Review - Beyond Evidence-Based Psychotherapy
Fostering the Eight Sources of Change in Child and Adolescent Treatment
by George W. Rosenfeld
Routledge, 2008
Review by Minna Forsell
Nov 3rd 2009 (Volume 13, Issue 45)

To present a book with such a promising title as Rosenfeld's is to awaken the readers' hopes of a new and thought-provoking perspective on psychotherapy. This is also what the back cover texts promise. Actually, the discrepancy between the comments on the back cover and my impressions of the book was so large that I had to reread the introduction to find out what this text was supposedly about. There, Rosenfeld promises a client-driven approach that "de-emphasizes treatment techniques as change agents" and which will "help therapists navigate through a complex, exciting and meaningful career". Among other interesting things. Does he deliver?

Rosenfeld's credo is that "the therapist's mission is to contribute to fostering change by maximizing the impact of eight forces". In the first part of Beyond Evidence-based Psychotherapy, these forces are discussed and developed in eight well-written chapters where all the themes are exemplified by the author's conduct as a therapist. His stance is pragmatic and mildly imperative rather than exploratory. Clients' problems and therapeutic processes are approached in a down-to-earth manner with much focus on symptom reduction and customer satisfaction. The motto seems to be that therapy is no mysterious venture, but a practical job with potential rewards. Chapter titles in the first part of the book include "How can I keep clients in treatment so they can benefit?", "Managing treatment" and "Engage clients by helping them seek greater happiness". I cannot see how Rosenfeld's approach de-emphasizes technique, but maybe this depends on where the reader is coming from.

The text is intended for both new and experienced practitioners, and accordingly it speaks as if to a universal audience, curiously mixing interesting reflections with the sine qua nons of psychotherapy. For example, in a chapter devoted to "the therapist's contribution to treatment", Rosenfeld kindly informs the reader that "connecting with clients often requires active listening (which demonstrates understanding and the willingness to stay attuned to clients while they are having pleasant and unpleasant feelings), being interested in their interests, and mirroring their strengths" (p 64). Sometimes, reading this book is like listening to a child who has just learnt something complex, and who tells about it as if it were the easiest thing ever. It's a tad bit annoying, because if there is something that certainly isn't a piece of cake, it's understanding human processes; and psychotherapists know it. Except for Rosenfeld. This attitude is, however, one of Beyond Evidence-Based Psychotherapy's greatest merits. It is surprisingly inspiring to listen to this extremely reasonable man talking about his craft in the voice of a rationalistic romantic.

Part two of the book is devoted to case studies. The first chapter describes a typical day in Rosenfeld's practice, and the next one gives an account of the cases' progresses over a three month period. In these chapters Rosenfeld demonstrates how he uses the treatment approaches presented in part one. He cooperates with parents, other caretakers and teachers, and with his young clients he gives, shares, raises, fosters and helps. It all sounds so easy, as if "people are just people", and "treatment is just a plan with a goal".

The book that Rosenfeld delivers is not visionary, nor does it "provide an intimate picture of the real world of adolescent psychotherapy", as it says on the cover. Rather, to me, Beyond Evidence-Based Psychotherapy shows the potpourri of commonsensical techniques that emerges from psychotherapists' offices when intuition, existential perspectives, and daring, independent, creative thinking disappear in a mind of evidence-based limitations. The word 'beyond' does not belong in the title of this text.

© 2009 Minna Forsell

Minna Forsell is a psychologist, recently graduated from the University of Stockholm. She currently works in a psychiatric health care center in Volda, Western Norway.