John Christopher Muran

John Christopher Muran
Adelphi University | AU · Gordon F. Derner School of Psychology

Ph.D.

About

225
Publications
182,722
Reads
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7,011
Citations
Introduction
J. Christopher Muran currently works at the Gordon F. Derner School of Psychology, Adelphi University and at Mount Sinai Beth Israel Brief Psychotherapy Research Program, Mount Sinai School of Medicine.
Additional affiliations
January 2022 - present
New York University
Position
  • Faculty
July 2016 - present
Icahn School of Medicine at Mount Sinai
Position
  • Faculty
March 2009 - present
Adelphi University
Position
  • Professor (Full)
Education
September 1993 - June 1998
New York University
Field of study
  • Postdoctoral Program in Psychotherapy and Psychoanalysis
September 1989 - August 1990
University of Toronto
Field of study
  • Postdoctoral Fellowship in Cognitive Therapy, Clarke Institute of Psychiatry
September 1985 - December 1989
Hofstra University
Field of study
  • Combined Professional-Scientific Psychology

Publications

Publications (225)
Article
Objective: The purpose of this study was to provide some definition of rupture repair in a cognitive-behavioral therapy (CBT) for personality disorders, specifically how treatment tasks or goals are renegotiated. Method: Following a task analysis, a rational model was developed with the support of an expert panel. An empirical analysis was conducte...
Article
Most research on alliance rupture-repair processes in psychotherapy has been carried out with adults and little is known about the alliance dynamics with adolescents, especially in psychodynamic treatments.Objective: This study aimed to better understand the process of alliance rupture-resolution and its role in a good-outcome case of a depressed a...
Article
A brief review of the conceptual and empirical literature on the alliance construct from its analytic origins, through its integrative applications, and to its empirical investigations regarding its predictive and causal relation to psychotherapy outcome and including research on alliance ruptures and their repair.
Article
About one in five clients drops out of treatment prematurely. Premature termination has been found to correlate with patient, therapist, and treatment factors, as well as complex interpersonal processes, including ruptures in the therapeutic alliance. This study examines the therapeutic alliance using a qualitative approach to patient-, therapist-,...
Article
This study aimed to determine how control charts ‐ a form of time‐series line graphs ‐ can be implemented in psychotherapy research to indirectly identify probable rupture‐repair episodes that are associated with psychotherapy outcome. There is no current standard in psychotherapy research with regard to how to use control charts to identify ruptur...
Article
Objective: The aim of the current study is to explore experiences of trainees engaged in alliance-focused training (AFT), a group supervision modality with an explicit focus on awareness of ruptures and implementation of repair strategies. Using Cognitive Behavioral Therapy (CBT) group supervision as a point of comparison, the study examines super...
Article
This commentary highlights common principles shared across the diverse clinical case examples featured in this In Session issue on Rupture Repair in Practice. We discuss the importance of therapists recognizing subtle signs of rupture and responding to ruptures with curiosity and compassion. We also consider how therapists can use repair strategies...
Article
In this introduction to this issue on Rupture–Repair in Practice, we present our understanding of alliance ruptures using common language to appeal to all theoretical orientations. Specifically, we define withdrawal movements away from another or oneself (efforts towards isolation or appeasement) and confrontation movements against another (efforts...
Article
Group supervision presents unique opportunities for psychotherapy trainees to deepen their understanding of alliance ruptures and repair strategies. Trainees can explore challenging clinical moments and benefit from diverse perspectives and support. Group supervision also provides trainees with multiple opportunities to experience ruptures and repa...
Article
Full-text available
Objective: Even though the early alliance has been shown to robustly predict posttreatment outcomes, the question whether alliance leads to symptom reduction or symptom reduction leads to a better alliance remains unresolved. To better understand the relation between alliance and symptoms early in therapy, we meta-analyzed the lagged session-by-se...
