Ambivalence in Psychotherapy: Facilitating Readiness to Change

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Overview

Most discussions of resistance are strongly linked to particular therapy approaches—yet clients in any kind of therapy can experience ambivalence that gets in the way of change. This lucidly written book reframes resistance as ambivalence and presents effective, practical ways to deal with it. Integrating humanistic, cognitive-behavioral, and psychodynamic perspectives, the authors offer richly detailed descriptions of strategies for helping clients get "unstuck," with particular emphasis on motivational interviewing and the two-chair approach. Grounded in research, the volume includes helpful case examples that cut across different clinical problems and therapeutic models.
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Editorial Reviews

From the Publisher

"The authors offer an integrative model drawing from the four main psychotherapeutic approaches: cognitive-behavioural, humanistic-experiential, psychodynamic, and systemic....The authors write in a lucid and engaging style, drawing on their own personal experience of ambivalence, in addition to that of their clients. Herein lies the strength of this book, they manage to write in a way that reflects the very clinical approaches they outline....The book is a practical resource for therapists and a refreshing change from the dogma that plagues other texts grounded in singular psychotherapeutic approaches. It would suit psychologists of all orientations and levels of experience. I wholeheartedly recommend it."--The Psychologist

"Engle and Arkowitz have done a first-rate job of reframing the long-problematic concept of resistance while attending thoroughly to the essential phenomena to which the term has referred. They offer, as well, an astute and comprehensive approach to dealing with these phenomena. I am not at all ambivalent about this book!"--Paul L. Wachtel, PhD, Doctoral Program in Clinical Psychology, City College, City University of New York

"An outstanding contribution to integrative psychotherapy. The authors offer an exciting new approach to helping clients overcome ambivalence about change. The book is specific and detailed and captures the essence of the method, which combines two-chair dialogue and motivational interviewing to provide an excellent set of integrative therapeutic tools. Reading this book really will help you help your clients. This is an invaluable resource for therapists and students alike, regardless of orientation, who want to enhance their clinical effectiveness."--Leslie S. Greenberg, PhD, Department of Psychology, York University, Toronto, Ontario, Canada

"Practicing therapists from all orientations have clearly been confronted with resistance as an obstacle to the change process. The question is: Are there ways of understanding resistance and dealing with it clinically? Conceptualizing resistance as involving a state of ambivalence, Engle and Arkowitz address this question in their groundbreaking volume. This conceptualization has important therapeutic implications, and the authors provide invaluable clinical guidelines--vividly illustrated with case descriptions and therapy transcripts--for dealing with resistance as ambivalence, so as to facilitate the therapeutic change process."--Marvin R. Goldfried, PhD, Department of Psychology, Stony Brook University

"Engle and Arkowitz provide a thoughtful analysis of the enduring issue of resistance and noncompliance in psychotherapy. They survey theories and measures of resistance as well as various ways to respond to it, emerging with an integrative approach centered on the phenomenon of ambivalence. Special attention is devoted to two-chair methods and applications of motivational interviewing, with illustrative case examples of how to use these tools in helping clients get unstuck and move on with their lives."--William R. Miller, PhD, Department of Psychology, University of New Mexico

"Ambivalence is one of the most challenging obstacles to change for client and therapist. Engle and Arkowitz offer a comprehensive exploration of ambivalence and propose an interesting, integrative model for accessing, exploring, understanding, and addressing ambivalence in psychotherapy. They offer innovative cognitive and emotion-enhancing techniques to reach the deep emotional underpinnings as well as the conflicting cognitive schemas that support patient ambivalence. Anyone who works with clients will benefit from the book's clinical wisdom, detailed strategies, and informative examples of ways to manage ambivalence and build people's motivation to change."--Carlo C. DiClemente, PhD, Department of Psychology, University of Maryland, Baltimore County

Clinical Social Work Journal

"A volume that will be of practical help to clinicians of all disciplines in breaking the cycle of starts and stops to treatment....This is an excellent text for beginning and advanced clinicians, offering fresh ideas about a problematic subject that is often the source of frustration for clinicians. The authors provide an integrative model that can appeal to practitioners from many theoretical perspectives. They remove the stigma associated with resistance and reframe it as a central focus of therapy. New clinicians will find this book an opportunity to try out some techniques an ways of processing a client's ambivalence about change. Seasoned practitioners will surely be stimulated to rethink old patterns of work and work through ambivalence toward certain clients."--Clinical Social Work Journal
Psychotherapy Research

