Interpersonal Reconstructive Therapy: Promoting Change in Nonresponders


What can be done to help those persons who consistently do not respond to therapeutic interventions, despite significant suffering and repeated attempts to seek treatment? Filling a crucial need, this book presents a powerful evidence-based approach to working with individuals with severe, treatment-refractory conditions, including but not limited to personality disorders. Leading scientist-practitioner Lorna Smith Benjamin provides both a comprehensive introduction to interpersonal reconstructive therapy (IRT) ...
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What can be done to help those persons who consistently do not respond to therapeutic interventions, despite significant suffering and repeated attempts to seek treatment? Filling a crucial need, this book presents a powerful evidence-based approach to working with individuals with severe, treatment-refractory conditions, including but not limited to personality disorders. Leading scientist-practitioner Lorna Smith Benjamin provides both a comprehensive introduction to interpersonal reconstructive therapy (IRT) and clear, step-by-step guidelines for practice. At the heart of IRT is a clearly explained method of case conceptualization that links presenting symptoms to longstanding patterns in interpersonal relationships; targets the motivational factors that maintain current difficulties; helps therapist and client collaborate to stay focused on key therapeutic goals; and facilitates the learning of new patterns through a variety of carefully planned interventions. Solidly grounded in theory and research, the volume is illustrated with rich clinical examples that bring core principles to life.
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Editorial Reviews

From the Publisher
"Essential reading for anyone interested in psychotherapy with 'difficult' cases. Benjamin's clearly articulated model of psychopathology and psychotherapeutic change processes integrates insights from interpersonal, psychodynamic, cognitive-behavioral, and attachment theory. Detailed clinical case material is provided throughout the book to illuminate key points. I have found this book extremely helpful in my clinical work as well as in my teaching. Students, clinical teachers, and experienced psychotherapists will be raving about this book for many years to come."—George Silberschatz, PhD, Department of Psychiatry, UCSF School of Medicine

"Interpersonal Reconstructive Therapy is a complex, but rewarding book which describes effective treatment strategies and techniques for working with ‘nonresponders' or patients with psychiatric conditions that were previously untreatable. Dr. Benjamin combines psychodynamic and cognitive behavioral theory to address dysfunctional patterns of behavior, while providing therapists with flow charts to make sound clinical interventions and facilitate effective outcomes."—Muriel Prince Warren, DSW, ACSW, Behavioral Science Book Service Advisory Board Member

"An astute and compassionate clinician, Dr. Benjamin fulfills our highest expectations as an insightful and sophisticated teacher of therapeutic science. Interpersonal Reconstructive Therapy is a work of impeccable scholarship in which therapeutic complexities are assessed clearly and incisively, employing a set of concise principles. Benjamin brilliantly conceptualizes her groundbreaking model and illustrates this authoritative guide with fascinating clinical examples. With her well-articulated method of social structural analysis, she demonstrates a tool—a lens, as she terms it—that codifies and links biographic history and a patient's presenting problem. Elucidating her approach impressively and persuasively, Benjamin has written an illuminating text for thinkers, therapists, psychiatric residents, and clinical graduate students."—Theodore Millon, PhD, DSc, Institute for Advanced Studies in Personology and Psychopathology

"A practicing psychiatrist and educator, I have used earlier drafts of this book in training growing numbers of experienced clinicians. Like myself, my trainees have found IRT well worth learning. It provides strategies for conducting therapy in a focused, original way that is highly likely to result in constructive, stable change for many patients who were previously unresponsive to treatment. This book encapsulates Dr. Benjamin's decades of work to objectively define psychopathology and the components of effective psychotherapy. It offers an inherently wise, user-friendly articulation of central psychological concepts, with specific intervention guidelines and rich clinical examples. This is inspiring reading for experienced clinicians and a vital resource for teaching and training."—Kathleen Sigrist Levenick, MD, Clinical Assistant Professor of Psychiatry, University of Wisconsin-Madison

