The therapeutic relationship should be of interest to all clinicians. Most of us have been trained that a good relationship is the rock upon which effective therapy is built, and if nothing else we can all recite at least three important words on the subject: warmth, genuineness and empathy. But it is easy to part ways from the topic much beyond this point – perhaps to regard it as a “given”, or of lesser priority than devoting our energies to the exploration and practice of more conceptually distinctive, technical, or “sophisticated” components of cognitive behavioural therapy.

In this new paperback edition, Paul Gilbert and Robert Leahy do a wonderful task of drawing our attention back to the neglected area of the therapeutic relationship and show us that we can benefit and enrich our understanding by a deeper analysis of the issues involved. They asked a number of eminent authors to share recent research and advance their views on such issues as: the importance of early engagement and rapport, how to deal with ruptures and boundary setting, conceptualizations of dynamic interpersonal processes in the relationship such as transference and countertransference, and matters concerning endings and problems therein.

In 12 engaging chapters, the authors introduce us to a number of thought-provoking perspectives. For example, Miranda and Andersen take on the thorny phenomenon of transference, a central construct within psychodynamic approaches but often sidelined or even ignored in cognitive therapy. They present a model of how to conceptualize transference from a social-cognitive perspective, invoking the notion that mental representations of the “self” are tied in memory to representations of “self-other” relationships. Gilbert also invites us to explore the mysterious ways that two people's minds can influence one another; this time drawing upon evolutionary ideas and recent neurological findings such as “mirror neurons” and their possible role in our understanding of empathy. Katzow and Safran conceptualize the therapeutic alliance as a “negotiation” and offer a stage model of resolving ruptures when things go wrong. Newman reminds us that there may be a two-way interaction between alliance variables and outcome. He offers practical advice in dealing with harder-to-engage clients, including some common traps of becoming over-optimistic (and therefore invalidating) micro-managing clients' thinking and becoming embroiled in power struggles or competition. Leahy unpacks the possible interactions in clients' and therapists' differing schemata and sheds light on the emergent mismatches that can arise, along with the unhelpful patterns of compensatory behaviour that may be established.

These are just some highlights in a fascinating read, covering themes also of attachment, compassion, acceptance and supervision. Nevertheless, I was left with a puzzle. On the one hand, the book made me realize what an unsophisticated, reductive view I had before of the therapeutic relationship and perhaps how CBT has unwisely neglected the topic. On the other hand, in my experience, many highly effective and compassionate therapeutic relationships have been formed by the cognitive therapists I have had the pleasure to work and train with. Perhaps we are doing something right that we yet only barely understand. Certainly, in any event, these chapters contain much wisdom, the assimilation of which can only take us, whether clinicians or researchers, in a positive direction. In summary, Gilbert and Leahy have assembled a scholarly and thoughtful collection of explorations into the complex, intriguing cognitive and interpersonal phenomenon that is the therapeutic relationship.