Review of Coasting in the countertransference: Conflicts of self interest between analyst and patient.

Reviews the book, Coasting in the countertransference: Conflicts of self interest between analyst and patient by Irwin Hirsch (see record 2008-02945-000). The term countertransference now often incorporates all the conscious as well as unconscious reactions a therapist has toward their patient, and as such has become a primary source of data about the patient’s intrapsychic and interpersonal experience. In his remarkable book Coasting in the Countertransference, Irwin Hirsch returns us to the earlier more problematic notion of countertransference, only Hirsch’s focus is no longer on the internal drives and resistances of the therapist. For Hirsch, the economic and social circumstances under which psychotherapists practice have a dire—and mostly unacknowledged—impact on clinical processes. This is an absolutely necessary book that forces us to reexamine some of the painful social conundrums of the current state of dynamic psychotherapy as well many of the contemporary technical innovations which we are most smugly pleased with. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Review of Supportive therapy for borderline patients—A psychodynamic approach.

Reviews the book, Supportive therapy for borderline patients—A psychodynamic approach by Lawrence H. Rockland (see record 1992-97952-000). In this book, the author addresses the supportive psychotherapy of clients with Borderline Personality Disorder (BPD). While there is an abundant literature on expressive and psychoanalytic treatments for the borderline client there is very little on supportive approaches in the psychotherapy literature. Rockland offers a guide to the therapist who, after careful assessment and treatment planning, decides that a primarily supportive psychotherapy is most appropriate for his/her client, either initially or throughout the treatment. Using a practical, how-to format, Rockland applies the principles of Psychodynamically Oriented Supportive Therapy (POST)—an approach that he formulated (Rockland, 1989)—to clients with BPD. This text will assist clinicians in conceptualizing interventions that are often already part of their "supportive" repertoire but are applied in an unorganized and unsystematic fashion. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Review of Eye movement desensitization and reprocessing: Basic principles, protocols, and procedures.

Reviews the book, Eye movement desensitization and reprocessing: Bask principles, protocols, and procedures by Francine Shapiro (1995). This text is a carefully crafted, almost 400 page book on the theory, mechanisms and workings of eye movement desensitization and reprocessing (EMDR). Francine Shapiro espouses much of what is important in psychotherapy and puts aside much of what has been controversial as she describes EMDR. Simply put, this work is the best representation of the procedure to date. For the clinician who uses this procedure, this book is a must. It outlines its necessary ingredients, standard problems, newer uses, typical mistakes, and changes (over its six year oddessy). Several strengths are noteworthy, including EMDR's painstaking assessment of the client, client safety factors, client preparation, as well as the importance of identifying the moving goalpost of "best" targets, needed cognitions, emotions, and sensations. Importantly too, the focus of EMDR is targets and not disorders. Implied but important to underscore, EMDR applies an essential rubric of psychotherapy, the nondirective unfolding of the client according to a least restrictive principle of intervention (by the therapist). EMDR seems to have this down well. If movement is present, the therapist remains truly nondirective, and uses simple rules; if not, a more active "therapeutic intervention" is called for. A procedure that can perform these tasks and do this in a user-friendly manner is not easy to find. This book highlights this unfolding dynamic. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Countertransference: The professional identity defense.

Suggests that too much of what happens in therapy involves the unconscious need of professionals to defend their professional images at the expense of the client (e.g., if the client does not respond in therapy as expected by the therapist, the client—not the therapist—is resisting). This is true of professionals of theoretical persuasions and may be manifested as (a) data denseness—a blindness to certain client data that would require a response different from the orthodox response; (b) a smug attitude toward one's own understanding of the client; and (c) structural rigidities in conducting the work that predetermines responses. It is suggested that this difficulty stems not only from the practitioner's anxiety, but from biases built into the theory of various schools of therapy. Each school sets up therapy taboos. The violation of these taboos may act operationally to introduce new important data rather than simply interfering with the fine tuning of therapeutic focus. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Review of The psychotherapy of the self.

