Review of Outcomes assessment in clinical practice.

Reviews the book, Outcomes assessment in clinical practice edited by Lloyd I. Sederer and Barbara Dickey. This book is a timely publication dealing with the urgent and imperative situation in health care delivery, especially in the area of mental health services. There are four Sections in the book. Section I is titled Integrating Outcomes Assessment into Clinical Practice. This section conveys in a rational and reasonable sequence the definition, impetus, history, scope, process, and current crisis-like status of mental health care, in terms of its financing, its validity, and its effectiveness. Section II is called Instruments of Outcomes Assessment and contains sixteen chapters, each describing a different instrument of assessment. Section III optimistically proclaimed a future improvement of health care delivery and access. These five chapters were exciting, but require a most open and direct acknowledgement of the need for protection of patients and therapists in this field. Complementing Section II is Section IV which contains the Appendices. According to the reviewer, this book has the potential to advance the practice of psychotherapy. But presenting it as a means to satisfy so many volatile and uncontrolled social, political, economic, and other forces can lead to its corruption. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Review of Strategic marketing: How to achieve independence and prosperity in your mental health practice.

Reviews the book, Strategic marketing: How to achieve independence and prosperity in your mental health practice by Kalman M. Heller (1997). The author of this book believes there is ample opportunity for solo and small group practices not merely to survive but to thrive; you don't have to sell out to big business in order to maintain or create the small but successful practice that is your chosen way to help others. What you do is develop a marketing-driven practice. He promises that if you do, you will (a) become a more competent therapist, (b) increase your referrals and revenues, and (c) have more fun! In an extremely well-organized and concise fashion, he presents what you need to know about strategic marketing and what you have to do in the form of proactive behaviors to succeed. This is a relatively short book of 137 pages divided into 11 chapters. The first eight are devoted to laying the groundwork for the concepts of marketing, accepting that mental health practice is a business, the utility of developing a business plan, and selecting a practice strategy and specialized "products." Heller, unfortunately, has made promises and expressed optimism which are incompatible with the marketplace realities of private practice in the United States and in that sense may be dangerously misleading to the younger practitioner. Like the APA Guidelines for Practice, to follow all of Heller's planning, evaluation, and practice promotion activities would likely leave little time to treat patients, at least not enough hours to generate the revenue to live, which of course is the objective of the book. This is not a fatal criticism, but certainly is one for the reader to understand beforehand in order to avoid a panic attack by book's end. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Review of Saying good-bye to managed care.

Reviews the book, Saying good-bye to managed care by Sandra Haber, Elaine Rodino, and Iris Lipner (see record 2001-16521-000). This is a very challenging, well-written text that is likely to be of greatest interest to three readily identifiable groups of psychologists, as well as other therapists and mental health professionals. First, students and younger professionals new to the field are likely to be looking for "hot tips" and substantive ideas of a more lasting variety that can help them build a new clinical practice. Second, more mature psychotherapists who wish to "insulate" their practices against the financial impact of managed-care encroachment on their professional decision-making and on their incomes may be looking for ways to diversify their professional activities, so they can be less dependent upon any single entity-whether it is a referral source, a particular "type" of client, a special clinical population, or another problem. Third, many therapists, regardless of practice duration or commitment in terms of hours per week, are looking to develop practice "niches" that reflect their own interests, abilities, and developing competencies. As Haber et al. remind us, questions of effectiveness go hand in hand with other questions of information quality; that in fact is a secret of sustained, effective marketing strategies-no matter what the field. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Review of From research to clinical practice.

Reviews the book, From research to clinical practice, edited by George Stricker and Robert H. Keisner (1985). The intended audience for this edited volume "will probably be practicing psychotherapists...[with] a minimum knowledge of the research area but a ready familiarity with clinical concepts" (p. xv). In addition, the editors suggest to the chapter authors that a successful chapter should provide new meaning for the term "scientist professional" by providing a feedback loop between research and practice. The authors also state that the theoretical focus of this volume is psychodynamic. The book is divided into four areas each preceded by a brief overview. The following areas are covered: Basic issues, social psychology, developmental psychology, and special topics. Overall, I found the chapters to be informative and well written. I think some practitioners may find this book overly academic in tone and may question whether enough of the chapters are sufficiently relevant to busy, practicing clinicians. This is not a book on spotting golden research nuggets between the covers of the volume. Instead, this book requires careful mining of considerable content in order to find sparkling applications. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Review of Supervising the reflective practitioner: An essential guide to theory and practice.

