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Developing cognitive-behavioural counselling
Book Reviews
965
T. M. SKOVHOLT and M. H. RONNESTAD: The Evolving Professional Self--Stages and Themes in Therapist and Counsellor Development. Wiley, Chichester (1995). xii + 221 pp. £16.95. Scholarly and well researched, this book, according to the authors, was at least five years in the making. It is a very good example in stating the case for qualitative research and the authors are fully aware of the limitations imposed by the methodology in practice. They know that one of the criticisms levelled against them could be that they chose to generalise from a cross-sectional study when a longitudinal approach would have been more appropriate. Broadly explanatory theories of development and a historical life-span orientation, as well as more specific theories of counsellor/therapist development, are reviewed in the first chapter. Chapters 2-9 develop the eight stages which the authors postulate as developmental stages of transition that all successful counsellors and therapists undergo in their professional life. Not negotiating the transitions successfully can lead to stagnation or pseudo-development, and a possible exit through premature closure from the therapist/counsellor role, at any of these crisis points. The authors, in their extensive research which forms the background to this book, identified 20 themes grouped under the headings: 1. Primary characteristics, 2. Process descriptors, 3. Sources of influence, and 4. Secondary characteristics. Evidence for these themes are provided through marginal comments over edited interviews with three Senior Informants presented in Appendix B. Empirical, laboratory research is unlikely to yield concepts like "'an older wiser person" (p. 91), simply because they cannot be operationalised. What this book shows quite emphatically is that counselling and therapy are intensely personal pursuits almost unique to the individual practising these ~arts'. The present day successful practitioner is no different from the archetypical shaman or the 'wise old man/woman'. At the Integrity Stage, the final stage according to the authors, the individuated therapist/counsellor draws little from "empirical studies in the behavioural sciences". Instead, he/she "'readily talks about understanding human behaviour through anthropology, literature, novels, poetry, religion, and similar fields" (p. 90). This is not science in the generally accepted sense of the term. Convservely, those therapists/counsellors who are likely to fall by the wayside report '~a lack of positive client response to the therapist/counsellor's use of a major theoretical approach that the therapist/counsellor had worked hard to m a s t e r . . . " (p. 118). Symptom removal, therefore, may not be enough. Clients seek an encounter with an authentic individual who has made sense of his or her own life and expect a range of services from "such diverse areas as reducing anxiety" to "struggling with meaning and purpose in one's life" (p. 1). It would be interesting to see if and how this book is likely to influence the selection, training and development of new entrants to the profession of therapist/counsellor or, equally likely, whether it would be ignored as irrelevant to the scientific study of a vaguely understood and still mysterious area of human activity. MIGEL JAYASINGHE
MICHAEL J. SCOTT, STEPHEN G. STRADLING and W. DRYDEN: Developing Cognitive-Behavioural Counselling. Sage Publications, London (1995). ix + 141 pp. £9.95 paperback; £19.95 hardback. This book is part of a series entitled "Developing Counselling" published by Sage and edited by Windy Dryden. The series provides counsellors and counselling trainees with short, practical guides on the problems they come across in the counselling process. In this volume the authors take the principles of the cognitive-behavioural therapy originally developed by Beck and Ellis to develop a useful approach in the counselling of clients with depression and anxiety. By looking at the limitations of the standard brief cognitive-behavioural counselling of many common problems, the authors suggest that an effective therapeutic intervention should consider early maladaptive interpretations (EMIs) and the presence of personality disorders. A guideline for assessment and treatment of major disorders is given with case examples to illustrate the appplication of cognitive-behavioural counselling in the therapeutic context. The limitation of this book is that, with so many topics to cover, some disorders such as social phobia and the avoidant personality are only briefly discussed and insufficient information about counselling of these problems is provided. Besides, management of personality disordered patients is well detailed in depression but not in the anxiety disorders. That said, the book does achieve its aims with respect to helping counsellors to think how their work can be refined with a cognitive-behavioural approach. It is a useful guide to clinical psychologists in training and other mental health professionals. L1GIA M. ITO
M. B. SOBELL and L. C. SOBELL: Problem-Drinkers--Guided Self-Change Treatment. Guilford Press, New York (1993). 206 pp. $24.25. T. J. O'FARRELL (Ed.): Treating Alcohol Problems--Marital and Family Interventions. Guilford Press, New York (1993). 446 pp. $36.95. After first reading these books I drafted a review, but before sending my comments to the editor, I began having second thoughts about what 1 had written. I was nagged by the feeling that I had neglected to mention something important.
