Review of Boundaries in psychotherapy: Ethical and clinical explorations.

Reviews the book, Boundaries in psychotherapy: Ethical and clinical explorations by Ofer Zur (see record 2007-00030-000). In this book, Dr. Zur outlines a number of the salient boundary issues in psychotherapy. As such, this book provides a valuable resource for practising mental health professionals regardless of theoretical orientation. Specifically, this book aims to shed light on the definition and use of psychotherapeutic boundaries by providing a context-based and comprehensive discussion of diverse boundary issues. The book is divided into four parts, and each of the first three parts is made up of four chapters. Part 1, "Boundaries in Context," addresses an assortment of topics concerning boundaries in psychotherapy. Part 2 focuses on issues that affect the therapeutic frame. Part 3 addresses boundary issues that exist within the therapeutic encounter. In Part 4, appropriately titled "Final Thoughts," the author provides a cogent epilogue that highlights the complex and multifaceted nature of professional boundaries and stresses the importance of conducting risk- benefit analyses and other diligent risk management studies when contemplating crossing boundaries in psychotherapy. With regard to the author's stated objectives for writing this book, he accomplishes his goal of shedding light on the definition and use of psychotherapeutic boundaries. Overall, the author's simple and clear writing style makes this an extremely easy book to read. Other strengths include the succinct definition of terms and inclusion of practical tips and suggestions to help the reader navigate the complexities that entrench boundary issues in psychotherapy. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Metaphor in psychodynamic psychotherapy with borderline and non-borderline clients: A qualitative analysis.

Conducted an intensive, qualitative analysis of borderline and non-borderline client's and therapist's experiences of metaphoric expression in a single psychotherapy session. Open-ended interviews were conducted with 2 therapists and 4 clients (aged 24–38 yrs; 2 borderline and 2 non-borderline) who were actively engaged in psychoanalytically-oriented, long-term psychotherapy. The intensive analyses of inquiry interview transcipts revealed 3 important categories of metaphor functions that were shared by all 4 psychotherapy dyads: (1) metaphors illuminate clinical issues, (2) metaphor functions to depict clients' self and object relationships, and (3) therapist metaphor stimulates an intensification of client experiential engagement in therapy. Patterns differentiating the borderline and non-borderline dyads in relation to metaphor use were discussed in the context of 2 core categories: the Representation Mode of Interaction and the Literal Mode of Interaction. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Review of Psychotherapeutic change: An alternative approach to meaning and measurement.

Reviews the book, Psychotherapeutic change: An alternative approach to meaning and measurement by Alvin R. Mahrer (1985). This small and unpretentious volume is a welcome addition to the growing number of recent publications in the field of psychotherapy research that emphasize the need for innovative and more dynamic and functional conceptualizations of the meaning and measurement of psychotherapeutic change. Despite (or perhaps because of) its provocative content, Psychotherapeutic Change is an enjoyable book to read. Mahrer's style of writing is engaging, clear, and free of the customary clinical jargon. Also refreshing is the fact that the material throughout the book comes straight from the concerns of a practitioner. Although the reader may not always agree with the author and may be annoyed by the occasional repetitiveness of some ideas, this book will prove to be a source of stimulating ideas for students, clinicians, and researchers of psychotherapy alike. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Review of Working it out: Using exercise in psychotherapy.

Reviews the book, Working it out: Using exercise in psychotherapy by Kate F. Hays (see record 1999-02984-000). In this book, Hays presents a thoughtful, albeit at times controversial, advocacy for integration of physical exercise into the practice of psychotherapy in an explicit way. Although many mental health practitioners recognize the healing value of physical exercise and even encourage their patients to pursue physical activity, as part of their treatment, Dr. Hays takes this approach to an entirely different level. She argues persuasively that physical exercise, promoted by the therapist in the context of a cognitive-behavioral treatment model, represents for many who seek the services of a psychotherapist a treatment of first choice. She supports her views on this matter by skillfully weaving throughout the book a comprehensive and scholarly review of relevant clinical empirical literature, along with case studies from her own clinical practice. The case studies are a particularly appealing part of this book because they clearly and instructively give the reader an impression of what transpires between Dr. Hays and her clients or patients. One senses that above all she is a warm, empathic, and sensitive clinician who skillfully applies a blend of cognitive-behavioral interventions, enhanced by individually tailored regimens of physical exercise. As stated in the introduction, the author intends "…to inspire mental health professionals to bring to their work a clearer understanding of, interest in, and enthusiasm for exercise in the process of recovery from mental and emotional problems." Dr. Hays identifies practicing psychotherapists as the primary intended audience for her book, but it seems more likely to appeal to students in training for this craft. The more seasoned veterans among us are less likely to be inspired by Dr. Hays's enthusiasm for jogging with our patients, and her proposals for doing this certainly raises many serious concerns and potentially hazardous issues regarding the nature of the relationship between therapist and client. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Metaphoric language, metaphoric cognition, and cognitive therapy.