Reviews the book, Supervising the reflective practitioner: An essential guide to theory and practice by Joyce Scaife (see record 2010-09732-000). This review begins with an elaboration on the two key terms in the title. First, the book is about supervising rather than being or becoming a reflective practitioner. As Scaife notes, much of supervision involves modeling, and therefore, a supervisor must be reflective in order to encourage the student to become more reflective. However, a psychodynamic practitioner would think of this as parallel process, so that the reflection in supervision might ultimately be translated into reflection in psychotherapy. The more important term in the title is reflective practitioner. This immediately draws to mind the concept of reflective practitioner introduced by Donald Sch?n (1983), and there are some very important parallels that the reviewer points out. In conclusion, the reader will be rewarded by multiple exercises that will be useful in supervising and in classroom teaching. Scaife very helpfully points out that assessment often is contrary to the spirit of reflection, because the student attempting to satisfy the instructor is not attending to his or her own needs, as is necessary for successful reflection. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Innovative brief pithy psychotherapy: A contribution from corporate managed mental health care.

The managed health care movement has reached a stage of maturity that has allowed it to begin to invest in the development of new clinical intervention approaches. Modern managed mental health care therapy, also known as pithy therapy, is expected to replace more traditional, lengthier forms of therapy by the year 2000. This article presents sections of the new treatment manual for purposes of illustrating the newly developed techniques. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Review of Succeeding in private practice: A business guide for psychotherapists.

Reviews the book, Succeeding in private practice: A business guide for psychotherapists by Eileen S. Lenson (1994). Lenson, a social worker, has produced a usable and well thought out overview for any psychotherapy practitioner considering private practice. She suggests more than a dozen points such as freedom from routine, the need to be an energetic self-starter, and ability to delay gratification to determine fitness for private practice. After reviewing the various forms for a business (solo, partnership, corporation), Lenson outlines setting up an office and arranging for necessary supplies and services. Only a paragraph or so is allotted to each item, including computers, and the use of consultants such as accountants and attorneys. Lenson's real strengths are in the thorough and detailed discussion she provides for the business of doing business, including record keeping, fee setting, personnel issues, taxes, and marketing. She has drawn extensively from her own experience as well as from Psychotherapy Finances and Practice Builder, two specialized publications for professional practitioners. Chapters on office paperwork, insurance, and collections could stand alone as procedures manuals, they are so well-organized and comprehensive. Sample forms included are clear and attractively laid out. Succeeding in Private Practice is well-organized, attractively laid out with short paragraphs, thorough indexing, and numbered or bulleted lists. It lends itself well for use as a handbook since topics can be found easily. Let this book by Eileen Lenson be the first or second on a list for the beginning practitioner who must then go on to read many other works and seek advice from experienced psychotherapists in his or her own field. (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 importance of professional psychology: A view from managed care.

Over the past 15 years, the development of managed health care has led to changes in the way that psychology is practiced and in the ways that quality is measured in the health care system. In this article, the current status of population-based Health Plan Employer Data and Information Set quality metrics are reviewed. Many medical measures of quality have improved in the past 5 years, whereas behavioral health measures have shown only modest improvement. Reasons for this finding are discussed, and it is suggested that quality of care for individuals and populations could improve as psychology adopts evidenced-based practice and clinical practice guidelines. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Review of Critical issues in psychotherapy: Translating new ideas into practice.

Reviews the book, Critical issues in psychotherapy: Translating new ideas into practice edited by Brent D. Slife, Richard N. Williams, and Sally H. Barlow (see record 2001-05779-000). Bridging the often enormous gap between theory and practice in psychotherapy, this volume seeks to examine a variety of models of psychotherapy in the light of recent advances in theoretical psychology, philosophy of science, and critical thinking. The book is organized around numerous issues of fundamental importance to contemporary psychotherapy, including chapters addressing the problems of empirically validated therapies, individualism, spirituality, multiculturalism, biological reductionism, managed care, freewill/determinism, eclecticism, feminism, and diagnostics. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Review of Re-envisioning psychology: Moral dimensions of theory and practice.

