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Maximizing Effectiveness in Dynamic Psychotherapy Self-Compassion in Psychotherapy101 Healing StoriesA Clinician's Guide to Legal Issues in PsychotherapyA Map of the MindA Primer for Beginning PsychotherapyACT With LoveActive Treatment of DepressionAffect Regulation, Mentalization, and the Development of SelfAlready FreeBad TherapyBecoming an Effective PsychotherapistBefore ForgivingBeing a Brain-Wise TherapistBetrayed as BoysBeyond Evidence-Based PsychotherapyBeyond MadnessBeyond PostmodernismBinge No MoreBiofeedback for the BrainBipolar DisorderBody PsychotherapyBoundaries and Boundary Violations in PsychoanalysisBrain Change TherapyBrain Science and Psychological DisordersBrain-Based Therapy with AdultsBrain-Based Therapy with Children and AdolescentsBrief Adolescent Therapy Homework PlannerBrief Child Therapy Homework PlannerBrief Therapy Homework PlannerBuffy the Vampire Slayer and PhilosophyBuilding on BionCare of the PsycheCase Studies in DepressionCaught in the NetChild and Adolescent Treatment for Social Work PracticeChoosing an Online TherapistChronic DepressionClinical Dilemmas in PsychotherapyClinical Handbook of Psychological DisordersClinical Intuition in PsychotherapyClinical Pearls of WisdomCo-Creating ChangeCognitive Therapy for Challenging ProblemsCompassionConfessions of a Former ChildConfidential RelationshipsConfidentiality and Mental HealthConfidingContemplative Psychotherapy EssentialsControlConversations About Psychology and Sexual OrientationCoping with BPDCouch FictionCounseling in GenderlandCounseling with Choice TheoryCouple SkillsCrazy for YouCreating a Life of Meaning and CompassionCreating HysteriaCritical Issues in PsychotherapyCrucial Choices, Crucial ChangesDeafness In MindDecoding the Ethics CodeDeconstructing PsychotherapyDeep Brain StimulationDemystifying TherapyDepression 101Depression in ContextDialogues on DifferenceDissociative ChildrenDo-It-Yourself Eye Movement Techniques for Emotional HealingDoing CBTE-TherapyEarly WarningEncountering the Sacred in PsychotherapyEnergy Psychology InteractiveErrant SelvesEssays on Philosophical CounselingEssentials of Wais-III AssessmentEthically Challenged ProfessionsEthics and Values in PsychotherapyEthics in Plain EnglishEthics in Psychotherapy and CounselingExpectationExploring the Self through PhotographyExpressing EmotionFacing Human SufferingFairbairn's Object Relations Theory in the Clinical SettingFamily TherapyFavorite Counseling and Therapy Homework AssignmentsFear of IntimacyFlourishingFolie a DeuxForms of Intersubjectivity in Infant Reasearch and Adult TreatmentFoundations of Ethical Practice, Research, and Teaching in PsychologyFreud and the Question of PseudoscienceFrom Morality to Mental HealthFundamentals of Psychoanalytic TechniqueGenes on the CouchGod & TherapyHalf Empty, Half FullHandbook of Clinical Psychopharmacology for TherapistsHandbook of Counseling and Psychotherapy with Lesbian, Gay, and Bisexual ClientsHandbook of Evidence-Based Therapies for Children and AdolescentsHealing the Heart and Mind with MindfulnessHeinz KohutHelping Children Cope With Disasters and TerrorismHigh RiskHistory of PsychotherapyHow and Why Are Some Therapists Better Than Others?How Clients Make Therapy WorkHow People ChangeHow Psychotherapists DevelopHow to Fail As a TherapistHow to Go to TherapyHypnosis for Inner Conflict ResolutionHypnosis for Smoking CessationI Never Promised You a Rose GardenIf Only I Had KnownIn Others' EyesIn SessionIn Therapy We TrustIn Treatment: Season 1Incorporating Spirituality in Counseling and PsychotherapyInside the SessionInside TherapyIs Long-Term Therapy Unethical?Issues in Philosophical CounselingIt's Not as Bad as It SeemsItís Your HourLearning from Our MistakesLearning Supportive PsychotherapyLetters to a Young TherapistLife CoachingLogotherapy and Existential AnalysisLove's ExecutionerMadness and DemocracyMaking the Big LeapMan's Search for MeaningMetaphoria: Metaphor and Guided Metaphor for Psychotherapy and HealingMind GamesMindfulness and AcceptanceMindfulness-Based Cognitive Therapy for DepressionMindworks: An Introduction to NLPMockingbird YearsMoments of EngagementMomma and the Meaning of LifeMotivational Interviewing: Preparing People For ChangeMulticulturalism and the Therapeutic ProcessMultifamily Groups in the Treatment of Severe Psychiatric DisordersNarrative PracticeOn the CouchOne Nation Under TherapyOur Inner WorldOur Last Great IllusionOutsider ArtOutsider Art and Art TherapyOvercoming Destructive Beliefs, Feelings, and BehaviorsOverexposedPathways to SpiritualityPersonality and PsychotherapyPhilosophical CounselingPhilosophical Counselling and the UnconsciousPhilosophical Issues in Counseling and PsychotherapyPhilosophical PracticePhilosophy and PsychotherapyPhilosophy for Counselling and PsychotherapyPhilosophy PracticePhilosophy's Role in Counseling and PsychotherapyPillar of SaltPlan BPlato, Not Prozac!Polarities of ExperiencesPower GamesPractical 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PsychotherapyThe Education of Mrs. BemisThe Ethical Treatment of DepressionThe Ethics of PsychoanalysisThe Gay and Lesbian Psychotherapy Treatment PlannerThe Gift of TherapyThe Great Psychotherapy Debate: The Evidence for What Makes Psychotherapy Work The Healing JourneyThe