A model of cognition is presented that includes propositional cognition together with imaginal and metaphoric cognitive modalities. It is posited that metaphor is a distinct form of cognition that appears to combine propositional and imaginal cognition. Client-generated linguistic metaphors appear to represent deep, tacit, metaphoric knowledge that can be directly accessed, explored, and ultimately transformed by the client using a step-by-step interview protocol. Two case examples, involving a 38-yr-old male and a 43-yr-old female, illustrate how this brief intervention can access and change imaginal and metaphoric cognition not readily accessed by traditional cognitive methods. This approach is compared and contrasted with constructivist theory of cognitive therapy and with Ericksonian interventions using embedded metaphors. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Review of The first session in brief therapy.

Reviews the book, The first session in brief therapy edited by Simon H. Budman, Michael F. Hoyt, and Steven Friedman (see record 1992-98543-000). This book provides an overview of the models of brief psychotherapeutic intervention. A major focus is how brief therapists structure and manage their initial contact with the patient. The editors intend this volume to be a casebook in which the reader can learn what therapists actually do in their clinical practice and offers the reader opportunities to further develop and sharpen his/her thinking regarding brief therapy. According to the reviewer, this book provides a fine survey of the current diversity of approaches to brief therapy. Taken as a whole, the book stimulates considerable thought on the most efficacious use of time in psychotherapy and will appeal to a wide audience including graduate students. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Metaphor understanding and accessing conceptual schema: Reply to Gibbs (1992).

R. W. Gibbs (see record 1992-42479-001) argued that metaphoric expressions may reflect preexisting conventional metaphoric mappings in long-term memory. The class-inclusion model, in contrast, focuses on conceptual structures that are constructed and accessible in working memory during metaphor comprehension. The authors agree that prestored metaphoric mappings may be available, but they may not be accessible and hence not used in any given context. The authors point out problems in identifying those metaphorical mappings that may be relevant to a given metaphoric expression and suggest that conceptual metaphors may not be identifiable until after a metaphor has been interpreted. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Review of The integrative power of cognitive therapy.

Reviews the book, The integrative power of cognitive therapy by Brad A. Alford and Aaron T. Beck (see record 1997-97373-000). This book makes a case for Cognitive Therapy (CT) as the integrative paradigm for psychotherapy. The writing instructs the reader in Cognitive Therapy and advocates its superiority to other approaches, especially the so-called psychotherapy integration movement of the Society for Exploration of Psychotherapy Integration (SEPI), to integrate the diversity that is contemporary psychotherapy. The authors want to show us the way into the twenty-first century, and there are far worse guides for us to follow. CT is comprehensive in theory and technique, and it is sensibly grounded in empirical findings and to a lesser extent in cognitive psychology. Nonetheless, some will be reluctant to grant a monopoly to Beck and his successors. All should read this book and decide on which side of the issue to stand. At the very least, the reader will learn about CT or have previous learning consolidated, and will engage in a provocative debate about the nature and future of psychotherapy. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Review of Scientist-practitioner perspectives on test interpretation.

Reviews the book, Scientist-practitioner perspectives on test interpretation edited by James W. Lichtenberg and Rodney K. Goodyear (see record 1998-06400-000). As Lichtenberg and Goodyear clearly state, the purpose of this book was not to ingrain a scientific perspective towards the entire psychotherapy process, but rather to challenge readers to adopt a scientific attitude when critiquing the utility a particular tests has for a client, as well as appropriately interpreting the results. This book is suitable as a supplement to texts in a graduate psychotherapy course. It reminds the reader of the most important considerations when interpreting and sharing test results with clients. It shapes a novice's perspective by offering practical suggestions for the process of test interpretation. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A metaphor-enriched social cognition.

