50 years of psychotherapy research shows that quality of therapeutic alliance is the most robust predictor of treatment success. The book provides a framework for negotiating impasses in the alliance and transforming them into breakthroughs.

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.