Reviews
Fighting Your Dark Shadow: Managing Depression With Cognitive Behaviour Therapy. Therrie Rosevald and Tian P.S. Oei, illustrated (in full colour) by Marco Schmidt. Brisbane, depressionmanaged.com, 2007. PB. pp. 136. ISBN 978 0 646 47032 0. AU$24.95. (Ask for it by title in good bookshops, or order online at www.australianacademicpress.com.au).
This book has been co-authored by Therrie Rosenveld, who has experienced depression first hand, and Tian P.S. Oei who draws upon his scientific research and clinical knowledge. This combination creates an experiential and theoretical merger that provides the reader with straightforward strategies to overcome depression. The book is easy to read and targeted at those suffering from depression, and their families and carers, rather than the professional. It is colourfully, humorously and thoughtfully illustrated throughout by cartoonist Marc Schmidt, which adds novelty and interest to what is an otherwise serious issue, and one that is becoming ever more prominent in our personal and professional lives. The aim of the book is to provide the reader with an insight into depression, as well as provide ‘The Right Tool Kit’ for those suffering depression, and their families/carers. These are tools that don’t promote a quick fix, rather, they are tools that are evidence based and will last the distance required on the journey through depression. The tool kit provided by the authors consists of an understanding of depression, how depression is maintained, and how the use of cognitive behavioural therapy strategies can fight depression, with an emphasis on process rather than cure. There is a strong theme throughout that guides the reader to the need to take responsibility for their personal healing, ultimately leading to a sense of control and the opportunity for long-term change. There are many books available on depression and CBT, however, this book has the edge. It’s affordable, accessible and it speaks a language that all can understand. Myrean A. Traupmann Senior Social Worker Disability Services Commission, Perth, Western Australia E-mail:
[email protected]
Adolescent Therapy that Really Works: Helping Kids Who Never Asked for Help in the First Place. Janet Sasson Edgette, NY, Norton, 2006. PB, pp. 203, ISBN 9780393705003, A$29.95.
In Helping Kids, the author departs from the behavioural approaches to helping that occupy many therapy shelves, and rather, focuses her attention on an THE AUSTRALIAN AND NEW ZEALAND JOURNAL OF FAMILY THERAPY Volume 30 Number 3 2009 pp. 227–231
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approach that is cleverly strategic and relationally oriented. Many practice vignettes and very useful examples throughout the book illustrate the rationale and effectiveness of this approach. While Janet Edgette details the need to establish a meaningful and genuine relationship between therapist and teen, in order that meaningful conversations can occur, the need for establishing purposeful goals and effective working relationships with other involved parties is also covered. Edgette prefaces her book with a reminder to the reader that the majority of teens entering therapy did not initiate the contact, and are not necessarily grateful to be there. Nor are they necessarily appreciative of the efforts of the therapist in trying to be helpful. The author challenges the traditional approach of enlisting clients to become partners in therapy when working with troubled youth, and instead invites the therapist to develop ways of working alongside the adolescent in order to engage their interest and active involvement in the therapy process. She refers to this as adopting ‘a teen-sensitive approach’ (3), discussing the need for the therapist to ‘be real’ (3) when working with youth, and she reminds us that the majority of therapists who struggle, are trying too hard to make the therapy work. Edgette shows a compassionate understanding of the competent therapist floundering in this work, and offers sound reasoning for our difficulties. In order to provide a base from which change can occur, she reminds the reader that it is essential to create environments where the teenager will listen to what he’s never let anyone tell him before, where permission is given to the therapist by the teen to say what they need to hear in order to be affected by it. I like the way Edgette writes with compassion and conviction about the teen experience of therapy. She gives excellent examples of the impasses and difficulties within the therapeutic encounter. Understanding a young person’s change style is important to the outcome for therapy, and guides her interventions. The final chapters of Helping Kids are directed to assisting parents to better relate and help their adolescent both during and between sessions, helping to recognise and change unhelpful interactions, working to instil a faith that change is possible, and restoring parental authority within the family. She offers the reader various scenarios and reflective accounts that showcase her work, producing more productive sessions and effective family functioning, while at the same time maintaining the dignity and accountability of all involved. This is a helpful resource for any therapist working with troubled families and adolescents. It is written in simple language that at the same time encapsulates the complexities and challenges of working with this client group. Teena Olsen Family Therapist, Private Practice North Perth, WA
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Mastering Family Therapy: Journeys of Growth and Transformation. Salvador Minuchin, Wai-Yung Lee, George M. Simon, Hoboken, NJ, Wiley, 2006. 2nd Edn. PB. pp. 266. ISBN 9780471757726. A$59.95.