Reviews the book, The psychotherapy of the self by Hyman L. Muslin and Eduardo R. Val (see record 1987-98090-000). This book is written for mental health professionals. Its intention is to present criteria for psychopathology from a self-psychological viewpoint. Based on a differential diagnosis, a psychoanalytic treatment modality is suggested that is judged to be most suitable to the assessed psychopathology. This book offers excellent clinical material, presented in detail, with an ongoing commentary which illuminates the interviewer's interpretation of the data presented. The problems with the book do not lie in the clinical material presented. Its problems result from the way in which the material is organized and the theoretical claims that are stated or implied. A more controversial but equally important criticism of the book is the manner in which data collection and the relationship between therapist and client are conceptualized. The reviewer found the book to contain some major shortcomings. It is theoretically lacking, though clinically stimulating. A reader will find the book valuable for its clinical material and the manner in which this is presented. In addition, there are insights to be gained relating to the functioning of the therapist as he or she experientially participates in the process of psychotherapy. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Studying psychotherapy using the one-with-many design: The therapeutic alliance as an exemplar.

Most psychotherapy research uses a one-with-many design, in which each therapist (the one) treats multiple clients (the many), which raises the challenge of nonindependent data. We present a statistical model for analyzing data from studies that use a one-with-many design. This model addresses the problems associated with nonindependence and can address theoretically relevant questions. To illustrate this model, we analyzed data in which 65 therapists and their 227 clients rated their therapeutic alliance. The primary finding was that both therapist and client alliance ratings were largely relational (i.e., specific to the unique therapist–client combination). There was little consensus among clients treated by the same therapist about the quality of the therapeutic alliance, although some therapists reported forming stronger alliances than other therapists. There was substantial dyadic reciprocity, indicating that if a therapist reported an especially good alliance with a particular client (better than with his or her other clients), then that client was also likely to report an especially good alliance (better than those reported by the therapist’s other clients). (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Review of A tired woman's guide to passionate sex: Reclaim your desire and reignite your relationship.

Reviews the book, A tired woman's guide to passionate sex: Reclaim your desire and reignite your relationship by Laurie B. Mintz (2009). Statistics bear it out: The most common sexual complaint that women have is low desire, and the most common reason that women cite is being too tired for sex. A tired woman’s guide is a thorough, research-based, cognitive– behavioral self-help program to help women not only revive their interest in sex but also be more assertive and take more time for self-care, which is sorely absent in the contemporary lives of women. Because the author has taken care to eliminate the crass language that is sometimes found in popular books about sexuality, it is a book that a psychotherapist or health care provider could easily recommend without fear of offending a female client of any age. The book is organized into nine chapters and is written in a professional and friendly manner that will appeal to the lay reader. Although the purpose of the book is to educate and motivate a lay audience, the book would be improved by having specific references to research included so that a psychotherapist unacquainted with the research in the field of female sexual health would be able to do further reading or research on the topic. Even a brief list of references to major studies would be preferable to none at all. Second, the book lays the blame for being “too tired” squarely on the woman’s shoulders. Much is made of the woman’s task of helping her partner understand how she feels and what she wants. Although this is a good ideal, it assumes that the male partner is receptive to feedback or will make the requested changes. Although the author recommends pornography made for women by a woman, it may still be a potential turnoff for some readers. Clinicians need to be prepared for a potential exploration of the topic should they recommend the book. Still, A tired woman’s guide to passionate sex is better than many books on the topic. Perhaps because Mintz is brave enough to admit to her readers that she, herself, was a woman too tired for sex at one time and needed to go on her own journey to recover her lost libido, the book works as an empathic companion to the woman who is puzzled by her own lack of drive. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Review of Transformative relationships: The control-mastery theory of psychotherapy.

Reviews the book, Transformative relationships: The control-mastery theory of psychotherapy by George Silberschatz (see record 2005-00928-000). This book is an edited text that thoroughly reviews theory, research, and practice on control-mastery theory, a psychodynamic method developed at the San Francisco Psychoanalytic Institute. Overall, this is an impressive research program summarized in this chapter in a very accessible manner. The research program is a good case study of an effort to build an evidence-based treatment close to clinical reality. In addition, the book as a whole is probably the best way to get a summary of all aspects of control-mastery theory as well as a clear and interesting exposition of different aspects of the theory, research, and practice. One important clinical implication of the testing concepts is that the meaning of a therapist's interventions will vary depending on what specific pathogenic beliefs the client is testing. Control-mastery theory is highly case specific; a technique that is helpful to one client may not be appropriate or helpful to another. How effective the therapy is will be determined not by the technique used but by the extent to which the therapist can disconfirm the client's pathogenic beliefs. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Therapist strategies for building involvement in cognitive–behavioral therapy for adolescent depression.

