Edited and authored by leading psychotherapy researchers, this book exceeds its aims, and offers readers a comprehensive review of what is known about this important clinical concept. It comprises three sections: a critical summary of empirical studies, discussion of the alliance from different psychotherapeutic perspectives (covering all the major models found in the National Health Service), and reports of alliance training programmes.

First, we are given the origins and descriptions of the concept, and a helpful explanation of the relationship between technique and alliance. Support for and criticism of the alliance concept is well summarised. The validity of the alliance as a predictor of outcome in psychotherapy is critically appraised. The alliance comes out as a pantheoretical concept, intimately linked to but different from the relationship between therapist and patient. This entire section felt like essential reading for anyone practising time-limited psychotherapy.

The second section, covering different theoretical perspectives and guidance, is more of a patchwork. The variation between models in approaches to fostering a good alliance is apparent, but therapeutic sectarianism seems not to be prevalent here. Overall, the most detailed evidence-based practice guidance is to be found in the psychodynamic chapter.

The third section of the book gives fascinating accounts of psychotherapy training studies aimed at maximising the alliance. What comes across most strongly is the challenge for trainee therapists of integrating structured approaches into an effective and personal therapeutic ‘style’. One chapter suggests augmenting traditional psychotherapy training (didactic teaching and supervised practice) with simulated therapy in a virtual reality environment, which sounds futuristic (and expensive!). I preferred other chapters which advocate for role-play and video feedback instead. All of these final chapters convey the attention to detail needed in training programmes for a complex skill-set like psychotherapy.

This book is highly technical in the sense that it aims to be evidence-based rather than an opinion piece. The editors have managed to achieve this scientific goal while still making the book readable. Their stated aim was to cut to the chase in presenting research findings, and they did so throughout. A multitude of both qualitative and quantitative studies are deftly presented here. This is an authoritative review of a specialist area, and should be a reference text for psychotherapists of all backgrounds. It will also be of interest to any psychiatrist who wants to appraise their own alliance-forming skills.