Ruptures in the alliance are common clinical phenomena that therapists will inevitably encounter and need to be prepared to recognize and collaborate with the client to repair. Rupture repair is associated with a positive outcome in treatment, suggesting that repairing a rupture may not only address difficulties that impede the work of therapy, but may also facilitate a corrective experience that contributes to positive change. This chapter presents several clinical strategies for repairing ruptures, particularly in the context of CBT. We begin by discussing how therapists can use interpersonal markers of confrontation and withdrawal, as well as intrapersonal markers of their own emotional experience, to recognize when a rupture process is occurring. We then describe several pathways to repair: two pathways that employ immediate repair strategies, alliance-building and maintaining strategies and strategies for renegotiating therapy tasks or goals and an expressive pathway of strategies for exploring the rupture, particularly the use of metacommunication. We conclude with a clinical example that illustrates how a therapist might navigate choice points related to using these different strategies in the course of repairing a rupture.