This study examined predictive relations between 9 therapist behaviors and client involvement in manual-guided, cognitive–behavioral therapy for adolescent depression. Analyses included 42 adolescents who met criteria for a depressive disorder (major depressive disorder, dysthymic disorder, or adjustment disorder with depressed mood) and who were treated in school-based clinics. Therapist behaviors hypothesized to promote client involvement were coded from Session 1 audiotapes; client involvement was coded from Session 2. Unlike prior research, the current study examined associations between behaviors and involvement while controlling for initial client resistance to isolate the therapist contribution to involvement. Results show that 3 therapist behaviors from Session 1 (attending to teen’s experience, exploring teen’s motivation, and less structure) predicted greater client involvement in Session 2, controlling for initial resistance. Only exploring motivation and less structure uniquely predicted Session 2 involvement when the 3 behaviors were examined simultaneously. Session 1 therapist behaviors predicted significant variance in involvement at Sessions 2, 4, and 8. Client initial presentation as resistant was associated with more exploring motivation and praising, but initial resistance did not explain associations between therapist behaviors and involvement. Implications for implementing evidence-based treatments are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Influence tactics in psychotherapy.

Examined the process of psychotherapy within the context of social power theory. Therapist influence acts were classified in terms of the goals or reasons why therapists exercised influence and the strength of the influence attempt. The analysis was based on 22 tapes of psychotherapy sessions, provided by 5 female and 6 male therapists. Each therapist provided a tape of 1 male and 1 female client. Findings indicate that therapists were consistent in their use of tactics from one client to another. Male therapists, compared with female therapists, used significantly more influence tactics and interrupted their clients significantly more often. Therapists of both genders used significantly more passive forms of influence earlier in the session and more active forms later. Therapists of both genders told female clients what to do significantly more often than they did male clients, although they significantly more often explained thoughts, feelings, and behaviors to male clients than to female clients. Therapists used stronger influence attempts—those judged as demanding a response from the client—significantly more frequently with female clients than with male clients. (20 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Review of Handbook of evidence-based psychodynamic psychotherapy: Bridging the gap between science and practice.

Reviews the book, Handbook of evidence-based psychodynamic psychotherapy: Bridging the gap between science and practice by Raymond A. Levy and J. Stuart Ablon (see record 2008-14828-000). This book presents a lucid and timely review of research advances assessing the efficacy and effectiveness of psychodynamic psychotherapies in treating many psychological disorders. From research on broad-based meta-analyses of the effectiveness of psychodynamic psychotherapy to close process analysis of therapist and patient interactions, the invited contributors of this volume translate complex research findings into clinically relevant information for clinicians working in the field. The volume is organized to lead the reader from broad-based reviews of psychodynamic psychotherapy outcome studies to examining in-session processes of patient– therapist interactions that affect the patient’s well-being, improvement, and personality change. In all, it lives up to its title and should be added to any clinician’s library. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The real relationship in psychotherapy: Relationships to adult attachments, working alliance, transference, and therapy outcome.

The purpose of this study was to understand how the real relationship (RR) relates to important process and outcome variables from both the clients’ and therapists’ perspectives. Using a sample of 31 therapist/client dyads at a university counseling center, the authors examined the RR at the 3rd session of therapy and at termination. The results revealed that client adult attachment avoidance was negatively correlated with client RR, while client adult attachment anxiety was uncorrelated. Therapists’ ratings of negative transference were negatively correlated with therapist-rated RR and were uncorrelated with client-rated RR. Hierarchical linear modeling analyses were conducted to predict postintervention outcome from client and therapist perceptions of the RR. Therapists’ ratings of the RR accounted for a significant amount of variance in client posttreatment symptoms while controlling pretreatment symptoms. Client-rated RR total scores and client and therapist 3rd-session alliance scores were not significant predictors of postsymptom ratings. Implications of the usefulness of measuring the RR in psychotherapy are discussed, as are recommendations for future study. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Review of Negotiating consent in psychotherapy.

Reviews the book, Negotiating consent in psychotherapy by Patrick O'Neill (see record 1999-08089-000). This book examines the importance of negotiating consent in psychotherapy, the extent to which it occurs between client and therapist during therapy, and its impact on the therapeutic process. The author achieves this through the use of qualitative research methods, conducting in-depth interviews with clients and therapists alike. O'Neill also incorporates the concept of narrative construction to frame the therapeutic process. According to the reviewer, this book is straightforward and refreshingly free from psychological jargon so it can be read by both professionals and the general public. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Review of Conducting child custody evaluations: A comprehensive guide.

