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Cognitive psychotherapy—Stasis and change
86
BOOKREVIEWS
antidepressants and anxiolytics, less than a page is devoted to chemotherapy, a much more common experience of women with breast cancer. A discussion of its often devastating physical and psychological side effects, including alterations to the appearance and implications for survival of those who need it is entirely lacking. There is no acknowledgement anywhere in the book of the reality of fear of dying, usually prematurely in one’s prime, leaving behind young children, a loving partner and unfinished life’s tasks. This surely would be the prime focus of any cognitively oriented programme for women with breast cancer. Instead, the problems described in the book as addressed in the programme are rather unreal and trite. As a clinical psychologist committed to behavioural and cognitive methods, I feel that this book shows that there are limits to ‘giving psychology away’. When we use various treatment techniques sensitively, in the clinical setting and in the context of the needs of the whole person, they can be very effective. When the techniques and procedures are described in a vacuum, as here, they seem off-putting if not ridiculous. I was embarrassed at the thought of what an intelligent reader would make of a four-page long, 24-step procedure to achieve a goal of looking at the post-operative scar and letting the husband see it. It had me and my teenage daughter in stitches!
W. DRYDEN and P. TROWER (Eds):Cognitive Psychotherapy-Stasis S30.80.
and Change. Springer,
New York (1989). x + 198 pp.
This edited volume is directed towards an examination of the factors associated both with stasis (the co-editors have purposely not used the term ‘resistance’, as they are concerned with the historical association between this term and the psychoanalytic tradition) and change within cognitive psychotherapy. The editors have obviously attempted to select contributions that will variously address issues related to stasis and change, from the perspectives of theory, practice, and other related issues. The volume is organized into three sections. The first, which involves different perspectives on these issues, has three chapters, and for the most part deals with cognitive conceptualizations of patient change. Of these three chapters, the one by Liotti is particularly good, and offers a fresh, innovative approach to the conceptualization of patient change from a constructivistic point of view. The second part of the volume includes four chapters that variously address issues such as the therapeutic alliance, patient factors associated with change, and the importance of educating clients and involving them in the process of change. There is also a fourth chapter in this section, which is essentially a reprint of a client’s guide to Rational Emotive Therapy. The third section of the book deals with a variety of more specific areas, and also comprises four chapters. There is a chapter on the concept of resistance in social skills training, a fairly good chapter on issues related to change in cognitive psychotherapy by Dowd, and a useful chapter on the issue of homework compliance. This section also contains a somewhat unusual contribution, in that a chapter by Ellis on consumerism in cognitivebehavioural therapy is included. Of the eleven chapters in this text, eight are reprints or modifications of previous publications or presentations, ranging from 1983 to 1988. Some of the selections are quite fresh and innovative, but others are either not exciting, or are dated, or simply inappropriate (the chapters on the client manual for Rational Emotive Therapy, and consumerism). One of the impressions that one might take away from this book is that the field of cognitive psychotherapy has not yet adequately dealt with concepts of stasis and change, and the lack of such efforts is reflected in the uneven quality of this volume. Indeed, it is possible that this text has been prepared at too early a stage in the field of cognitive psychotherapy development. Although there are just now beginning to be texts related to issues of stasis and change (for example, Meichenbaum and Turk’s Facilifating Treafment Adherence), my suspicion is that a text such as this one would be better produced in five or so years from now. At the very least, though, this volume may help stimulate other theorists and researchers to begin to examine the issues related to patient change and resistance to change. KEITH DOBSON
PETER TYRER: Classification of Neurosis. Wiley, Chichester
(1989). xxii + 195 pp. f29.95.
This book deals with how neurotic disorders are classified, the focus being the two major classificatory systems that are available. One is the American Psychiatric Association’s Diagnostic and Statistical Manual, 3rd Edition-Revised (DSM-III-R); the other is the tenth revision of the World Health Organisation’s International Classification of Diseases (ICD-lo), which is still available only in draft form. Tyrer writes from the viewpoint of a clinician. He says: “As ultimately the fate of any classification depends on the reaction of its main users it is clinicians who hold the key to success of the new systems”. In his discussion, the author focuses on the similarities and differences between the two systems, and comments on the novel concepts found in one or both. Empirical data and clinical evidence are cited. The tabulation of the diagnostic criteria offered in the DSM-III-R and the ICD-10 side bv side facilitates comparison and aids the reader. Illustraiive case histories add a liveliness to the text and increase the chnical flavour of the-book. The discussion of the literature is somewhat selective, as perhaps is inevitable in a short book like this. For example, some of the most important and influential work on obsessive-compulsive disorder is not cited. Nor are recent studies on the treatment of post-traumatic stress disorder. On the whole, this book will be found useful by all those dealing with neurotic disorders, either as clinicians or as researchers. It encourages critical thinking, and that is always the mark of a good book. A. READ
BOOKREVIEWS
antidepressants and anxiolytics, less than a page is devoted to chemotherapy, a much more common experience of women with breast cancer. A discussion of its often devastating physical and psychological side effects, including alterations to the appearance and implications for survival of those who need it is entirely lacking. There is no acknowledgement anywhere in the book of the reality of fear of dying, usually prematurely in one’s prime, leaving behind young children, a loving partner and unfinished life’s tasks. This surely would be the prime focus of any cognitively oriented programme for women with breast cancer. Instead, the problems described in the book as addressed in the programme are rather unreal and trite. As a clinical psychologist committed to behavioural and cognitive methods, I feel that this book shows that there are limits to ‘giving psychology away’. When we use various treatment techniques sensitively, in the clinical setting and in the context of the needs of the whole person, they can be very effective. When the techniques and procedures are described in a vacuum, as here, they seem off-putting if not ridiculous. I was embarrassed at the thought of what an intelligent reader would make of a four-page long, 24-step procedure to achieve a goal of looking at the post-operative scar and letting the husband see it. It had me and my teenage daughter in stitches!
