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.

Jeremy D. Safran, PhD, until his death in 2018, was Professor of Psychology at the New School for Social Research, where he served for many years as Director of Clinical Training, and Senior Research Scientist at New York's Beth Israel Medical Center. A renowned psychotherapy researcher, clinician, teacher, and mentor, Dr. Safran was past president of the International Association for Relational Psychoanalysis and Psychotherapy. He was a recipient of honors including the Senior Distinguished Research Career Award from the Society for Psychotherapy Research and the Scholarship and Research Award from Division 39 of the American Psychological Association.
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.

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