Reviews the book, Conducting child custody evaluations: A comprehensive guide by Philip Michael Stahl (see record 1994-98484-000). In this book, the author details how the courts benefit from custody evaluations, how the family benefits, when evaluations could actually be harmful, and offers some particularly unique and useful suggestions on evaluator biases. He brings up the interesting issue of who is the real client/consumer. He understands that the client really cannot be the child independent of his/her family, even though we all mourn the cliche, "best interests of the child," as if this phrase were some operationally clear "guideline." A main author bias is "the best parenting is achieved with two parents" (p. 25). There is at least some research evidence (and clinical experience) that would dispute this in more cases than the author might care to acknowledge. A second bias is that children must perceive that their parents can develop a post-divorce relationship free of hostility in which each parent is a champion for the other. Stahl displays a keen understanding of the dynamics of the post-divorce world. In his heart, he seems more a therapist than an "objective evaluator" and harbors a strong bias to help people move productively through the crises that are everywhere in evidence in post-divorce situations. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Review of Attachment, play and authenticity: A Winnicott primer.

Reviews the book, Attachment, play and authenticity: A Winnicott primer by Steven Tuber (2008). Based on Tuber’s lectures in the doctoral program in clinical psychology at the City University of New York at City College, and his clinical work for the past 30 years or so, this book is the culmination of countless hours of playing with Winnicott—after all, becoming “real...takes a long time”—and Tuber makes no bones about his perspective. His admiring immersion in Winnicott is unabashed, unapologetic, and unencumbered by an allegiance to any particular overarching school of psychoanalytic thinking. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Review of Clinical interaction and the analysis of meaning: A new psychoanalytic theory.

Reviews the book, Clinical interaction and the analysis of meaning: A new psychoanalytic theory by T. Dorpat and M. Miller (see record 1992-98407-000). This text views psychoanalysis and psychoanalytic psychotherapy from the perspective of the newly proposed concept of "Meaning Analysis." The authors purport to advance psychoanalytic theory and technique by taking a fresh perspective on two important aspects of analytic encounter: the interaction between the analyst and analysand (therapist and patient) and how interactions in this relationship affect transference and countertransference. This book also examines the analysis of meaning and how treatment can assist in the understanding and reconstruction of client beliefs. The authors present a reanalysis of Freud's theory and the goal of the book is to elucidate the "flaws" in his work. The reviewer believes that many readers will be intrigued by the criticisms of Freud and the blending of more recent research into analytic models. This book is recommended for both analytically oriented therapists and interested readers who want to learn more about analytic treatment. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Review of Five therapists and one client.

Reviews the book, Five therapists and one client by Raymond J. Corsini (see record 1993-97589-000). To address the question of how the course of therapy would differ depending on the therapist's basic orientation, Corsini created a fictitious client with relatively minor but persistent problems. Therapists from five major systems of psychotherapy were chosen to write very specifically about how they would treat this client. The five systems include Adlerian, person-centered, rationale-emotive, behavioral, and eclectic. The book is divided into six chapters with one chapter for each of the five systems and an introductory chapter in which the problems of the client are given. This is an informative book for professionals, students, and those who are simply interested in the process of psychotherapy and human growth. The book provides very practical, basic information about the therapeutic process from five different perspectives as well as deeper theoretical insight into these respective approaches. Even the sophisticated reader will find much of value in Corsini's book. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Review of Turning points: Treating families in transition and crisis.

Reviews the book, Turning points: Treating families in transition and crisis by Frank S. Pittman III (see record 1987-97676-000). A masterful, witty, down-to-earth, humorous, and creative psychotherapist, Pittman's artistry as a clinician will make a lasting impression on readers of Turning points. The book demystifies family dynamics and the role of the therapist in the family drama. Thirty-one brief case vignettes illustrate Pittman's approach to families "in transition and crisis." Pittman's intent is to communicate the wisdom he has culled from over twenty-five years as a family therapist. This is an extremely ambitious task. Unfortunately, it is only partially realized in Turning points. Because the author appears to consider virtually any family problem to be transition- or crisis-related, the book's domain is any and all marital or familial concerns that a therapist might confront. By attempting too much and only providing an overview of each problem, the book leaves the reader (particularly the more experienced therapist) hungry for specifics. On the other hand, the book certainly achieves its purpose as a compendium of general strategies for the therapeutic handling of a wide variety of difficult families. It seems best to consider Pittman's theoretical views as diagnostic guideposts for the clinician rather than as explanatory models with predictive value. The book's main appeal lies in its advice to readers who are searching for practical ideas on handling a wide range of family crises. (PsycINFO Database Record (c) 2010 APA, all rights reserved)