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Personal development in counsellor training
1058
Book Reviews
a reference to Weenolsen's attempt to empirically study existential ideas. Similarly, there is the case study in which sacked nurses have to be helped view their predicament positively. We could argue that people who are treated like machine cogs have good reason to be depressed. Does the training of clients towards renewed cog-hood represent a valuable contribution? However, these are minor criticisms of what otherwise is one of the most well written and informative books I have read for some time. KAY GAVAN
W. K. M. H A L F O R D and H. J. M A R K M A N (Eds.): Clinical Handbook of Marriage and Couples Interventions. Wiley, Chichester (1997). xxviii + 720 pp. £70.00. This large volume is an attempt to put together a comprehensive set of chapters on marital and couple relationships and on interventions for problems in such relationships. Section I deals with the nature of a healthy marriage, including discussions of violence and cultural issues. In Section II, developmental influences on marriage are considered, including attachment in early relationships and the couple's relationship with children. The effects of ageing are also discussed. In Section III, personal and environmental influences are discussed. Individual psychopathology and physical health are among the topics considered. Section IV is the most relevant part of the book to practising therapists. It deals with assessment and intervention with couples. The various approaches to couple therapy are considered in separate chapters - - including one by Epstein, Baucom and Daiuto on the cognitive-behavioural approach. A topic rarely covered in other texts is the effect of infidelity and how to help a couple to rebuild their relationship after it - - well handled by Glass and Wright in their chapter. Several other chapters in this section deal with specific issues, like aggression, depression and alcoholism. Van Widenfelt and colleagues write about the prevention of relationship problems, again a novel feature. In Section V, the final part of the book, two important areas are well discussed. The first is that of the effectiveness of couples interventions. The limitations of the existing literature are highlighted, and the importance of systematically evaluating both the mediators and moderators of change is emphasised. This is a very constructive chapter, which couple therapists and researchers in the area will value. The second is the future. A number of critical issues are highlighted in a highly readable way. Markman, Halford and Cordova make this chapter a fitting end to this massive volume: realistic, perceptive, critical, yet optimistic. It would be churlish to make a list of criticisms of this book for the sake of writing a stereotypical review. The book represents an immense intellectual task, and the editors - - and contributors - - have performed splendidly. However, with so much effort gone into the book, why is there no author index? And why is the subject index so thin? Also, in the discussion of individual psychopathology, a chapter on traumatic stress would have been useful. On the whole, however, this is an excellent book, and is likely to be the main resource for couple therapists for some time. While the price is prohibitive for most potential individual readers, the book is not overpriced, given its size, richness and range of contents. P. DE SILVA
P. CHADWICK, M. BIRCHWOOD and P. TROWER: Cognitive Therapy for Delusions, Voices and Paranoia. Wiley, Chichester (1996). xviii + 212 pp. £15.99. This book is a very welcome addition to the small number of recently published books which detail cognitive and cognitive-behavioural approaches to the problems of people with psychosis. At this stage in the rapid development of psychological therapy, informed by empirical and theoretical advances, every new book has scope for new ideas. This book is not only bursting with them, but is impressive also in its systematic and rigorous approach to describing and applying therapy. It is remarkable for the clarity of expression and the consistency of its message. The reader is taken through each argument with careful, systematic reasoning, whether the argument concerns the usefulness of the schizophrenia concept, the cognitive view of delusions and hallucinations, the conceptual steps of cognitive therapy, or the authors' proposed distinction between 'punishment' and 'persecution' paranoia. In addition to these detailed explorations which provide the conceptual underpinning of the book, there is an equally strong emphasis on how to do cognitive therapy, together with a number of interesting and illuminative case examples. The overall effect is to offer the reader a thorough introduction to the authors' work and a good sense of what they do when they see clients. Both theoretically and therapeutically, these endeavours are impressive. In contrast to the work of some of the other groups developing therapeutic approaches with this clientele, this book is determinedly about cognitive therapy; it draws hardly at all on behavioural or rehabilitative approaches and the case examples make little mention of the broader service context or the input of other mental health professionals. This is in keeping with the theoretical stance taken, which rejects the usefulness not only of the schizophrenia concept but also o f any illness model. There is a strong emphasis on treatment and a high degree of optimism about the effectiveness of cognitive therapy. This confidence is certainly moderated by an awareness of the complexity of outcome evaluation for delusions and hallucinations, with a recognition of different dimensions of change. However, given the novelty of many of the ideas proposed, which have not yet been subjected to rigorous evaluation, we should keep an open mind while waiting for the publication of controlled studies. Nonetheless, therapeutic knowledge often advances in practice as well as in theory before the evidence is gathered; I believe that this is an important book and would warmly recommend its purchase to all interested in the theory and therapy of the problems of people with psychosis. PHILIPPA GARETY