Article
The empirical literature on therapist training paints a quite complicated picture (Hill & Knox, 2013; Knox & Hill, in press). In their important effort to advance the literature, Frank, Becker-Haimes, and Kendall (2020) focused their attention on training in evidence-based interventions (EBIs or treatment techniques with empirical support) and revi...
Article
Full-text available
Objective: The objective of the study was to provide a foundational understanding of mental and physical pre-performance routines of elite squash athletes. Method: The sample included 18 squash professionals who were ranked in the top 10 in the world, balanced by gender, generation, and nationality. Each participated in a semi-structured interview...
Article
Previous studies have shown that individuals with personality disorder (PD) suffer from significant interpersonal distress. Some PDs, such as avoidant personality disorder (AvPD), have been characterized with a clear homogeneous interpersonal profile. Other PDs, such as obsessive-compulsive personality disorder (OCPD), have shown significant hetero...
Chapter
Full-text available
Patient and therapist interpersonal interactions and the negotiation of negative process, often referred to as rupture resolution, have been shown to be critical to the change process in psychotherapy. In this chapter, we will present an evidence-based stage process model of rupture resolution, demonstrating a progression from mutual recognition of...
Preprint
Background: To draw clinically meaningful evidence-supported implications about the alliance-outcome association, recent studies have investigated patient-therapist congruence on ruptures in alliance. The present study investigated patient-therapist congruence on ruptures and its consequences on subsequent session outcome in two types of treatments...
Article
Full-text available
Background: To draw clinically meaningful evidence-supported implications about the alliance-outcome association, recent studies have investigated patient-therapist congruence on ruptures in alliance. The present study investigated patient-therapist congruence on ruptures and its consequences on subsequent session outcome in two types of treatments...
Chapter
Full-text available
The authors discuss the phenomena of “misattunements,” or ruptures, in the working alliance. They present a set of skills and tools that aim to help therapists recognize and identify when ruptures occur, and they introduce a model for managing these moments. Albeit difficult, ruptures in the working alliance are common, and research shows that a th...
Article
Full-text available
Objectives: Literature on outcome assessment suggests that 35–40% of patients in randomized control trials terminate treatment with unchanged or higher levels of symptomatology. The goal of the present study was to shed light on this phenomenon and the factors accounting for it using a single case study design that investigates the process and outc...
Chapter
A rupture is a deterioration in the therapeutic alliance, manifested by a disagreement between the patient and therapist on treatment goals, a lack of collaboration on therapeutic tasks, or a strain in their emotional bond. This chapter presents the most frequently used measures of alliance ruptures and clinical examples to illustrate their repair....
Article
Full-text available
Jeremy D. Safran’s contributions to our understanding of the complexities of the therapeutic relationship, and its role in the process of patient change in psychotherapy, have been profound. In this paper, we briefly summarize the evolution of his thinking about the alliance and highlight how his ambivalence about this construct contributed to his...
Article
Ambivalence, resistance, and alliance ruptures are three terms commonly used in psychotherapy, across different theoretical approaches and modalities. However, it is still not clear how those terms are related and how the connection can be used to maintain a therapeutic alliance while addressing clients’ ambivalence. This paper aims to briefly desc...
Article
The current study explored trainee therapists' experiences in alliance-focused training (AFT), a form of group supervision focused on training therapists to recognize and negotiate alliance ruptures. We analyzed interviews with 36 former trainees who received AFT during their predoctoral psychology internships. Findings centered on trainees' views...
Article
Full-text available
Decades of work by Jeremy Safran and his colleagues have established that ruptures in the therapeutic alliance are not necessarily obstacles to the treatment, and that the process of repairing these events has the potential to deepen the therapeutic relationship and promote change. The field of alliance rupture research has largely focused on thera...
Article
Grounded in a view of the therapeutic alliance as a process of intersubjective negotiation between patient and therapist, this study examines therapist reflective functioning (RF) as a predictor of process and outcome of psychotherapy in 43 cases of brief relational therapy. Psychotherapy process was measured with the Working Alliance Inventory, Se...
