Twenty-First Century Psychotherapies E-Book

Jay L. Lebow

• Herausgeber: John Wiley & Sons
• Kategorie: Fachliteratur
• Sprache: Englisch

Seitenzahl: 1420

Veröffentlichungsjahr: 2008

Beschreibung

Praise for Twenty-First Century Psychotherapies "Jay Lebow has done a masterful job in presenting a lucid overview of the leading theories of psychotherapy, strategies of change, and intervention techniques at the forefront of the field. This outstanding volume is a must-read for seasoned clinicians and trainees alike." --Froma Walsh, Mose & Sylvia Firestone Professor in the School of Social Service Administration, Professor of Psychiatry in the Pritzker School of Medicine, and Codirector of Center for Family Health, The University of Chicago "This book provides a well-written, up-to-date survey of the theories and practices of psychotherapy that have stood the test of time and seem to be here to stay. A great strength is the chapter authors' inclusion of the evidence for each approach, since Evidence-Based Practice truly is a hallmark of the twenty-first century. This outstanding resource will enable readers to both understand and implement therapy." --Ronald F. Levant, EdD, ABPP, Dean and Professor of Psychology, University of Akron, and 2005 President, American Psychological Association "Twenty-First Century Psychotherapies offers a remarkably comprehensive, up-to-date, and scholarly examination of the dominant approaches to therapy. Written by leading and articulate experts in each intervention model, this book draws together the most forward-thinking perspectives in individual, group, and couples/family therapy. This will be a treasured reference to novice and experienced clinicians alike, and I expect it to be a much-consulted companion to professionals for many years to come." --Nadine J. Kaslow, PhD, ABPP, Professor and Chief Psychologist, Emory University School of Medicine at Grady Health System Twenty-First Century Psychotherapies provides thorough coverage of the methods of psychotherapy now held in the highest regard, both for the quality of the research evidence behind them and for their effectiveness with a variety of treatment populations and treatment settings.

Leseprobe

Contents

Contributors List

Preface

Chapter 1: Introduction

Defining Psychotherapy

Goals of Psychotherapy

Views of How to Live Life

Core Determinants of Human Experience

Treatment of Disorders and Difficulties

Schools of Psychotherapy

Focus of This Book

References

Chapter 2: Behavior Therapy

Theoretical Concepts of Behavior Therapy

History of Behavior Therapy

Contemporary Variations of Behavior Therapy

Theories of Personality and Development of Psychopathology

Theory of Psychotherapy

References

Chapter 3: Cognitive Therapy

History of Cognitive Therapy

Theory of Personality and Psychopathology

Theory of Psychotherapy

Empirical Support

Summary

References

Annotated References

Key References for Case Studies

Web and Training Resources

Chapter 4: Experiential Therapy

History of the Experiential Approach and Its Variations

Theory of Personality and Psychopathology

Theory of Psychotherapy

Summary

References

Annotated References

Key References for Case Studies

Web and Training Resources

Chapter 5: Mindfulness- and Acceptance-Based Therapy

History of Mindfulness- and Acceptance-Based Therapies

Theories of Psychopathology, Health, and the Development of Difficulties

Theory of Psychotherapy

Empirical Support

Summary

References

Annotated References

Key References for Case Studies

Web and Training Resources

Chapter 6: Postmodern/Poststructuralist Therapies

Postmodernism, Poststructuralism, and Psychotherapy

History of Postmodernism and Psychotherapy

Common Characteristics of Postmodern Therapies

Solution-Focused Therapy

Narrative Therapy

Collaborative Therapy

References

Annotated References

Key References for Case Studies

Web and Training Resources

Chapter 7: Psychoanalytic Psychotherapy

History of Psychoanalytic Psychotherapy and Its Variations

Theory of Personality and Psychopathology

Theory of Psychotherapy

Description of Experiential Dynamic Short-Term Psychotherapy

References

Annotated References

Key References for Case Studies

Web Resources

Chapter 8: Existential Psychotherapy

History of Existential Psychotherapy and Its Variants

Theory of Personality and Psychopathology

Theory of Psychotherapy

Empirical Support

Description of a Specific Approach to Treatment

Summary

References

Annotated References

Key References for Case Studies

Web and Training Resources

Chapter 9: Feminist Therapy

History of Feminist Therapy: Initial Stirrings

Development of Feminist Therapy Theory

Current Status

Theory of Personality and Psychopathology: Distress, Not Pathology, and Usual, Not Normal

