In this unique book, master clinicians and psychotherapy researchers examine how technique and the therapeutic relationship are inseparably intertwined.

Using a variety of theoretical and research "lenses" and drawing on various models of psychotherapy, including psychodynamic therapy, cognitive–behavioral therapy, emotion-focused therapy, and brief family therapy, the contributors discuss the factors affecting client outcomes.

Engaging case studies bring these processes to life by demonstrating how successful therapists negotiate the relationship and make key moment-to-moment decisions.

Table of Contents


Orya Tishby and Hadas Wiseman

  1. The Psychotherapy Relationship: Where Does the Alliance Fit?
    Adam O. Horvath

I. The Case Studies: Integrating Research and Practice

  1. You Can't Cross the Same River Twice: A Case Study of Alliance Rupture and Repair
    Laura Kohberger, Jeremy D. Safran, and J. Christopher Muran
  2. Patient and Therapist Relational Patterns: Implicit Negotiations
    Emanuel Schattner and Orya Tishby
  3. Closeness and Distance Dynamics in the Therapeutic Relationship
    Hadas Wiseman and Dana Atzil-Slonim
  4. Facilitating the Sense of Feeling Understood in Patients With Maladaptive Relationships
    Sigal Zilcha-Mano and Jacques P. Barber
  5. Clinical Choice Points and Professional Ethics in Psychoanalysis
    Gaby Shefler
  6. The Therapeutic Relationship: A Warm, Important, and Potentially Mutative Factor in Cognitive–Behavioral Therapy
    Louis G. Castonguay, Soo Jeong Youn, Henry Xiao, and Andrew A. McAleavey
  7. Negotiating Multiple Roles and Stances in Cognitive–Behavioral Therapy
    Yoni Elizur and Jonathan D. Huppert
  8. Affirming the Case for Positive Regard
    Barry A. Farber and Jessica Y. Suzuki
  9. Empathy and Responsiveness in Emotion-Focused Therapy
    Jeanne C. Watson
  10. Where Alliance and Systems Theory Meet in Brief Family Therapy
    Laurie Heatherington, Valentín Escudero, and Myrna L. Friedlander
  11. The Use of Immediacy in Supervisory Relationships
    Clara E. Hill and Shudarshana Gupta

II. Mapping Models and Conclusions

  1. Mapping Models of the Therapeutic Relationship: Implications for Integrative Practice
    Stanley B. Messer and Daniel B. Fishman
  2. Conclusion: The Tapestry of the Therapeutic Relationship and Recommendations for Clinicians and Researchers
    Orya Tishby and Hadas Wiseman


About the Editors

Editor Bios

Orya Tishby, PsyD, received her master's degree from Hebrew University and doctorate from Rutgers, where she received the 1991 Best Dissertation Award from the New Jersey Psychological Association.

She is an associate professor in clinical psychology and clinical social work, Hebrew University of Jerusalem in Israel, and is the former director of the Hebrew University Psychological Services. She is head of the clinical psychology graduate program, and clinical faculty at the School of Social Work and Social Welfare, as well as director of the Freud Center for Research in Psychoanalysis.

Dr. Tishby practices and supervises long- and short-term psychodynamic psychotherapy, and her research focuses on the therapeutic relationship and countertransference.

She is coeditor (with Hadas Wiseman) of The Therapeutic Relationship: Innovative Investigations.

Hadas Wiseman, PhD, completed her doctorate in clinical psychology at York University, Toronto, Ontario, Canada. She received clinical training at the Clark Institute of Psychiatry, Toronto, and at the Psychological Services at Hebrew University, where she also completed her postdoctorate.

She is currently a professor in the Department of Counseling and Human Development, Faculty of Education, at the University of Haifa, Israel, and chair of the doctoral studies committee of the Department of Counseling and Human Development.

Dr. Wiseman is also on faculty in the Weiss-Livnat International MA Program in Holocaust Studies, University of Haifa.

Her scholarly work and research has focused on psychotherapy process, the therapeutic relationship, attachment and relationship patterns in psychotherapy, personal and professional development of psychotherapists, and intergenerational trauma and interpersonal relationships in families of Holocaust survivors.

She served as president of the International Society for Psychotherapy Research.

She coauthored (with Jacques P. Barber) Echoes of the Trauma: Relational Themes and Emotions in Children of Holocaust Survivors and coedited (with Orya Tishby) of The Therapeutic Relationship: Innovative Investigations.

Dr. Wiseman is a certified clinical psychologist in private practice in Kiryat Tivon, Israel.

Reviews & Awards

The link between relationship processes and technique is brought to life in a rich array of engaging case studies that demonstrate how successful therapists negotiate the relationship, make key moment-to-moment decisions, and promote positive change in their clients.
Midwest Book Review

Blending research findings with clinical observation, this volume describes and vividly illustrates what clinicians and researchers need to know about the therapy relationship. It documents what one needs to know in understanding how therapy works, regardless of one's orientation.
—Marvin R. Goldfried, PhD
Distinguished Professor of Psychology, Stony Brook University, Stony Brook, NY

All roads lead to the therapeutic alliance, and Tishby and Wiseman's masterly compendium of clinical cases shows us how to get there. Infused with a spirit of methodologic pluralism and an urge to "pull apart the fabric" of the therapeutic relationship to understand its patterns, these cases bring clinicians, educators, and researchers into the nuances of that unique connection and demonstrate the clarity and sensitivity needed to find attunement and empathy.
—Richard F. Summers, MD
Clinical Professor of Psychiatry, Senior Residency Advisor, Perelman School of Medicine, University of Pennsylvania, Philadelphia

Tishby and Wiseman have gathered experts from diverse theoretical orientations to identify the research base of the psychotherapy relationship on treatment process and outcome. This book uniquely emphasizes the immediacy of the therapeutic encounter to illustrate how specific therapist responses to specific client statements are grounded in research. It is essential reading for teachers, supervisors, and students but also for veteran psychotherapists who will learn new ways to develop and enhance relationships with their clients.
—Abraham W. Wolf, PhD
Professor Emeritus of Psychology in Psychiatry, Case Western Reserve University, Cleveland, OH

This compelling volume offers fresh and useful perspectives on the psychotherapy relationship. A fascinating report from the cutting edge of our profession and a unique and practical resource for clinicians and researchers at all levels, from trainees to senior practitioners.
—Robert L. Hatcher, PhD
Director, Wellness Center, Graduate Center–City University of New York, NY