Heart & Soul of ChangeThe Heroic ClientThe Husbands and Wives ClubThe Love CureThe Making of a TherapistThe Mindful TherapistThe Mirror Crack'dThe Mummy at the Dining Room TableThe Neuroscience of PsychotherapyThe Neuroscience of Psychotherapy: Healing the Social BrainThe New Rational TherapyThe Older Adult Psychotherapy Treatment PlannerThe Other Side of DesireThe Pastoral Counseling Treatment PlannerThe Philosopher's Autobiography The Pornographer's GriefThe Portable CoachThe Portable Ethicist for Mental Health Professionals The Present Moment in Psychotherapy and Everyday LifeThe Problem of EvilThe Problem with Cognitive Behavioural TherapyThe Psychodynamics of Gender and Gender RoleThe Psychotherapy 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Works for Whom? Second EditionWhen the Body SpeaksWhispers from the EastWise TherapyWittgenstein and PsychotherapyWorking MindsWoulda, Coulda, ShouldaWriting About PatientsYoga Skills for Therapists:Yoga Therapy
Research has determined that psychotherapy does indeed work. The question at hand now is "How does it work?" The authors of this book submit that the answer to this question has ramifications for all those involved in the practice of psychotherapy including professors, students, policy makers, insurance providers, and practitioners of all sorts. To answer the question the authors set out to provide a theoretical framework that cuts across all of the therapeutic approaches that have been empirically shown to be effective.
In the past, those claiming to answer the question of how psychotherapy works have polarized into two opposing groups. These are referred to as the "best practice" group and the "common factors" group. The best practice group argues for specific therapy protocols for specific therapy populations, whereas the common factors group maintains that a positive client-therapist relationship, among other factors, is most significant in issuing forth positive change in therapy. Since each side presents a compelling argument the authors were (themselves) compelled to find a unifying factor that each side might share.
In Greek mythology, the golden thread helped the warrior Thesus safely find his way to the center of a labyrinth and back. The tread traced his pathway through seemingly endless disorienting corridors in which his movement was (at times) contrary to intuition. Today there are a large and growing number of different, purportedly effective psychotherapies. However, their differences in approach and suggested mechanisms for change appear to contradict each other, creating a modern-day labyrinth for all those interested. What makes these treatments effective? What do they have in common? What pathways do they share, and what thread, if any, connects them? Those encountering this dilemma cry out for a modern golden thread to find their way (pp. 8-9).
The authors contend that "second-order change" is that golden thread. They submit that the unifying perspective on "change" unites all effective psychotherapy. "First order change is defined as a class of resolutions that do not change a problem or make a problem worse. In Contrast, second-order change is a change of those first-order resolutions, which results in a resolution of the problem" (p. 15). First-order change is related to stability, while second-order change is related to transformation.
Clearly, there is more to these brief definitions, and the authors do a fine job at preparing a presentation that could have gone way beyond the scope of this book. But, Frazer and Solovey draw upon their extensive clinical and theoretical backgrounds to offer this unifying theory. And by keeping the subject concise they make their point clear, understandable, and practical.
Each clinical chapter follows a format where the authors formally define a problem to be addressed, and then analyze the "best practice" recommended for the clinical scenario, including a synopsis of the practical goals, steps, and research supporting it. Then, they examine the situation showing how second-order change operates as an underlying pathway to improvement in that therapeutic setting. In this way, case examples and comparisons with current therapeutic approaches place "second order" change in a practical light. Beyond this, the text offers recommendations for making the second-order shift in both practice and policy.
While dealing with a fairly high-minded meta-analysis of psychotherapy, the authors have managed to keep this text at a very readable level (i.e., college level). Professors and researchers of clinical psychotherapy might benefit from reading this book. It would make a worthy addition to any graduate level clinical course. Given the unifying principle of second-order change, students might refrain from getting caught-up in the undue process of determining a best-practice approach to therapy, and thusly focus their attention on the process of change that is so essential to effective psychotherapeutic treatment. However, it is this reviewer's opinion that reading this book would benefit researchers, practitioners, and students alike. I will read it again, and I will probably refer to it often.
© 2008 Rosemary Cook
Rosemary Cook is a Psychotherapist in private practice living on Long Island, NY.
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