A Practical Clinical Suggestion for Strengthening the Alliance Based on a Supportive-Expressive Framework

Supportive-expressive psychodynamic psychotherapy builds on the core conflictual relationship theme (CCRT) as a framework for case formulation and interpretations. Much has been written on how interpretive techniques should be implemented in the treatment sessions to bring about therapeutic change, but less is known about implementing supportive techniques for strengthening the alliance using this framework. The present article uses CCRT formulations to articulate clear and concrete supportive techniques that clinicians can use in clinical practice. To this end, we offered 4 main steps and used clinical case examples to illustrate them. We described how the CCRT formulation may be used to rise above relational enactments in a supportive way and how it can provide a corrective emotional experience to enhance the emotional bond between the patient and the therapist. Clinical cases from the pilot phase of a randomized clinical trial, together with theoretical conceptualizations and empirical findings, are intertwined to demonstrate the potential of the techniques presented.