Social cognition is the scientific study of the cognitive events underlying social thought and attitudes. Currently, the field's prevailing theoretical perspectives are the traditional schema view and embodied cognition theories. Despite important differences, these perspectives share the seemingly uncontroversial notion that people interpret and evaluate a given social stimulus using knowledge about similar stimuli. However, research in cognitive linguistics (e.g., Lakoff & Johnson, 1980) suggests that people construe the world in large part through conceptual metaphors, which enable them to understand abstract concepts using knowledge of superficially dissimilar, typically more concrete concepts. Drawing on these perspectives, we propose that social cognition can and should be enriched by an explicit recognition that conceptual metaphor is a unique cognitive mechanism that shapes social thought and attitudes. To advance this metaphor-enriched perspective, we introduce the metaphoric transfer strategy as a means of empirically assessing whether metaphors influence social information processing in ways that are distinct from the operation of schemas alone. We then distinguish conceptual metaphor from embodied simulation—the mechanism posited by embodied cognition theories—and introduce the alternate source strategy as a means of empirically teasing apart these mechanisms. Throughout, we buttress our claims with empirical evidence of the influence of metaphors on a wide range of social psychological phenomena. We outline directions for future research on the strength and direction of metaphor use in social information processing. Finally, we mention specific benefits of a metaphor-enriched perspective for integrating and generating social cognitive research and for bridging social cognition with neighboring fields. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The role of metaphor in psychotherapy and personality change: A theoretical reformulation.

Examines theoretical foundations for the effectiveness of metaphor in psychotherapy. Limitations of the purely psychoanalytic approach to metaphor are described, and this is, in part, because it had neglected its own metaphorical foundations. Alternative models suggest that metaphor's effectiveness in psychotherapy reveals certain structural features of personality and the process of personality change. Specific ways of working therapeutically with metaphors arise from theoretical insights. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Using metaphor to read the organisation of the NHS. National Health Service

The paper is concerned with the complexity of the British National Health Service (NHS) as an organisation and with different ways of seeing this. Morgan proposes that explanations of organisational life are based on metaphors which highlight particular interpretations (Morgan, G., 1986, Images of Organisation. London, Sage). The ability to "read" a complex phenomenon depends on being able to see how these different aspects co-exist. The study applies metaphoric thinking to the organisation of the NHS. Utilising documentary data sources, a diagnostic reading is made examining different metaphors to highlight key aspects of the situation. The metaphors of machine and organism are drawn from Morgan's conceptual scheme, those of religion and marketplace are proposed as of particular relevance to the NHS. In the religious metaphor the focus is on the mission of the NHS in terms of its founding principles of universality, comprehensiveness, equality and collectivism. Perceived as a machine the NHS is characterised as an organisation originally based on technocratic rationality and its subsequent history interpreted as moving towards increasingly centralised control. An alternative perspective on the same events is considered in terms of the organic metaphor. In this view the NHS is examined as an open system, which is devolved, decentralised, participative and responsive to its environment. The image of the marketplace focuses on the impact on the organisation of the introduction of competition and incentives in the post-reform period. Other images are sketched briefly. In the critical evaluation the insights generated by the different images are assessed and the different interpretations linked together. It is concluded that metaphoric thinking enables us to appreciate and interpret the ambiguities and paradoxes in NHS organisational life.     

Review of Personality styles and brief psychotherapy.

Reviews the book, Personality styles and brief psychotherapy by Mardi Horowitz, Charles Marmar, Janice Krupnick, Nancy Wilner, Nancy Kaltreider, and Robert Wallerstein (1984). This book by Horowitz and his colleagues falls in the category of psychodynamic psychotherapy, and in fact lies very close to the heart of traditional, but updated, forms of psychoanalytic psychotherapy. Clinicians who have attempted to master ego-analytic psychotherapy will recognize key concepts in this book that are germane to traditional therapy. These include: stressful events that precipitate psychopathology in specific personality types; the concept of wish, defense, and the dynamic compromise behavior/attitude; patterns of defensive organization and cognitive style typical of personality types; therapeutic tactics related to those personality patterns; and the triad of insight-transference relationship, current relationships, and parental relationships. Horowitz's book has value for a number of overlapping purposes. It should be included in a course on short-term therapy, it is an up-to-date and sophisticated review of personality theory, it is important in the empirical refining of psychodynamic technique, short- or long-term, and it is essential for an understanding of how psychotherapy research is indeed beginning to have a significant impact on psychotherapy theory and technique. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Therapists' intentional use of metaphor: Memorability, clinical impact, and possible epistemic/motivational functions.

