Through the book's nine chapters, Druss gives the reader an overview of the landscape of psychotherapy, from the initial appointment to a return to treatment after termination, visiting the terrain through case stories. Although clearly drawing on his twenty-five years of experience as a supervising psychoanalyst, Druss emphasizes the common need to create a good working alliance, whether embarking on a cognitive-behavioral course, consultation-liaison work, or long-term psychotherapy. He teaches that a good therapeutic alliance can take flexibility and imagination to develop; he provides the examples of connecting with one patient through writing on a chalkboard, with another by sharing stamp collections. While promoting creativity, Druss is clear about maintaining boundaries. He conveys the inevitability of idiosyncrasy in our patients, and he provides encouragement through his own example of persistence in making connections in the face of distrust.