Alliance–Focused Training – An Evidence–Based Guide to Negotiating Ruptures in Therapy

This book presents alliance-focused training (AFT), which helps therapists better anticipate, recognize, and repair ruptures in the therapeutic alliance.

Decades of clinical research and experience have proven the essential contribution of the therapeutic alliance to psychological change and positive outcomes in therapy. A key element of a successful alliance is the ability to anticipate and navigate the inevitable misunderstandings and miscommunications that can lead to ruptures in the therapeutic relationship if unaddressed. But many therapists lack this ability, and they require training to fully address ruptures and repair therapeutic relationships with their clients.

In this book, authors J. Christopher Muran, Catherine F. Eubanks, Lisa Wallner Samstag, and James Macdonald present alliance focused training (AFT), an empirically-supported, transtheoretical protocol which has been shown to increase patients' expressiveness, which is a key component in positive outcomes in therapy, as well as therapists' ability to recognize and tolerate their own negative reactions to clients. In AFT, therapists are given the opportunity to experiment with metacommunication, by which they can better explore their own internal experience and recognize conflicts as they emerge during alliance ruptures. Chapters first describe the background and research that led to the development of the protocol; next, the protocol itself is presented, with chapters on rupture recognition and rupture repair, via didactic instruction and experiential exercises. Then, rich and extensive case examples demonstrate how therapists can successfully use the protocol to identify and repair real ruptures with clients, and lead to long-lasting therapeutic change.

J. Christopher Muran, PhD is dean and professor at the Gordon F. Derner School of Psychology, Adelphi University, and codirector of the Center for Alliance-Focused Training. He is principal investigator of the Psychotherapy Research Program at Mount Sinai Beth Israel where he is also on faculty at Icahn School of Medicine at Mount Sinai. He has had postdoctoral training in cognitive (University of Toronto) and psychoanalytic therapies (New York University).

He is a fellow of APA and has served on its Clinical Practice Guidelines Advisory Steering Committee. He is also past-president of the Society for Psychotherapy Research (SPR) and past-editor of its journal Psychotherapy Research. He has served on several editorial boards, held other faculty appointments, and received multiple honors, including distinguished career awards from APA, SPR, and the National Register. He has published over 180 papers, 10 books, and 4 videos--generally on rupture repair and alliance-focused training.

Catherine F. Eubanks, PhD is professor in the Gordon F. Derner School of Psychology, Adelphi University and codirector of the Center for Alliance-Focused Training. She is a fellow of APA, past president of the Society for the Exploration of Psychotherapy Integration (SEPI), past executive officer of the North American Society for Psychotherapy Research (SPR), and a previous recipient of early career awards from APA Division 29 and SPR.

She was associate editor of Journal of Clinical and Consulting Psychology and currently serves as managing editor of Psychotherapy Research. She has published a number of journal articles and book chapters, coauthored one book, coedited two others, and co-produced three videos, primarily focused on rupture repair and alliance-focused training.

Lisa Wallner Samstag, PhD is full professor in the Clinical Psychology Doctoral Program and the Department of Psychology at Long Island University (Brooklyn Campus) where she is the director of Psychotherapy Research and a cinical supervisor in the Psychological Services Center. She is also a senior consultant at the Psychotherapy Research Program at Mount Sinai Beth Israel. She completed postdoctoral training in psychoanalysis at the William Alanson White Institute, is a fellow of APA and is past associate editor/book review editor of Psychotherapy.

Dr. Samstag has published over 50 psychotherapy research studies, articles, and book chapters, and coedited one book, with a particular focus on the study of the therapeutic relationship, including the identification of ruptures and other factors that contribute to poor outcome and premature termination.

James Macdonald, PhD, DClinPsych, MSt MBCT, is a clinical psychologist in private practice at Headington Psychotherapy, Oxford, UK. He has had extensive training in various treatment and training models, including Experiential Dynamic Therapy (EDT), Mindfulness-Based Cognitive Therapy (MBCT), Emotion-Focused Therapy (EFT) and Alliance-Focused Training (AFT). He has previously taught at the Oxford Institute for Clinical Psychology Training and Research.

He has a longstanding interest in how psychotherapy research can lead to improvements in clinical process and outcomes, and has supervised, taught and published in the area of psychotherapy research. He is currently interested in the development of mindfulness approaches in AFT and the integration of AFT principles and practices with those of EFT, with recent publications on these two topics.