"Clinicians have long been plagued with the dilemma of how to work with complicated and difficult-to-treat clients. Clinical experience and research tells us that even with our most effective interventions, symptom reduction is more difficult to bring about when dealing with nonresponders. In this clearly written, practice-oriented book, Benjamin provides us with a unique blend of clinical experience, clear thinking and balanced wisdom. Demonstrating a sophisticated integration of psychodynamic and cognitive-behavioral therapy, Benjamin maintains that both self-discovery and self-management are required to bring about change. How this can be accomplished is clearly spelled out in this most important contribution to the field."—Marvin R. Goldfried, PhD, Department of Psychology, State University of New York at Stony Brook

"Lorna Smith Benjamin is a master clinician and teacher. She has written what now becomes the best available guide to the art and science of psychotherapy. Her interpersonal method is presented in such a clear and compelling manner that the book is an excellent introduction for the novice, but also a gold mine for the more experienced."—Allen J. Frances, MD, Department of Psychiatry, Duke University

"Lucidly written and clinically compelling, Interpersonal Reconstructive Therapy helps graduate student therapists understand and intervene more effectively with their clients. In the best of the scientist-practitioner tradition, Benjamin flexibly integrates different theoretical approaches, and utilizes an attachment-informed perspective, to create this comprehensive, evidence-based approach. Completing an exit survey as they approached graduation, a number of my students reported that this was the most helpful text they had read in their graduate training. Wise and compassionate, this text is a gift to our field."—Edward Teyber, PhD, California State University, San Bernardino

Psychotherapy Review
"This book provides one of the most creative and innovative contributions in many years to the conceptualization, understanding, and treatment of personality disorders. Dr. Benjamin wisely brings together and integrates with a sophisticated understanding a vast research literature with years of direct, intensive experience. Through following this manual, she offers systematic, pragmatic advice for clinicians involved in the potentially frustrating task of treating these personality disorders."—Psychotherapy Review
Psychology and Psychotherapy
"A major contribution to the theory and practice of psychotherapy....A most rewarding book to read."—Psychology and Psychotherapy
"A master clinician, Benjamin has spent most of her career researching and treating the interpersonal processes of patients with personality disorders and other interpersonal problems....One of the more delightful aspects of the volume is Benjamin's masterful translation of complex and abstract theoretical concepts into simple, everyday language....It's hard to imagine many clinicians not advancing their own thinking and practices about working with their most difficult patients by reading this book."—Psychotherapy
American Journal of Psychiatry
"[Benjamin] exhibits sound clinical judgment and is unafraid to tackle the most difficult and dangerous crises (including suicidal and homicidal behavior as well as psychotic experiences). She inspires confidence, and I would happily refer patients to her."—American Journal of Psychiatry
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Product Details

  • ISBN-13: 9781572305380
  • Publisher: Guilford Publications, Inc.
  • Publication date: 1/1/2003
  • Edition number: 1
  • Pages: 372
  • Product dimensions: 6.10 (w) x 9.00 (h) x 1.30 (d)

Meet the Author

Lorna Smith Benjamin, PhD, is Professor in the Department of Psychology at the University of Utah and Co-Director of the Interpersonal Reconstructive Therapy Clinic at the University of Utah Neuropsychiatric Institute. She is the author of Interpersonal Diagnosis and Treatment of Personality Disorders, Second Edition.

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Table of Contents

1. Introduction and Overview
2. Case Formulation
3. Choosing Interventions
4. Structural Analysis of Social Behavior: The Clarifying Lens
5. Step 1: Collaboration
6. Step 2: Learning about Patterns, Where They Are From, and What They Are For
7. Step 3: Blocking Maladaptive Patterns
8. Step 4: Enabling the Will to Change
9. Step 5: Learning New Patterns
10. Interpersonal Reconstructive Therapy in Clinical and Research Contexts

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