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Negotiating the Therapeutic Alliance: A Relational Treatment Guide
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.
260 pages, Paperback
First published January 11, 2000
14 people are currently reading
210 people want to read
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Displaying 1 - 7 of 7 reviews
February 20, 2023
Safran and Muran are esteemed figures in the field of relational analysis. They are most noted for their thoughts on conflict resolution, believing as they do that therapeutic change arises from the manner in which ruptures in the relationship between analyst and patient are encountered, addressed, and repaired. They believe therapy is an ongoing process of intersubjective negotiation - meaning the wrangle with one's therapist is essentially what therapy is all about.
This relational treatment guide was written to assist fellow practitioners in their dealings with patients. Safran and Muran offer a series of approaches to consider when that relationship goes off track. They remind us that any therapy of value will run up against such impasses - this is, after all, the true grit of good work. We're meant to hit those angry spots; those squabbles and disputes and logjams that threaten to tear the acquaintance apart. A good alliance is an alliance flexible enough to weather the storm and, in the process, facilitate an awareness of the self-defeating patterns that incite it. Because the relational school of thought is founded on mutual responsibility, these patterns are hunted down not only in the patient but in the therapist as well.
The book is a substantial resource, both for those in practice and anyone involved in a therapeutic relationship that's reached that nails-on-a-chalkboard stage. If you're just about to walk? This will give you a window into what that enigma across from you is probably experiencing.
This relational treatment guide was written to assist fellow practitioners in their dealings with patients. Safran and Muran offer a series of approaches to consider when that relationship goes off track. They remind us that any therapy of value will run up against such impasses - this is, after all, the true grit of good work. We're meant to hit those angry spots; those squabbles and disputes and logjams that threaten to tear the acquaintance apart. A good alliance is an alliance flexible enough to weather the storm and, in the process, facilitate an awareness of the self-defeating patterns that incite it. Because the relational school of thought is founded on mutual responsibility, these patterns are hunted down not only in the patient but in the therapist as well.
The book is a substantial resource, both for those in practice and anyone involved in a therapeutic relationship that's reached that nails-on-a-chalkboard stage. If you're just about to walk? This will give you a window into what that enigma across from you is probably experiencing.
September 19, 2025
Det tok bare rett over fire år å lese denne ferdig. Ganske tunglest men likevel en av de beste bøkene jeg har lest innen psykoloterapi. anbefales veldig, nyttig uavhengig av terapiretning
August 3, 2025
En guldvärd bok om den terapeutiska alliansen. Bygger på ett tungt, nästan dogmatiskt, relationellt perspektiv där terapeutens inre värld och egna upplevelser ses som avgörande för alliansåterbyggande vid mötet med alliansbrott. Den centrala termen och färdigheten är METAKOMMUNIKATION: ett reflekterande här-och-nu kommunicerande om vad som uppstår i relationen mellan terapeut och patient.
Boken går igenom det teoretiska på ett läsvänligt och inbjudande sätt, är fylld med långa och pedagogiska terapivinjetter, och innehåller tydliga ”så här kan du gå till väga”-tips, där läsaren får en konkret (så konkret det går i detta sammanhang) bild av hur man kan ta sig an alliansbrott av två olika typer: tillbakadragande (withdrawal ruptures) och konfrontativa. Boken har dessutom en del som går igenom hur man på ett målmedvetet sätt (a al deliberate practice) kan träna på detta, samt hur man kan förhålla sig till det och använda sig av det i handledning.
En bok jag kommer hålla hårt i och sannolikt återvända till flera gånger under kommande yrkesår. Rekommenderar till alla som ägnar sig åt eller är intresserade av att ägna sig åt terapi.
Boken går igenom det teoretiska på ett läsvänligt och inbjudande sätt, är fylld med långa och pedagogiska terapivinjetter, och innehåller tydliga ”så här kan du gå till väga”-tips, där läsaren får en konkret (så konkret det går i detta sammanhang) bild av hur man kan ta sig an alliansbrott av två olika typer: tillbakadragande (withdrawal ruptures) och konfrontativa. Boken har dessutom en del som går igenom hur man på ett målmedvetet sätt (a al deliberate practice) kan träna på detta, samt hur man kan förhålla sig till det och använda sig av det i handledning.