HAZEL JOHNS: Personal Development in Counsellor Training. Cassell, London (1996). vii + 148 pp. £12.99. Although this book is meant to be, and is, a practical handbook, it is not a prescriptive manual or even a 'how to' book. It is authored by a leading counsellor trainer who, in the Preface, hints at being an enthusiast of literature and the arts in general. There can be no personal development outside of cultural influences in which a person happens to be immersed,
Book Reviews
1059
so a narrow skill-based approach would have been inappropriate. This, I believe, is the main reason why this book is discursive to the point that it almost becomes a personal document. Hazel Johns' eclecticism, her breadth of knowledge, and her long experience of counselling and counsellor training, make this slim volume a storehouse of pertinent information seeped in what can only be called wisdom. Since language is the primary tool of intra- and inter-personal communication, she rightly stresses and exemplifies the primacy of language throughout the book. The author has a preference for long sentences. However, these are always finely balanced, with the reader led along shades of meaning and varied emphases using examples to clarify the points made. While the monotony of the text is broken up with a few figures, tables and bullet points in all the chapters except the last, the liberal use of sentences of 60 words or more creates a hypnotically baroque effect. To give an example: Yet, central personal issues of growth may be highlighted which are formative, and so still developing (a counsellor working with bereaved clients may 'discover' unfinished grieving for her own parents, triggered by, for example, a need to limit the expression of distress by a client) or normative, clarifying appropriate standards for a counsellor (the desire, for instance, to allow a particular counselling relationship to become a friendship). The impression one gets from such closely packed sentences is that the author knows backwards what she is talking about and is keen to impart that knowledge to the reader without waflte or condescension. There is no obscurity although, as said before, the cadences are hypnotic and perhaps even therapeutic. I read this book from cover to cover carried along by the power of the author's rhetoric reflecting her enthusiasm and her intimate knowledge of her subject-matter. One could not summarise and do justice to this book. It would not translate easily into a programmed text or a series of behavioural statements. To use one of Hazel Johns' own neologisms, this book is 'ultimately learningfur, which is, ultimately, what really matters. MIGEL JAYASINGHE
Book Reviews
a reference to Weenolsen's attempt to empirically study existential ideas. Similarly, there is the case study in which sacked nurses have to be helped view their predicament positively. We could argue that people who are treated like machine cogs have good reason to be depressed. Does the training of clients towards renewed cog-hood represent a valuable contribution? However, these are minor criticisms of what otherwise is one of the most well written and informative books I have read for some time. KAY GAVAN
W. K. M. H A L F O R D and H. J. M A R K M A N (Eds.): Clinical Handbook of Marriage and Couples Interventions. Wiley, Chichester (1997). xxviii + 720 pp. £70.00. This large volume is an attempt to put together a comprehensive set of chapters on marital and couple relationships and on interventions for problems in such relationships. Section I deals with the nature of a healthy marriage, including discussions of violence and cultural issues. In Section II, developmental influences on marriage are considered, including attachment in early relationships and the couple's relationship with children. The effects of ageing are also discussed. In Section III, personal and environmental influences are discussed. Individual psychopathology and physical health are among the topics considered. Section IV is the most relevant part of the book to practising therapists. It deals with assessment and intervention with couples. The various approaches to couple therapy are considered in separate chapters - - including one by Epstein, Baucom and Daiuto on the cognitive-behavioural approach. A topic rarely covered in other texts is the effect of infidelity and how to help a couple to rebuild their relationship after it - - well handled by Glass and Wright in their chapter. Several other chapters in this section deal with specific issues, like aggression, depression and alcoholism. Van Widenfelt and colleagues write about the prevention of relationship problems, again a novel feature. In Section V, the final part of the book, two important areas are well discussed. The first is that of the effectiveness of couples interventions. The limitations of the existing literature are highlighted, and the importance of systematically evaluating both the mediators and moderators of change is emphasised. This is a very constructive chapter, which couple therapists and researchers in the area will value. The second is the future. A number of critical issues are highlighted in a highly readable way. Markman, Halford and Cordova make this chapter a fitting end to this massive volume: realistic, perceptive, critical, yet optimistic. It would be churlish to make a list of criticisms of this book for the sake of writing a stereotypical review. The book represents an immense intellectual task, and the editors - - and contributors - - have performed splendidly. However, with so much effort gone into the book, why is there no author index? And why is the subject index so thin? Also, in the discussion of individual psychopathology, a chapter on traumatic stress would have been useful. On the whole, however, this is an excellent book, and is likely to be the main resource for couple therapists for some time. While the price is prohibitive for most potential individual readers, the book is not overpriced, given its size, richness and range of contents. P. DE SILVA