Article
Objective: Two decades of empirical research suggest that changes in symptoms are not linear, and many patients gain much of their symptom reduction in one between-sessions interval. Theoretically, such gains are expected to be manifested in the working alliance as well, following a rupture session; however, no study to date has directly examined b...
Article
Present an obituary for Jeremy David Safran (1952-2018). In 1993, Safran became full professor and director of clinical training at the New School for Social Research. At the New School, he developed the program with an affiliation to Beth Israel Medical Center, where he was a principal consultant on a psychotherapy research program founded by Arno...
Article
Objective: Our aim was to examine the reliability and validity of the Rupture Resolution Rating System (3RS), an observer-based measure of alliance ruptures and resolution processes. Method: We used the 3RS to rate early sessions from 42 cases of cognitive behavior therapy. We compared the 3RS to a simplified version of the Structural Analysis o...
Article
A rupture is a deterioration in the therapeutic alliance, manifested by a disagreement between the patient and therapist on treatment goals, a lack of collaboration on therapeutic tasks, or a strain in their emotional bond. We present the most frequently used measures of alliance ruptures and clinical examples to illustrate their repair. To examine...
Conference Paper
Full-text available
Aim: One of the most prominent achievements attributable to psychotherapy probably stands in the vast body of literature demonstrating its efficacy for a variety of diagnoses. However, a close look at the literature shows that some foundational questions such as defining and assessing outcomes have not yielded extensive literature. This study inves...
Article
Full-text available
Objective: Striking the balance between creating challenge through confrontation (drawing attention to discrepancies) to encourage change and offering support through the therapeutic relationship to ensure safety for patients represents a central issue for psychotherapists. The aim of the present study was to assess immediate effects of confrontati...
Article
Full-text available
This article attempts to integrate the literature on emotion regulation (i.e., the trajectory of emotional experience) and on pre-performance routines (i.e., how performers prepare themselves in advance to maximize their performance). The authors propose that the development of preperformance routines can be advanced by careful consideration of con...
Poster
Full-text available
Client ambivalence toward change has been shown to be a central influence on outcomes in psychotherapy, as higher levels of ambivalence can result in limited engagement in therapy. Furthermore, research has consistently demonstrated the importance of the therapeutic alliance, which can be impacted by alliance ruptures, or moments of tension or mis...
Technical Report
Full-text available
This document includes scripts that elaborate on the therapeutic alliance interventions listed in the OQ Clinical Support Tools Manual – Brief (CST: Lambert et al., 2007).
Article
Full-text available
The working alliance is one of the most consistent predictors of outcome. Yet, little empirical knowledge exists on how therapists can use this association to maximize the outcome of cognitive behavioral therapy (CBT) for individual clients. The present study aimed to examine pre-treatment client interpersonal characteristics that determine what fu...
Article
Objective: It has been demonstrated that patient perspective on alliance can predict subsequent treatment outcome as reported by the therapist, but not the other way around. This study aimed to investigate the circumstances in which therapists can provide estimations of alliance capable of predicting patient perceptions of subsequent session outcom...
Article
Objective: In order to improve success rates in psychotherapy, an alliance-focused training (AFT) protocol was developed and evaluated with regard to patient-therapist interpersonal behavior in a 30-session protocol of cognitive-behavioral therapy for outpatients comorbid with Axis I and II conditions conducted in a medical center setting. Method:...
Article
Objective: The study of alliance rupture has become quite prevalent since 1990 and especially in the past 10 years where we have seen a noticeable surge in empirical publications on the subject. This honorary paper attempts to provide a critical review of this literature from the perspective of someone who has contributed to it in his collaborative...