W. DRYDEN and P. TROWER (Eds):Cognitive Psychotherapy-Stasis S30.80.
and Change. Springer,
New York (1989). x + 198 pp.
This edited volume is directed towards an examination of the factors associated both with stasis (the co-editors have purposely not used the term ‘resistance’, as they are concerned with the historical association between this term and the psychoanalytic tradition) and change within cognitive psychotherapy. The editors have obviously attempted to select contributions that will variously address issues related to stasis and change, from the perspectives of theory, practice, and other related issues. The volume is organized into three sections. The first, which involves different perspectives on these issues, has three chapters, and for the most part deals with cognitive conceptualizations of patient change. Of these three chapters, the one by Liotti is particularly good, and offers a fresh, innovative approach to the conceptualization of patient change from a constructivistic point of view. The second part of the volume includes four chapters that variously address issues such as the therapeutic alliance, patient factors associated with change, and the importance of educating clients and involving them in the process of change. There is also a fourth chapter in this section, which is essentially a reprint of a client’s guide to Rational Emotive Therapy. The third section of the book deals with a variety of more specific areas, and also comprises four chapters. There is a chapter on the concept of resistance in social skills training, a fairly good chapter on issues related to change in cognitive psychotherapy by Dowd, and a useful chapter on the issue of homework compliance. This section also contains a somewhat unusual contribution, in that a chapter by Ellis on consumerism in cognitivebehavioural therapy is included. Of the eleven chapters in this text, eight are reprints or modifications of previous publications or presentations, ranging from 1983 to 1988. Some of the selections are quite fresh and innovative, but others are either not exciting, or are dated, or simply inappropriate (the chapters on the client manual for Rational Emotive Therapy, and consumerism). One of the impressions that one might take away from this book is that the field of cognitive psychotherapy has not yet adequately dealt with concepts of stasis and change, and the lack of such efforts is reflected in the uneven quality of this volume. Indeed, it is possible that this text has been prepared at too early a stage in the field of cognitive psychotherapy development. Although there are just now beginning to be texts related to issues of stasis and change (for example, Meichenbaum and Turk’s Facilifating Treafment Adherence), my suspicion is that a text such as this one would be better produced in five or so years from now. At the very least, though, this volume may help stimulate other theorists and researchers to begin to examine the issues related to patient change and resistance to change. KEITH DOBSON
PETER TYRER: Classification of Neurosis. Wiley, Chichester
(1989). xxii + 195 pp. f29.95.
This book deals with how neurotic disorders are classified, the focus being the two major classificatory systems that are available. One is the American Psychiatric Association’s Diagnostic and Statistical Manual, 3rd Edition-Revised (DSM-III-R); the other is the tenth revision of the World Health Organisation’s International Classification of Diseases (ICD-lo), which is still available only in draft form. Tyrer writes from the viewpoint of a clinician. He says: “As ultimately the fate of any classification depends on the reaction of its main users it is clinicians who hold the key to success of the new systems”. In his discussion, the author focuses on the similarities and differences between the two systems, and comments on the novel concepts found in one or both. Empirical data and clinical evidence are cited. The tabulation of the diagnostic criteria offered in the DSM-III-R and the ICD-10 side bv side facilitates comparison and aids the reader. Illustraiive case histories add a liveliness to the text and increase the chnical flavour of the-book. The discussion of the literature is somewhat selective, as perhaps is inevitable in a short book like this. For example, some of the most important and influential work on obsessive-compulsive disorder is not cited. Nor are recent studies on the treatment of post-traumatic stress disorder. On the whole, this book will be found useful by all those dealing with neurotic disorders, either as clinicians or as researchers. It encourages critical thinking, and that is always the mark of a good book. A. READ