P. CHADWICK, M. BIRCHWOOD and P. TROWER: Cognitive Therapy for Delusions, Voices and Paranoia. Wiley, Chichester (1996). xviii + 212 pp. £15.99. This book is a very welcome addition to the small number of recently published books which detail cognitive and cognitive-behavioural approaches to the problems of people with psychosis. At this stage in the rapid development of psychological therapy, informed by empirical and theoretical advances, every new book has scope for new ideas. This book is not only bursting with them, but is impressive also in its systematic and rigorous approach to describing and applying therapy. It is remarkable for the clarity of expression and the consistency of its message. The reader is taken through each argument with careful, systematic reasoning, whether the argument concerns the usefulness of the schizophrenia concept, the cognitive view of delusions and hallucinations, the conceptual steps of cognitive therapy, or the authors' proposed distinction between 'punishment' and 'persecution' paranoia. In addition to these detailed explorations which provide the conceptual underpinning of the book, there is an equally strong emphasis on how to do cognitive therapy, together with a number of interesting and illuminative case examples. The overall effect is to offer the reader a thorough introduction to the authors' work and a good sense of what they do when they see clients. Both theoretically and therapeutically, these endeavours are impressive. In contrast to the work of some of the other groups developing therapeutic approaches with this clientele, this book is determinedly about cognitive therapy; it draws hardly at all on behavioural or rehabilitative approaches and the case examples make little mention of the broader service context or the input of other mental health professionals. This is in keeping with the theoretical stance taken, which rejects the usefulness not only of the schizophrenia concept but also o f any illness model. There is a strong emphasis on treatment and a high degree of optimism about the effectiveness of cognitive therapy. This confidence is certainly moderated by an awareness of the complexity of outcome evaluation for delusions and hallucinations, with a recognition of different dimensions of change. However, given the novelty of many of the ideas proposed, which have not yet been subjected to rigorous evaluation, we should keep an open mind while waiting for the publication of controlled studies. Nonetheless, therapeutic knowledge often advances in practice as well as in theory before the evidence is gathered; I believe that this is an important book and would warmly recommend its purchase to all interested in the theory and therapy of the problems of people with psychosis. PHILIPPA GARETY
HAZEL JOHNS: Personal Development in Counsellor Training. Cassell, London (1996). vii + 148 pp. £12.99. Although this book is meant to be, and is, a practical handbook, it is not a prescriptive manual or even a 'how to' book. It is authored by a leading counsellor trainer who, in the Preface, hints at being an enthusiast of literature and the arts in general. There can be no personal development outside of cultural influences in which a person happens to be immersed,
Book Reviews
1059
so a narrow skill-based approach would have been inappropriate. This, I believe, is the main reason why this book is discursive to the point that it almost becomes a personal document. Hazel Johns' eclecticism, her breadth of knowledge, and her long experience of counselling and counsellor training, make this slim volume a storehouse of pertinent information seeped in what can only be called wisdom. Since language is the primary tool of intra- and inter-personal communication, she rightly stresses and exemplifies the primacy of language throughout the book. The author has a preference for long sentences. However, these are always finely balanced, with the reader led along shades of meaning and varied emphases using examples to clarify the points made. While the monotony of the text is broken up with a few figures, tables and bullet points in all the chapters except the last, the liberal use of sentences of 60 words or more creates a hypnotically baroque effect. To give an example: Yet, central personal issues of growth may be highlighted which are formative, and so still developing (a counsellor working with bereaved clients may 'discover' unfinished grieving for her own parents, triggered by, for example, a need to limit the expression of distress by a client) or normative, clarifying appropriate standards for a counsellor (the desire, for instance, to allow a particular counselling relationship to become a friendship). The impression one gets from such closely packed sentences is that the author knows backwards what she is talking about and is keen to impart that knowledge to the reader without waflte or condescension. There is no obscurity although, as said before, the cadences are hypnotic and perhaps even therapeutic. I read this book from cover to cover carried along by the power of the author's rhetoric reflecting her enthusiasm and her intimate knowledge of her subject-matter. One could not summarise and do justice to this book. It would not translate easily into a programmed text or a series of behavioural statements. To use one of Hazel Johns' own neologisms, this book is 'ultimately learningfur, which is, ultimately, what really matters. MIGEL JAYASINGHE