Conference Paper
Full-text available
Presidential Address
Article
Full-text available
In this article, we examine how the different attachment patterns enable or hinder the resolution of ruptures in the therapeutic alliance. We try to show that secure and insecure patients alike may experience ruptures in the therapeutic alliance, but that their abilities to participate in resolving such ruptures differ markedly. Recent findings...
Article
Full-text available
The aim of this article is to examine an integrative model of psychotherapy, assimilative psychodynamic psychotherapy (APP), and to illustrate it with a case conducted by the first author. This examination strives to understand ways in which APP’s approach to therapy is faithful to the psychodynamic model and compatible with the cognitive–behaviora...
Article
This study investigates the utility and psychometric properties of a new measure of psychotherapy process, the Alliance Negotiation Scale (ANS; Doran, Safran, Waizmann, Bolger, & Muran, 2012). The ANS was designed to operationalize the theoretical construct of negotiation (Safran & Muran, 2000), and to extend our current understanding of the workin...
Poster
Full-text available
Small, R. B., Muran, J. C., Safran, J. D., & Eubanks, C. (2016, June). The impact of Alliance-Focused Training on therapist self-expression, emotional involvement, and alliance perspective. Poster presented at the 47th International Annual Meeting of the Society for Psychotherapy Research, Jerusalem, Israel.
Article
Objective: This study examines the validity of the Alliance Negotiation Scale (ANS) in a psychotherapy research program. Analyses were designed to evaluate the relationship between the ANS and psychotherapy process and outcome variables. Method: Data were collected in a metropolitan psychotherapy research program. Participants completed 30 sessi...
Article
Objective: Better alliance is known to predict better psychotherapy outcomes, but the interdependent and interactive effects of both therapist- and patient-reported alliance levels have yet to be systematically investigated. Method: Using actor-partner interdependence model analysis the authors estimated actor, partner, and 2 types of interactiv...
Article
Full-text available
Objective: Notwithstanding consistent findings of significant relationships between the alliance and outcome, questions remain to be answered about the relatively small magnitude of those correlations, the mechanisms underlying the association, and how to conceptualize the alliance construct. We conducted a preliminary study of an approach to the...
Book
This book attempts to foster collaboration between clinicians and researchers by presenting the experiences of 11 groups of contributors who have conducted practice-oriented research (POR) in various countries and naturalistic settings. Each of these groups was asked to describe the context in which their collaborative initiatives took place, as we...
Article
Despite the widespread use of audio or video recording in psychotherapy training and research, there has been surprisingly little exploration of patient reactions to the use of recordings in psychotherapy, and there is even less written about patient factors that influence their willingness to consent to recording practices or the impact of such a...
Article
Full-text available
Objectives: The Adult Attachment Interview (AAI) has been the gold standard of attachment assessment, but requires special training. The Relationship Scales Questionnaire (RSQ) is a widely used self-report measure. We investigate how each correlates with brain activity during appraisal of subjects' mothers. Methods: Twenty-eight women were score...
Chapter
Full-text available
The conceptual and empirical literature on alliance ruptures and their resolution is a developing one that is receiving increasing attention, especially as clinicians and researchers continue to face the challenges of treatment resistance and failure across all treatment orientations. Alliance ruptures have been defined as negative patient communic...
Conference Paper
Full-text available
In two National Institute of Mental Health (NIMH)-funded studies, our program has developed alliance-focused treatment and training (AFT) protocols and has demonstrated their beneficial effect on treatment resistance and interpersonal process in psychotherapy. AFT is founded on relational principles derived from research on cognitive, affective, an...
Data
Full-text available
This is the training protocol for the Beth Israel Fidelity Scale that is currently implemented to check for therapist adherence in the Mount Sinai Beth Israel Psychotherapy Research Program.
Article
This paper serves as an introduction to the 25th anniversary issue of Psychotherapy Research. It includes a consideration of the original aims of the journal in light of the most cited articles, various developments in research orientation and methodology, and most recent publications. It demonstrates both diversity and consistency in content over...