965
T. M. SKOVHOLT and M. H. RONNESTAD: The Evolving Professional Self--Stages and Themes in Therapist and Counsellor Development. Wiley, Chichester (1995). xii + 221 pp. £16.95. Scholarly and well researched, this book, according to the authors, was at least five years in the making. It is a very good example in stating the case for qualitative research and the authors are fully aware of the limitations imposed by the methodology in practice. They know that one of the criticisms levelled against them could be that they chose to generalise from a cross-sectional study when a longitudinal approach would have been more appropriate. Broadly explanatory theories of development and a historical life-span orientation, as well as more specific theories of counsellor/therapist development, are reviewed in the first chapter. Chapters 2-9 develop the eight stages which the authors postulate as developmental stages of transition that all successful counsellors and therapists undergo in their professional life. Not negotiating the transitions successfully can lead to stagnation or pseudo-development, and a possible exit through premature closure from the therapist/counsellor role, at any of these crisis points. The authors, in their extensive research which forms the background to this book, identified 20 themes grouped under the headings: 1. Primary characteristics, 2. Process descriptors, 3. Sources of influence, and 4. Secondary characteristics. Evidence for these themes are provided through marginal comments over edited interviews with three Senior Informants presented in Appendix B. Empirical, laboratory research is unlikely to yield concepts like "'an older wiser person" (p. 91), simply because they cannot be operationalised. What this book shows quite emphatically is that counselling and therapy are intensely personal pursuits almost unique to the individual practising these ~arts'. The present day successful practitioner is no different from the archetypical shaman or the 'wise old man/woman'. At the Integrity Stage, the final stage according to the authors, the individuated therapist/counsellor draws little from "empirical studies in the behavioural sciences". Instead, he/she "'readily talks about understanding human behaviour through anthropology, literature, novels, poetry, religion, and similar fields" (p. 90). This is not science in the generally accepted sense of the term. Convservely, those therapists/counsellors who are likely to fall by the wayside report '~a lack of positive client response to the therapist/counsellor's use of a major theoretical approach that the therapist/counsellor had worked hard to m a s t e r . . . " (p. 118). Symptom removal, therefore, may not be enough. Clients seek an encounter with an authentic individual who has made sense of his or her own life and expect a range of services from "such diverse areas as reducing anxiety" to "struggling with meaning and purpose in one's life" (p. 1). It would be interesting to see if and how this book is likely to influence the selection, training and development of new entrants to the profession of therapist/counsellor or, equally likely, whether it would be ignored as irrelevant to the scientific study of a vaguely understood and still mysterious area of human activity. MIGEL JAYASINGHE
MICHAEL J. SCOTT, STEPHEN G. STRADLING and W. DRYDEN: Developing Cognitive-Behavioural Counselling. Sage Publications, London (1995). ix + 141 pp. £9.95 paperback; £19.95 hardback. This book is part of a series entitled "Developing Counselling" published by Sage and edited by Windy Dryden. The series provides counsellors and counselling trainees with short, practical guides on the problems they come across in the counselling process. In this volume the authors take the principles of the cognitive-behavioural therapy originally developed by Beck and Ellis to develop a useful approach in the counselling of clients with depression and anxiety. By looking at the limitations of the standard brief cognitive-behavioural counselling of many common problems, the authors suggest that an effective therapeutic intervention should consider early maladaptive interpretations (EMIs) and the presence of personality disorders. A guideline for assessment and treatment of major disorders is given with case examples to illustrate the appplication of cognitive-behavioural counselling in the therapeutic context. The limitation of this book is that, with so many topics to cover, some disorders such as social phobia and the avoidant personality are only briefly discussed and insufficient information about counselling of these problems is provided. Besides, management of personality disordered patients is well detailed in depression but not in the anxiety disorders. That said, the book does achieve its aims with respect to helping counsellors to think how their work can be refined with a cognitive-behavioural approach. It is a useful guide to clinical psychologists in training and other mental health professionals. L1GIA M. ITO
M. B. SOBELL and L. C. SOBELL: Problem-Drinkers--Guided Self-Change Treatment. Guilford Press, New York (1993). 206 pp. $24.25. T. J. O'FARRELL (Ed.): Treating Alcohol Problems--Marital and Family Interventions. Guilford Press, New York (1993). 446 pp. $36.95. After first reading these books I drafted a review, but before sending my comments to the editor, I began having second thoughts about what 1 had written. I was nagged by the feeling that I had neglected to mention something important.