En bok jag kommer hålla hårt i och sannolikt återvända till flera gånger under kommande yrkesår. Rekommenderar till alla som ägnar sig åt eller är intresserade av att ägna sig åt terapi.
April 12, 2022
A new therapy favorite!
Safran and Muran write from a two-person psychology. Some time is spent in the intro distinguishing their philosophy from other relation-oriented therapies/therapist-authors out there.
Ultimately this guide focuses on ruptures in the therapeutic alliance, identifying types of ruptures that can occur and specific ways to approach them. They offer two models as guidance rather than some formalized way to do therapy. This culminates with a description and case presentation of 'Brief Relational Therapy' (BRT) which places what is happening in the here-and-now of the therapeutic relationship as central to therapy.
They are clearly astute, experienced practitioners and scholars in their own right, and bring to light many subtleties that arise between therapist and client.
Some degree of rupture/impasse occurs in every therapy session (although many therapists would not attend to it). To make therapeutic use of them is the path of therapy, furthermore it's just logical to make use of them given their prevalence. Therefore, I think this book is a must read regardless of one's therapeutic orientation - no one can deny the relationship in therapy.
Notably they continually comment on the importance of therapist's own process and mindfulness as a necessary skill and practice.
Safran and Muran write from a two-person psychology. Some time is spent in the intro distinguishing their philosophy from other relation-oriented therapies/therapist-authors out there.
Ultimately this guide focuses on ruptures in the therapeutic alliance, identifying types of ruptures that can occur and specific ways to approach them. They offer two models as guidance rather than some formalized way to do therapy. This culminates with a description and case presentation of 'Brief Relational Therapy' (BRT) which places what is happening in the here-and-now of the therapeutic relationship as central to therapy.
They are clearly astute, experienced practitioners and scholars in their own right, and bring to light many subtleties that arise between therapist and client.
Some degree of rupture/impasse occurs in every therapy session (although many therapists would not attend to it). To make therapeutic use of them is the path of therapy, furthermore it's just logical to make use of them given their prevalence. Therefore, I think this book is a must read regardless of one's therapeutic orientation - no one can deny the relationship in therapy.
Notably they continually comment on the importance of therapist's own process and mindfulness as a necessary skill and practice.
January 2, 2025
5/5. Läst om två gånger.
Belyser den fundamentala vikten av den terapeutiska relationen, därmed det relationella perspektivet, och hur man kan jobba med det i praktiken. Begrepp som terapeutisk allians, överföring och motöverföring samt den verkliga relationen är av centralt intresse. Boken har flera år på nacken, men den är minst lika aktuell då som nu.
Idéhistorian som skildras i bokens inledande kapitel borde läsas av samtliga verksamma inom psykologi och psykoterapi. Klargör flera missuppfattningar om modern (och historisk) psykodynamisk terapi, för övrigt. Skildrar vidare flera principer och praktiska inslag från den relationella skolan som även KBT-paradigmet plockat upp (se Wenzel, 2024).
Metakommunikation, det är grejer det.
Belyser den fundamentala vikten av den terapeutiska relationen, därmed det relationella perspektivet, och hur man kan jobba med det i praktiken. Begrepp som terapeutisk allians, överföring och motöverföring samt den verkliga relationen är av centralt intresse. Boken har flera år på nacken, men den är minst lika aktuell då som nu.
Idéhistorian som skildras i bokens inledande kapitel borde läsas av samtliga verksamma inom psykologi och psykoterapi. Klargör flera missuppfattningar om modern (och historisk) psykodynamisk terapi, för övrigt. Skildrar vidare flera principer och praktiska inslag från den relationella skolan som även KBT-paradigmet plockat upp (se Wenzel, 2024).
Metakommunikation, det är grejer det.
January 8, 2023
Probably the therapy book I've most recomended to other therapists.
April 17, 2014
The most clear, comprehensive yet concise introduction to the field of Relational Analysis in particular and an analytic approach to the therapeutic relationship in general.
Displaying 1 - 7 of 7 reviews