The Therapeutic Alliance in Brief Psychotherapy
Tompkins, Michael A., Journal of Cognitive Psychotherapy
The Therapeutic Alliance in Brief Psychotherapy Jeremy D. Safran and J. Christopher Muran (Eds.). Washington, DC: American Psychological Association (www.apa.org/books/). 1998,238 pp., $39.95 (hardcover).
Although theorists and researchers for many years have studied briefer forms of psychotherapy, recent socioeconomic trends have amplified interest in brief treatments, particularly in understanding better the variables that distinguish shortfrom long-term psychotherapies as well as the variables that contribute to the effectiveness of the briefer forms. The Therapeutic Alliance in Brief Psychotherapy, edited by Jeremy Safran and Christopher Muran, focuses on one such variable, the therapeutic relationship and its role in the change process. The book presents contributions by leading clinicians and researchers on the most common brief therapeutic models: psychoanalytic, psychodynamic, functional analytic, cognitive, humanistic-experiential, strategic, systemic, and group. Chapters focus on how each model conceptualizes and utilizes the therapeutic alliance with special emphasis on the types of alliance ruptures most common to short-term therapeutic approaches and how they are handled.
The chapters on functional analytic, cognitive, systemic and strategic therapies were particularly interesting in that descriptions of these approaches do not generally emphasize the contribution of the therapeutic alliance to treatment outcome. In addition, the chapters did a good job of correcting many of the assumptions clinicians may have about these approaches. For example, in the chapter on cognitive therapy, the author suggests clients may come to therapy with the expectation that the treatment will focus on "rational thinking" and are surprised when the therapist encourages discussions of interpersonal issues, including the therapeutic relationship. The author describes strategies typically associated with cognitive therapy (booster sessions, encouraging clients to keep a written record of what was learned) as well as strategies typically associated with the humanistic-experiential approach (conveying positive regard and hope). Most chapters emphasize the importance of an individualized case formulation to help maintain and manage ruptures of the therapeutic alliance. …