The Therapeutic Relationship

The therapeutic relationship has been recognized by psychotherapy researchers and clinicians alike as playing a central role in the process and outcome of psychotherapy. This book presents innovative investigations of the therapeutic relationship focusing on various relationship mechanisms as they relate to changing processes and outcomes. A variety of perspectives on the therapeutic relationship are provided through different research methods, including quantitative and qualitative methods, and divergence in psychotherapy orientations, including psychodynamic, interpersonal, cognitive-behavioural therapy, emotion-focused process experiential therapy, narrative therapy, and attachment-based family therapy. The chapters, written by leading psychotherapy researchers, present cutting-edge empirical studies that apply innovative methods in order to: study process-outcome links; explore in session processes that address the question of how the therapeutic relationship heals; examine the contributions of clients and therapists to the therapeutic relationship; and suggest practical implications for training therapists in psychotherapy relationships that work. Research on the therapeutic relationship has been identified as a natural arena for bridging the gap between research and clinical practice, and will be of particular interest to practicing clinicians. This book was originally published as a special issue of Psychotherapy Research.

Hadas Wiseman is Professor of Counselling and Human Development at the University of Haifa, Israel. Her research interests include therapeutic relationships and attachments and the development of psychotherapists. She was formerly President of the Society for Psychotherapy Research. Orya Tishby is a Lecturer in Clinical psychology and clinical social work at Hebrew University, Jerusalem, Israel. Her research interests include therapeutic relationships, countertransference, and psychotherapy with adolescents. She is a clinical psychologist and supervisor.

1. Introduction: The therapeutic relationship: Multiple lenses and innovations 2. Understanding processes of change: How some patients reveal more than others - and some groups of therapists less - about what matters in psychotherapy 3. The associations among improvement and alliance expectations, alliance during treatment, and treatment outcome for major depressive disorder 4. How does the therapeutic alliance in cognitive-behavioural therapy for panic disorder develop throughout treatment? Sawtooth patterns, sudden gains, and stabilization 5. The therapeutic relationship in action: How therapists and clients co-manage relational disaffiliation 6. Therapeutic collaboration and resistance: Describing the nature and quality of the therapeutic relationship within ambivalence events using the Therapeutic Collaboration Coding System 7. Investigating the impact of alliance-focused training on interpersonal process and therapists' capacity for experiential reflection 8. To be or not to be immediate with clients: The use and perceived effects of immediacy in psychodynamic/interpersonal psychotherapy 9. The role of empathy in promoting change 10. Client attachment, attachment to the therapist and client-therapist attachment match: How do they relate to change in psychodynamic psychotherapy? 11. Types of countertransference dynamics: An exploration of their impact on the client-therapist relationship 12. Client disclosure and therapist response in psychotherapy with women with a history of childhood sexual abuse 13. Good versus poor therapeutic alliances with non-accepting parents of same-sex oriented adolescents and young adults: A qualitative study