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Therapeutic communication — Principles and effective practice
BOOK REVIEWS significance of testing, as well as the various and numerous contexts within which such results are necessary. The idea of a flexible testing battery is also relevant to this discussion, and is also presented well in the book, a topic related to the importance of individual differences, as discussed earlier. There is now evidence that participants can become test-wise, therefore, performance gains may be a function of specific test repetition rather than underlying change. A summary chapter to conclude the book and provide an effective ending would have been a synthesis of
Therapeutic
Communication
-
339
neuropsychological assessment. Overall, though, Clinician’s Guide is an excellent book, and should welcome addition to any clinicians’s library.
the be a
JOSEPH J. PLAUD F. RICHARD FERRARO Department of Psychology University of North Dakota P.O. Box 8380 Grand Forks ND 58202-8380, U.S.A.
Principles and Effective Practice
by PAUL L. WACHTEL Guilford Press, New York, 1993 This book assumes psychotherapy to be open-ended, probably long-term, and practical within a context of no current external forces or agents controlling or judging its progress and results. Wachtel assumes an ideal circumstance of therapists and patients involved in an adventure in personality change, not necessarily symptom relief nor escape from an immediate disturbing situation. The author distilled from years of practice, teaching, and supervision a classification symptom of psychodynamics, called cyclical psychodynamics. This carries on psychodynamic traditions with an emphasis on repetitive cycles of people-interaction and of intrapsychic processes in daily living. Wachtel in this volume offers a “_ distillation of what skilled clinicians, regardless of their identified orientation or school, have come to recognize are the most effective ways to communicate in the therapeutic session.” As part of his “how-to” approach. Wachtel describes comments by therapists as often more accusatory than facilitative. He demonstrates a number of ways this might be handled to be positive for the patient. He presents practical methods in an excellent chapter, “building on the patient’s strengths.” His text covers major areas of verbal communication by therapists in a quite comprehensive manner, including a well-balanced chapter on self-disclosure by the therapist. Within its stated goals, this volume should be of significant help to students and to practitioners of psychotherapy. Perhaps Wachtel could have included the roles of medications in psychotherapy. He neglects dealing with psychotic patients. The examples do not indicate adequate communication techniques with adolescents and children. Group therapy
achieves no recognition, nor does family therapy. Other syndromes and techniques such as dealing with the abused patient do not undergo discussion. In keeping with the themes of establishing and enhancing therapeutic communication, Wachtel states the role of a master teacher provides pragmatic theory blended with illustrative vignettes in such a manner as to give the readerxlinician not only knowledge but both additional and sharper therapeutic tools. His chapter on reframing, relabeling, and paradox is particularly illuminating. Nuances of communication styles are treated comparatively and persuasively rather than pejoratively. Dr Wachtel is also able to champion the reader-clinician’s own resources, ultimately addressing the therapist himself as a communicational tool. Dr Wachtel’s material is fecund with an admixture of theoretical knowledge, experience, and universally applicable clinical vignettes. The chapter on achieving resolution of the patient’s difficulties is particularly germane. The text seems less than succinct at times. More clarity could have been achieved with less text and more tables and summary outlines of principles elucidated. Overall, this book would be very useful and productive in training programs for all those engaging in forms of psychotherapy. IRWIN A. KRAFT Suite 240 3100 Weslayan Houston, TX 77027 U.S.A.
Therapeutic
Communication
-
339
neuropsychological assessment. Overall, though, Clinician’s Guide is an excellent book, and should welcome addition to any clinicians’s library.
the be a
JOSEPH J. PLAUD F. RICHARD FERRARO Department of Psychology University of North Dakota P.O. Box 8380 Grand Forks ND 58202-8380, U.S.A.
Principles and Effective Practice
by PAUL L. WACHTEL Guilford Press, New York, 1993 This book assumes psychotherapy to be open-ended, probably long-term, and practical within a context of no current external forces or agents controlling or judging its progress and results. Wachtel assumes an ideal circumstance of therapists and patients involved in an adventure in personality change, not necessarily symptom relief nor escape from an immediate disturbing situation. The author distilled from years of practice, teaching, and supervision a classification symptom of psychodynamics, called cyclical psychodynamics. This carries on psychodynamic traditions with an emphasis on repetitive cycles of people-interaction and of intrapsychic processes in daily living. Wachtel in this volume offers a “_ distillation of what skilled clinicians, regardless of their identified orientation or school, have come to recognize are the most effective ways to communicate in the therapeutic session.” As part of his “how-to” approach. Wachtel describes comments by therapists as often more accusatory than facilitative. He demonstrates a number of ways this might be handled to be positive for the patient. He presents practical methods in an excellent chapter, “building on the patient’s strengths.” His text covers major areas of verbal communication by therapists in a quite comprehensive manner, including a well-balanced chapter on self-disclosure by the therapist. Within its stated goals, this volume should be of significant help to students and to practitioners of psychotherapy. Perhaps Wachtel could have included the roles of medications in psychotherapy. He neglects dealing with psychotic patients. The examples do not indicate adequate communication techniques with adolescents and children. Group therapy
achieves no recognition, nor does family therapy. Other syndromes and techniques such as dealing with the abused patient do not undergo discussion. In keeping with the themes of establishing and enhancing therapeutic communication, Wachtel states the role of a master teacher provides pragmatic theory blended with illustrative vignettes in such a manner as to give the readerxlinician not only knowledge but both additional and sharper therapeutic tools. His chapter on reframing, relabeling, and paradox is particularly illuminating. Nuances of communication styles are treated comparatively and persuasively rather than pejoratively. Dr Wachtel is also able to champion the reader-clinician’s own resources, ultimately addressing the therapist himself as a communicational tool. Dr Wachtel’s material is fecund with an admixture of theoretical knowledge, experience, and universally applicable clinical vignettes. The chapter on achieving resolution of the patient’s difficulties is particularly germane. The text seems less than succinct at times. More clarity could have been achieved with less text and more tables and summary outlines of principles elucidated. Overall, this book would be very useful and productive in training programs for all those engaging in forms of psychotherapy. IRWIN A. KRAFT Suite 240 3100 Weslayan Houston, TX 77027 U.S.A.