as Windows into Core Organizing Principles -- Restructuring the Patient's Relational Schemas -- Affective Miscoordination and Repair -- Recovering a Split Off Part of the Self -- Transitional Experience -- Optimal Disillusionment -- Subjects and Objects -- Need versus Neediness -- Surviving and Containing -- Therapeutic Metacommunication : Mindfulness in Action. Clinical Vignettes -- Principles of Metacommunication -- Clinical Illustration -- Stage Process Models of Alliance Rupture Resolution -- A Resolution Model for Withdrawal Ruptures -- A Resolution Model for confrontation Ruptures --Brief relational therapy. The dynamic focus -- Awareness and the focus on the present moment -- Termination and optimal disillusionment --Case illustration -- A relational approach to training and supervision. Explicitly establishing and experiential focus --Mindfulness training --Self exploration -- The relational context of supervision -- Audio- and videotaping -- Awareness-oriented role plays -- Supervisors as models-- Training illustration.

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.