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Doody's Review ServiceReviewer: Christopher J Graver, PhD, ABPP-CN(Madigan Healthcare System)
Description: Despite a flood of behavioral and cognitive psychological interventions with strong empirical support for a number of different disorders, psychodynamic psychotherapy survives, as indicated by the release of this instructional book.
Purpose: It was developed as an instructional aide to psychiatry residents and is intended to teach the nuts and bolts of psychodynamic psychotherapy.
Audience: This book is appropriate for any behavioral health professional interested in learning psychodynamic psychotherapy, including psychiatrists, psychologists, and students of these disciplines. The authors are well entrenched in the East Coast psychodynamic culture and tradition.
Features: Interestingly, the introduction describes a very generic therapeutic approach that includes some aspects that could be considered part of cognitive behavioral therapy (CBT), and the authors disavow any particular school of psychodynamic thought. Nevertheless, ego-strength, super ego-strength, and defense mechanisms make their return in early chapters. The indications for using psychodynamic psychotherapy are explored in chapter 6. Despite a narrow focus of two main conditions that would indicate the use of this approach, these two conditions are expanded to encompass most any problem, some of which are quite arguably better suited to other intervention techniques (e.g., psychotic individuals). The main contraindication seems to be a patient who is unmotivated to commit significant time and resources to therapy. As the book progresses, the chapters become focused on the details of therapy through case examples, as well as follow-up activities at the end of each chapter that are helpful for learning the process. It also covers a host of general clinical skills, including reflection, therapeutic alliance, empathic listening, setting boundaries, etc. The middle chapters set up how to conduct psychotherapy sessions in the initial phases, but the book fails to provide detailed information about therapy over the long term and leaves the process vague and open-ended until one of the final chapters discusses specific ideas for termination. Although the book is certainly instructive, it often fails to provide any rationale for the direction given other than someone said so in a book. Many of the references to support the authors' instruction come from other books on psychodynamic topics and not from peer-reviewed journal articles or scientific studies (e.g., outcome studies, dismantling investigations).
Assessment: As an instructive guide, this book provides some introductory information about this therapeutic approach in a useful manner, but the details of the middle stage of therapy are generally lacking. Additionally, readers must take what the authors say largely on faith or consensus, without hard scientific or peer-reviewed information. For readers willing to do that, this can be a reasonable resource.