Book reviews, August 2006

Therapy – It's not all good

Shouldn't I be feeling Better Now?
Client Views of Therapy
Ed. Yvonne Bates
New York: Palgrave Macmillan; 2006;
Pb £14.99
(ISBN 1 4 0394740 6)
Reviewed by Sarah Lewis

This book is written for both clinicians and clients and consists of clients' descriptions of negative experiences of psychotherapy. Whilst acknowledging two-thirds of clients report positive benefits, 'Shouldn't I be feeling better by now?' highlights the distress reported by some of the third of clients who found psychotherapy damaging. The majority of essays refer to long-term psychoanalysis and counselling rather than shorter-term cognitive and behavioural approaches, however the book's message is clear: it's time for all individual practitioners and the profession as a whole to consider the negative consequences of psychotherapy. Failure to consider these issues can be extremely destructive to clients.
When I began reading this book I hoped to increase my awareness of therapeutic issues from a client's perspective and increase my sensitivity as a therapist by considering some negative experiences of therapy. Whilst the book states that psychotherapy can be efficacious at easing human distress, the overall tone of the book is particularly negative. It is critical of individual therapists, therapeutic processes and techniques as well as schools of psychotherapy.
As a therapist who can place this argument within the context of a wider literature I believe it offers a thought-provoking counterargument to the predominantly positive discourse surrounding psychotherapy. If I were a potential client however, this text would make me run a mile.

- Sarah Lewis is a Trainee Clinical Psychologist at the Section of Psychological Medicine, University of Glasgow.

Create an alliance
Coping with Alcohol and Drug Problems – The Experience of Family Members in Three Contrasting Cultures.
Jim Orford et al.
Hove: Routledge; 2005; Hb £39.95 (ISBN 0 415 37146 5)
Reviewed by NoreenTehrani

THE families of alcoholics and drug addicts are frequently characterised as helpless victims or even the real cause of the addict's behaviour. This book challenges these stereotypic views by looking at what it means to live with someone who misuses drugs or alcohol.
The qualitative research described in this book contrasts three different cultural settings, Aborigines from the Northern Territory of Australia, urban poor from Mexico City and residents of South-West of England. The research from these three settings describes the stress and strain involved in the struggle to cope with the behaviours of a substance abusing family member. Interviews with the families indicated that attitudes of helping agencies were commonly experienced as overly harsh and unhelpful and that family members and friends were often unsupportive or condemning of the relative, whilst showing sympathy and concern towards the substance abusing person.
The authors propose an approach that creates an alliance between professionals, substance misusing relatives and their families to respond to the needs of the whole family. An approach that empowers family members to talk about their experiences, explains their symptoms and identifies the benefits and disadvantages of a number of different coping styles.
An interesting book, invaluable to anyone interested in substance misuse in families.

- Noreen Tehrani is an occupational, health and counselling psychologist in private practice.

Small but perfectly formed
Psychodynamic Counselling in a Nutshell
Susan Howard
London: Sage; 2006;  Pb £9.99 (ISBN 1 4129 0773 X)
Reviewed by Rebecca Williams

SUSAN Howard, who is both a consultant clinical psychologist and psychoanalytic psychotherapist, has struck an easy balance here between theory and practice. She neatly illustrates key concepts such as transference, counter transference, making interpretations and so on, with succinct case examples.
Following an orientation to the area and the historical background, the 'mysteries' of psychodynamic counselling are unpacked with a clarity that has been lacking from many texts in this field. For example, why therapists don't personalise their rooms, how to move easily between attending to the client and attending to the therapists' own responses, and how to time interpretations appropriately, are all covered without jargon or oversimplification.
The guide ends with a series of pointers for those wishing to embark on a career in psychodynamic counselling, but I am certain that the case illustrations will also prove useful to newly qualified psychologists or counsellors. Indeed, this is probably one of the clearest and therefore most informative texts I have read on the subject, with the only pity being it ended all too soon!

- Dr Rebecca Williams works in the Arfon Learning Disabilities Team.