The memorability, clinical impact, and possible epistemic and motivational functions of therapists' intentional use of therapeutic metaphor were examined in 4 dyads of experiential psychotherapy. Clients tended to recall therapists' intentional metaphors approximately two-thirds of the time, especially when these metaphors were developed collaboratively and repetitively. Clients rated therapy sessions in which they recalled therapists' intentional use of metaphors as more helpful than sessions in which they recalled therapeutic events other than therapists' intentional metaphors. Four distinctive epistemic and motivational functions of therapeutic metaphor were observed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Review of The process of psychotherapy.

Reviews the book "The process of psychotherapy," by H. V. Ingham and L. R. Love (see record 1954-07599-000). In the preface the authors state "This book is an attempt to describe the ways in which a psychotherapist works. . . . Anyone engaged in psychotherapy is concerned with both an understanding of people and an appreciation of the ways of dealing with them. Certainly much more consideration has generally been given to a presentation of dynamic theory or to using the advantages of combining both fields than to efforts at describing how psychotherapy is conducted." The authors have been singularly successful in avoiding raising and discussing problems either of "dynamic theory" or the relation of theory to psychotherapeutic practice. It is difficult to evaluate this book because we are not told for whom it is intended. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Review of Psychotherapy with older adults.

Reviews the book, Psychotherapy with older adults by Bob Knight (see record 1987-97045-000). The techniques of providing psychotherapy to older adults are the main topics of this trenchant text. There are several case examples throughout the book that illustrate the process of psychotherapy with the elderly. Knight has provided a much-needed, readable introduction and how-to instructions on psychotherapeutic service provision to this burgeoning segment of the population. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Review of Handbook of homework assignments in psychotherapy: Research, practice, and prevention.

Reviews the book, Handbook of homework assignments in psychotherapy: Research, practice, and prevention edited by Nikolaos Kazantzis and Luciano L'Abate (see record 2006-11928-000). Reading this book title quickly one might think that this is a book of practical homework ideas, worksheets, and resources for clinicians. Reading it again more carefully, one discerns that it is more than that. What the editors have planned for the reader is a complete discussion of how therapy and personal change is supported by between-session activities in which the client engages. The book operationally defines "homework" in various kinds of therapy, the role that it plays in the change process, and presents research related to those important between-session tasks. Given this breadth, it is not surprising that the book is aimed at practitioners and researchers with all ranges of experience. The book is organised into four parts to help the reader with this diverse material. Part 1 reviews the concept and implementation of homework across nine well-known modalities (behavioural, client-centered, cognitive, emotion-focussed, interpersonal, psychodynamic, acceptance and commitment, brief strategic family, and personal construct therapies). Parts 2 and 3 of the book focus more on specific populations and disorders, including older adults, couples, and families. The final section of the book contains three "future" oriented chapters in distinct areas: research, practise, and prevention. Readers looking for an "academic" perspective on homework, a comparison of different approaches to between-session work, and inspiration in working with different populations will find a great deal here. The book may be less useful as quick reference on homework ideas for a client who is coming in to a session later today. It really does represent a "first to market" work that will be foundational for others interested in the theory and practise of psychotherapy homework, and certainly makes a very unique contribution. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Solution-focused therapies

This is the final part of the psychotherapy series, which has offered an overview and insight into some of the major talking therapies used by nurses. This series and extended material is being drawn together by Nursing Times and Phil Barker for a book on talking therapies. Previous topics covered in the series were: Psychodynamic psychotherapy, January 14 Humanistic therapies, February 11 Behavioural therapies, March 11 Family and systemic therapies, April 8.     

Metaphor dialog in psychotherapy

I suggest a psychotherapeutic approach which involves extended allegorical conversations between therapist and patient, and present 2 case examples. The approach, Metaphor Dialog (MD), can be described as a 4-way conversation among the conscious and unconscious aspects of both persons' psyches. Although it typically begins with patient-generated material, MD often involves empathic, intuitive, and spontaneous interventions by the therapist which may depart significantly from the metaphoric material overtly presented by the patient. I argue that such an approach represents a beneficial balance between existing metaphor-based techniques which emphasize either patient-generated or therapist-generated content. MD may offer important increases in therapeutic potency in contrast to techniques in which attention to the metaphors developed by 1 or the other party are assumed to be more effective or appropriate.