Reviews the book, Re-envisioning psychology: Moral dimensions of theory and practice by Frank C. Richardson, Blaine J. Fowers, and Charles B. Guignon (see record 1999-02563-000). Not often in the discipline of psychology does a work of genuinely praiseworthy philosophical sophistication come along that also manages to avoid not only being overly narrow in its relevance but also avoids being filled with unintelligible and pseudo-intellectual jargon. This excellent text is an example of one such work. The authors divided their text into three major sections beginning with a careful and ranging analysis of the ethical underpinnings of contemporary psychotherapy, followed by a timely and provocative discussion of individualism, social constructionism, and hermeneutics, and complete the volume with a preliminary exploration of the principle features of an interpretive psychology. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Estimating variability in outcomes attributable to therapists: A naturalistic study of outcomes in managed care.

To estimate the variability in outcomes attributable to therapists in clinical practice, the authors analyzed the outcomes of 6,146 patients seen by approximately 581 therapists in the context of managed care. For this analysis, the authors used multilevel statistical procedures, in which therapists were treated as a random factor. When the initial level of severity was taken into account, about 5% of the variation in outcomes was due to therapists. Patient age, gender, and diagnosis as well as therapist age, gender, experience, and professional degree accounted for little of the variability in outcomes among therapists. Whether or not patients were receiving psychotropic medication concurrently with psychotherapy did affect therapist variability. However, the patients of the more effective therapists received more benefit from medication than did the patients of less effective therapists. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Review of A perilous calling: The hazards of psychotherapy practice.

Reviews the book, A perilous calling: The hazards of psychotherapy practice by Michael B. Sussman (1994). In this book, the author presents chapters by therapists from various disciplines (e.g., psychology, social work, psychiatry) that examine the "hazards" that lay hidden in the practice of psychotherapy. The author contends that doing psychotherapy "poses significant dangers to clinicians" (p. 1). He believes that there are forces both internal and external to the therapist that may take their toll on the therapist's well-being. Sussman makes the point that while other overtly dangerous professions (e.g., firefighter) warn prospective candidates of the perils of their field, novice psychotherapists are not prepared for what awaits them. Psychotherapists, then, enter the profession unprepared for, if not blind to, possibilities that not only make them less effective in their work, but might actually harm themselves and their families. Sussman sees a real human cost to not preparing clinicians to be aware of, and deal with, these hazards. The book is divided into six parts that range from the therapist's personal development to renewal. Along the way the reader encounters professional, ethical and legal issues, clinical dilemmas, the emotional impact of the work, and the ailments of the therapist. Within each particular area are rather personal, and at times idiosyncratic, chapters from a variety of psychotherapists. There are chapters that deal with AIDS, the Holocaust, body shame, and being a female therapist. Most of the chapters have a distinctly clinical orientation, while a few come across as philosophical discourses. There is one chapter by an expert witness in the Margaret Bean-Bayog case who warns of the dangers of the press on one's career. The wide scope of the chapter topics, at times, gives the book a disjointed feel and the sense that it is trying to tackle too many issues at once. Overall, this book provides a new slant on what is involved in the practice of psychotherapy. It raises some important questions about the field and how we prepare for its impact on our lives, for the practice of psychotherapy surely does affect the practitioner. Sussman and some of the chapter authors make a good case for increasing communication about potential hazards and developing strategies and training methods that will minimize their effects. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Review of Changing the rules: A client-directed approach to therapy.

Reviews the book, Changing the rules: A client-directed approach to therapy by Barry L. Duncan, Andrew D. Solovey, and Gregory S. Rusk (see record 1992-97964-000). The title of this book, and particularly its subtitle, convey the central message of the book. The subtitle signals to us that we may expect to find an emphasis on the client's own problem formulations as a guide to the therapist's behavior. Such an emphasis has decisive implications for the conceptual and technical framework of the authors' therapy. Two implications are especially worthy of note at the outset: first, the book aligns itself conceptually with the phenomenologically oriented models of psychotherapy. Second, the book sets forth a technology that emphasizes the collaborative and equalitarian aspects of the client-therapist relationship. The book utilizes a practice-oriented approach that documents its case through extensive presentations of verbatim therapy excerpts rather than the formal use of empirical research. The book thus stands as a clinical contribution that depends for its validity upon the cogency with which extant theory is illustrated clinically. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Review of Generalized anxiety disorder: From science to practice.