"This book offers clinicians of all stripes new ways to think about and help their clients. Medical professionals may also find this book valuable in their work with clients noncompliant to their medical regimen. Last, this book is also very likely to promote discussion and research among those who study psychotherapy."--Psychotherapy Research
The Psychologist

"The authors offer an integrative model drawing from the four main psychotherapeutic approaches: cognitive-behavioural, humanistic-experiential, psychodynamic, and systemic....The authors write in a lucid and engaging style, drawing on their own personal experience of ambivalence, in addition to that of their clients. Herein lies the strength of this book, they manage to write in a way that reflects the very clinical approaches they outline....The book is a practical resource for therapists and a refreshing change from the dogma that plagues other texts grounded in singular psychotherapeutic approaches. It would suit psychologists of all orientations and levels of experience. I wholeheartedly recommend it."--The Psychologist
Journal of Critical Psychology

"As a psychologist who provides psychotherapy, this book is a dream come true. Quite often, I'm frustrated in my attempts to find literature that can enhance my integrative approach to psychotherapy. It seems that most books use only one psychotherapeutic model for a specific psychiatric problem or life management difficulty. However, Ambiance in Psychotherapy attempts to address a universal phenomenon in any form of psychotherapy. To their credit, the authors succeed in addressing one of the most germane issues that people struggle with: their ambivalence to change."--Journal of Critical Psychology, Counselling, and Psychotherapy
PsycCRITIQUES

"In this marvelous book, the practicing clinician has a primer for the incorporation of new techniques and the enhancement of extant understanding. The book is rich in clinical wisdom, and the case examples reflect the creativity of very experienced practitioners....The book tacitly adopts the stance that the therapies discussed are entities as opposed to amalgams. This position serves to make the authors' thinking accessible to the widest audience of practicing clinicians. Regardless of the reader's theoretical persuasion, research or applied practice interests, or level of expertise, this book is easy to read, straightforward in application, and an undeniable leap forward in the informed practice of the art and science of psychotherapy."--PsycCRITIQUES
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Product Details

  • ISBN-13: 9781593852559
  • Publisher: Guilford Publications, Inc.
  • Publication date: 2/24/2006
  • Edition description: New Edition
  • Pages: 240
  • Product dimensions: 6.30 (w) x 9.00 (h) x 1.00 (d)

Meet the Author


David E. Engle, PhD, is a therapist in private practice in Tucson, Arizona, and has been an instructor in gestalt and experiential psychotherapy for many years. Interested in both research and clinical practice, he has published numerous articles and is a coauthor of Focused Expressive Psychotherapy. Dr. Engle has been a summer faculty member at the University of Arizona's Division of Education and Professional Studies, and served for 5 years as Projects Coordinator for the Arizona Psychotherapy Project, University of Arizona College of Medicine, Tucson.

Hal Arkowitz, PhD, is Associate Professor of Psychology at the University of Arizona, Tucson, and has researched and published actively in the areas of anxiety, depression, and psychotherapy. He also maintains a clinical practice. Dr. Arkowitz was Editor of the Journal of Psychotherapy Integration for 10 years and has coedited two books: Comprehensive Handbook of Cognitive Therapy and Psychoanalytic and Behavior Therapy: Toward an Integration.

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Table of Contents


1. An Overview of Resistance and Ambivalence
2. Theories of Resistance and Ambivalence
3. An Integrative Model of Resistant Ambivalence
4. Measurement and Assessment of Resistance and Ambivalence
5. An Overview of Approaches to Working with Resistant Ambivalence
6. The Two-Chair Approach: Part I
7. The Two-Chair Approach: Part II
8. Motivational Interviewing: Principles and Strategies
9. Clinical Applications of Motivational Interviewing
10. Integrating Ambivalence Work with Other Therapeutic Approaches
Appendix: Comparison among Theories of Assistance
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