Only mildly curious about what Salvador Minuchin has to say these days, I was surprised to find him extremely engaging and enlightening. It was perhaps a little arrogant of me to imagine that the old master, who introduced me to family therapy 25 years ago, could teach me nothing new. The subtitle (‘Journeys of Growth and Transformation’) might have indicated that this was not simply the same old story repeated. This book presents Minuchin’s capacity to change and grow and offers a positive revision of structural family therapy. This second edition to the book (originally published in 1996) provides some additional chapters and ‘postscripts’ reflecting the 10 years that have passed. The therapeutic use of self in structural family therapy is the main theme of this book, co-authored by two of his former students, one of whom also contributes as one of the eight supervisees. This is a mellower Salvador Minuchin, positioning his model in a contemporary context. Part One is animated, like a conversation between knowledgeable and curious peers. This section provides an overview of theories of family functioning and an update of the structural therapy model. In Part Two, we observe the model in practice. The history of family therapy is presented with a twist. The authors divide the family therapy field into the two camps of interventionist and restrained therapy, the difference being in the therapist’s use of self as an instrument of change. Interventionist therapists include Satir, Whitaker, Bowen and Haley, and Minuchin. Restrained therapies include the brief therapy approach developed at the Mental Research Institute in Palo Alto, Solution Focused therapy, the Milan group, narrative therapy and the linguistic systems approach developed at the Galveston Family Institute by Harlene Anderson and Harold Goolishian. There is a brief critique of each of these therapies and also a chapter devoted to evidence-based therapies. Focus on language and narrative, and on different ways of understanding, the authors contend, is not enough for therapy, which they say should be oriented toward action. The critique of these therapies mainly focuses on the visibility or invisibility of the therapist. The authors claim that reducing therapies to measurable techniques devalues the role of the therapist and over-emphasises the role of technique. While they acknowledge that studies of these therapies indicate effectiveness, they question whether the effectiveness of family therapy can be assessed measuring symptoms and techniques, when the self of the therapist is so fundamental to the experience: It is the person of the therapist in his or her encounter with the client family who produces change in therapy (71).
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The authors make acknowledgement of the contributions of the psychodynamic schools of thought. Given that the parents were now physically in the room, the early family therapists considered that transference or countertransference were no longer relevant concepts. However this has a cost: … with the dismissal of these concepts the therapist as a person began to become invisible in the writings of the family therapy pioneers. As the therapist disappeared all that was left behind was his or her techniques (5).
