J. Christopher Muran's research while affiliated with Beth Israel Medical Center and other places

Publications (11)

Chapter
Full-text available
This chapter summarizes the empirical research on psychodynamic therapies focusing on 3 main questions: 1) what is the evidence for the efficacy of dynamic therapy? 2) what do we know about the role of the therapeutic alliance in dynamic therapy? 3) what do we know about the main mechanisms of change in dynamic therapy?
Article
This article reviews and synthesizes the diverse contributions of the authors in this issue of In Session: Psychotherapy in Practice. It presents a schematization of direct and indirect interventions that therapists typically implement to address problems related to the tasks and goals of treatment, or the affective bond between therapist and clien...
Article
Full-text available
This article outlines some of the main features of a research program on ruptures in the therapeutic alliance and reports some of the major findings to date. A rupture in the therapeutic alliance is a deterioration in the quality of the relationship between patient and therapist; it is an interpersonal marker that indicates a critical opportunity f...
Article
The purpose of this book is to present current trends in understanding the self in the context of the psychotherapeutic situation. By confronting other perspectives and coming to understand them, we can clarify both similarities and differences in a more nuanced way and learn to enrich our point of view. We can move to a new, shared understanding o...

Citations

... Ruptures have been defined in general terms as (1) any disagreements on how the patient and therapist work together (e.g., on tasks such as exploring thoughts and feelings, creating in-session exercises and betweensession experiments 1 ) and to what end (goals such as greater self-awareness, skill development, and/or decrease in symptom distress), and as 2) a deterioration in the bond (the extent to which the patient and therapist distrust or disrespect each other; see Safran & Muran, 1998, 2006. We have also defined them in terms of breakdowns in how patients and therapists negotiate their respective needs or desires (Muran, 2019;Muran & Eubanks, 2020). ...
... (d) emphasis on past experiences; (e) focus on interpersonal experiences; (f) emphasis on the therapeutic relationship; and (g) exploration of wishes, dreams or fantasies. The Safran and Muran (2000) model of intervention was also used for treatment ruptures and repairs as they occurred in the therapeutic relationship. Treatment was open-ended in length rather than of a fixed duration. ...
... For each of the factors measured, information based on scientific literature, treatment protocols, and professional literatures is provided to help the therapist navigate areas in which there seem to be problems in the patient. For example, if there is a problem with the therapeutic alliance, a therapist may choose from several alliance rupture repair strategies, inspired by the work of Safran and Muran (2000), such as offering transparency about a therapist's own intentions or errors. Moreover, the most advanced ROM systems also offer opportunities for treatment selection at the start of treatment with algorithms that predict which treatment is likely the most beneficial to the patient, and opportunities to learn from others (e.g., viewing video recordings from other treatments with similar patients). ...
... Morey (2019) identifies that enactment-informed interventions such as recognition and acknowledgement via interpretation rather than avoidance or direct management of behavior are essential to therapeutic progress. Other researchers have found that the management of rupture-repair episodes was positively related to good treatment outcomes (Safran et al. 2001). In summary, when clinicians acknowledge the multiple subjectivities, recognize ruptures and attend to the repair, they can powerfully transform and facilitate meaningful clinical work. ...
... Further, the interpreter's failure to attend to the patient's conversational contributions created a face-threatening situation and, because the interpreter was not able to engage in effective face management, the patient remained perplexed and began to turn to the OT, someone with whom she does not even share a common language, for help. At this point in the conversation, we would claim that an alliance rupture had occurred (Safran and Muran 1996), one that has potentially negative consequences for the patient-interpreter (and ultimately including the OT) relationship. The benefit of our analysis is that we can pinpoint where these ruptures occur, how they came into being interactionally and, therefore, how they may be avoided. ...
... A possible explanation that has been offered to account for this negative association is that therapists use interpretative actions in an attempt to repair a weakened alliance (Barber, Muran, McCarthy, & Keefe, 2013). The results of the current study suggest an alternative explanation to account for this negative association, such that patients simply do not expect such interventions to take place, and hence respond negatively to their presence during sessions. ...
... As such, in the counselling practice, the counsellor"s self as a social construction connotes that he/she is shaped through interaction with the client, the world each of them brings into the encounter, and the broader social, cultural, historical, and political context in which the therapy takes place (Muran, 2001). Health and illness as socially constructed indicate that they are not regarded as "facts," but narratives. ...