Reviews the book, Generalized anxiety disorder: From science to practice by Michel J. Dugas and Melisa Robichaud (2006). The reviewers commend the authors for providing a comprehensive overview of GAD. Chapters include information on diagnosis, assessment techniques and treatment modules. Dugas and Robichaud refer to their treatment as primarily cognitive and emphasize the difference between their approach and other cognitive and cognitive-behavioural treatments for GAD. The treatment presented does not employ relaxation training or other strategies to reduce physical tension and overarousal. Rather, this treatment makes use of specific cognitive interventions with the understanding that physical and affective symptoms will decrease with corresponding reductions in excessive worry. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Review of Beyond the reflection: The role of the mirror paradigm in clinical practice.

Reviews the book, Beyond the reflection: The role of the mirror paradigm in clinical practice by Paulina Kernberg, Bernadette Buhl-Nielsen, and Lina Normandin (see record 2007-00911-000). This modestly presented volume overflows with insight and new ways of looking at the mirroring experience for children and adolescents. Kernberg and her collaborators present the rich history of the image, metaphor, and pervasive role of the mirror in human experience; they carefully describe the "subjective experience of wonder, admiration, and an objective dimension of truth" in the mirror paradigm (2006, p. xv). For the psychotherapist, Kernberg's work provides a rich resource; the review of past and current research and theorizing about the mirroring function of mothers and primary caregivers is thorough and up-to-date with the most recent advances in neuroscience, attachment theory, and infant research. From Freud to Lacan, from Winnicott to Stern, and from Schore to Gergely, Kernberg presents a sweeping exposition of the various images of the mirror. This volume is worthwhile if only for its presentation of this body of recent research. But there is so much more to be found here. While this is not the first time that Kernberg has presented us with her work with mirror observation and interviews (Kernberg, 1984, 1987), this volume integrates the research about early mother- child experience, and the mirroring paradigm in the psychoanalytic theories about child development, with the phenomenology of child and adolescent psychotherapy. The clinician will find a useful application of the theory to clinical practice and diagnosis that is hard to find in the literature. Beebe and Lachmann (2002) have accomplished this integration between infant research and adult treatment, but Kernberg's application of her research and the demonstrated correlation between the findings of mirror experience, attachment histories, and clinical experience is a rare and welcome addition to the literature. There are also valuable links made between the findings around mirror experience and children's trauma histories. This reader came away feeling that a tremendous debt is owed to the authors for helping to ground clinical theory and practice in substantial current research. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Review of Experiential therapy: A symphony of selves.

Reviews the book, Experiential therapy: A symphony of selves by Richard E. Felder and Avrum Geurin Weiss (1991). This is a thoughtful and thought-provoking small volume that illustrates well the contributions, and the limitations of, experiential therapy. Defining psychopathology as a restricted capacity for experience, Felder and Weiss regard the basic objective of experiential therapy as increasing patients' capacity to experience and therefore to grow. This book embodies both the considerable virtues and the significant limitations of the experiential therapy movement. It reads in some ways as a historical document, clarifying the significant contributions made by a therapeutic orientation which established fundamentals, but remaining oblivious to the technical and systems-oriented innovations of the past decade. Today's therapist needs Gestalt techniques, Eriksonian interventions, awareness of family system factors, visualization strategies, facility in intrapsychic, couple and family conflict resolution—intervention techniques that make treatment more systematic and efficient. Still, the core ideas presented in Experiential Psychotherapy merit remembering. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Review of The therapeutic dialogue: A theoretical and practical guide to psychotherapy.

Reviews the book, The therapeutic dialogue: A theoretical and practical guide to psychotherapy by Sohan Lai Sharma (1986). Sharma has taken on the Herculean task of reviewing the whole of the available literature on psychotherapy, organizing it, and using the data to try to instruct the student therapist in the ways of a fundamentally eclectic, existential-humanistic model of psychotherapy. While I appreciate this effort, and wholeheartedly agree with this as the correct and necessary course for the future survival of psychotherapy, the way has already been more compellingly articulated by such writers as Jung, Rank, Rogers, Perls, R. D. Laing, Szasz, and May. Regrettably, though well-intentioned, Sharma's book lacks the requisite elegance, style, depth, and dynamism needed to help spark the essential resurrection of real psychotherapy. (PsycINFO Database Record (c) 2010 APA, all rights reserved)