A four-step model for family assessment (94, Chapter 6), Minuchin’s new development is presented along with a concise definition of essential concepts of the structural approach and case examples that illustrate their use. It was in reading Part Two, though, that I became engrossed. After a chapter by Minuchin on supervision, separate chapters written by the eight supervisees follow. These chapters were all included in the first edition. This edition contains postscripts for each chapter, written 10 years later, and further postscripts from Minuchin, written in the form of a letter to each supervisee. The many stories, themes and layers of relationships have the added dimension of moving through time. The teacher–student, the therapist–family, the supervisor–family and the relationships between family members are explored in all their interconnectedness. We not only see the transformation of the families, and of the student therapist, but also of the teacher. Minuchin is a powerful personality who attracts strong reactions. He has a strong, colourful idiosyncratic style that at times seems jarring and questionable. It is hard to imagine surviving supervision with him. A warmer softer side is glimpsed in his growing relationships with each of his students. He makes it clear that his role as supervisor is to assist students to ‘develop his or her own version of structural family therapy’ (104), that is, to find their own voice and style. These chapters tackle many issues that arise in supervision and in family work, including parallel process, managing different opinions and styles, political views and moving from an individual to a systemic focus. Feminism and gender, same sex relationships, culture and class are also discussed. Minuchin’s status is, however, predictably somewhat guru-like, and the expression of students’ respect and admiration at times distracts from the otherwise fascinating exploration of their experience. This is a book of many layers. It would be relevant and useful for anyone engaged in family therapy and supervision. It is comprehensive enough for those new to family therapy, but is also fresh and of sufficient depth to appeal to those who are familiar with the model. The message is that the structural family therapy model must adapt to the context of time and situation. Salvador Minuchin writes that he has a recurring nightmare about supervising someone who has only read his earlier work and not being able to tell them that what they were doing was wrong, because after all, he was the author. If you have been influenced by structural therapy concepts, read this book to refresh those old ideas. Elizabeth Telford Individual, Couple and Family Therapist
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What is This Thing Called Love? A Guide to Psychoanalytic Psychotherapy with Couples. Sarah Fels Usher. London/NY, Routledge, 2008. Pp. 162. Paperback. ISBN: 978-0-415-43384-6. $58.00.
The title of Sarah Fels Usher’s book is arresting, but a little misleading. The book is not primarily about ‘love’ (although she does include one chapter devoted to that subject). The subtitle is a more accurate guide — a plain-language description of how one psychoanalytically-trained therapist works with couples. As such, What is This Thing Called Love? has quite a bit to offer to those whose training has been systemic rather than psychodynamic. The two models actually prove to have much in common. An analytic therapist once asked me how, as a family therapist, I could possibly manage the ‘multiple competing transferences’ of the clients; the question left me with a longlasting anxiety that my couple and family work must be badly lacking. Sarah Usher, on the other hand, readily admits that in couple work, transference is far less prominent than in individual psychotherapy, partly because there is less room for fantasy when both members of the couple are present, and partly because ‘the therapist is required to be more ‘real’ too — it isn’t really possible to be a ‘blank screen’ with a couple; at least, not for very long. Indeed, what Sarah Usher often does in her case examples is to encourage couples to acknowledge the reality of their own partnership, instead of demanding the impossibly ideal, or expending their energies on viciously punishing each other for ‘crimes’ which someone else might once have committed. She adheres to exactly the same principles of ‘balancing time’ between partners as we do (while admitting that sometimes it is necessary to give most of a whole session to one or the other). She avoids ‘triangling’ phone calls or requests for ‘secret’ individual sessions, and keeps her interpretations to herself if she senses that a couple is too fragile to tolerate them yet. Some of her interventions are as pragmatic as any behaviourist’s (get a ‘call monitor’ function on your phone if you don’t want to end up talking to that intrusive family of origin member!). She readily shares her personal reactions to couples’ behaviour (something she would ‘hardly ever’ do in individual therapy). Shorn of the label ‘countertransference’, ‘I feel like you are two kids fighting for my attention’ is something many a relationship counsellor has said, or felt! Yet I also learned things from the particular perspective Sarah Usher brings to this little book. She reminded me that couples may fight bitterly, not just because they want to hurt or punish each other for perceived betrayal but because they fear to lose each other. Her analysis of unconscious motives for behaviour is, perhaps unsurprisingly, one of the most valuable features of the psychoanalytic approach. I was intrigued by her claim that changes in the brain chemistry of ‘those who claim to be madly in love’ resemble similar alterations in the chemistry of those with severe OCD. It makes sense — I would have liked a reference, though! Hugh Crago Couple therapist in private practice, Artarmon and Blackheath THE AUSTRALIAN AND NEW ZEALAND JOURNAL OF FAMILY THERAPY
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