Theory of Psychotherapy: Collaboration of Experts—Feminist Therapy, Empowerment, and the Egalitarian Relationship

Feminist Therapy and Multicultural Practice

Summary

References

Annotated Key References

Key References for Case Studies

Web and Training Resources

Chapter 10: Couple and Family Therapy

Defining Couple and Family Therapy

History of Couple and Family Therapy and Its Variations

Systems Theory Applied to Personality and Psychopathology

Theories of Psychotherapy

Assessment Procedures

Process of Psychotherapy

Culture and Gender

Empirical Support

Generic Integrative Family Therapy

Summary

Annotated References

Web and Training Resources

Chapter 11: Group Therapy

History of Group Psychotherapy

Theory of Personality and Psychopathology

Theory of Group Psychotherapy: How Change Occurs

Process of Psychotherapy

Strategies and Interventions

Special Issues That Arise in Group Psychotherapy

Ethical Concerns in Group Psychotherapy

Culture, Gender, and Sexual Orientation

Empirical Support

Summary

References

Annotated References

Web and Training Resources

Chapter 12: Integrative Therapy

Technical Eclecticism

Common Factors Approaches to Integration

Theoretical Integration

Assimilative Integration

History of the Approach

Multimodal Therapy

Common Factors Integration: The Future as a Common Factor

Assimilative Psychodynamic Psychotherapy

Integrative Theories of Personality and Psychopathology

Theory of Psychotherapy

Specific Approach: Assimilative Psychodynamic Psychotherapy

Annotated References

Web and Training Resources

Chapter 13: Technical Eclecticism and Multimodal Therapy

History of the Approach and Its Variations

Theory of Personality and Psychopathology

Theory of Psychotherapy

Assessment

Strategies and Interventions

Second-Order Basic Id Assessments

Homework

Adaptation to Specific Problem Areas

Annotated References

Web and Training Resources

Chapter 14: Common Factors in Psychotherapy

History and Variations

General Theory of Personality and Psychopathology

General Theory of Psychotherapy

Description of a Specific Approach

Summary

Annotated References

Web and Training Resources

Author Index

Subject Index

Copyright © 2008 by John Wiley & Sons, Inc. All rights reserved.

Published by John Wiley & Sons, Inc., Hoboken, New Jersey.

Published simultaneously in Canada.

Wiley Bicentennial Logo: Richard J. Pacifico.

No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording, scanning, or otherwise, except as permitted under Section 107 or 108 of the 1976 United States Copyright Act, without either the prior written permission of the Publisher, or authorization through payment of the appropriate per-copy fee to the Copyright Clearance Center, Inc., 222 Rosewood Drive, Danvers, MA 01923, [phone], fax [phone], or on the web at www.copyright.com. Requests to the Publisher for permission should be addressed to the Permissions Department, John Wiley & Sons, Inc., 111 River Street, Hoboken, NJ 07030, [phone], fax [phone], or online at http://www.wiley.com/go/permissions.

Limit of Liability/Disclaimer of Warranty: While the publisher and author have used their best efforts in preparing this book, they make no representations or warranties with respect to the accuracy or completeness of the contents of this book and specifically disclaim any implied warranties of merchantability or fitness for a particular purpose. No warranty may be created or extended by sales representatives or written sales materials. The advice and strategies contained herein may not be suitable for your situation. You should consult with a professional where appropriate. Neither the publisher nor author shall be liable for any loss of profit or any other commercial damages, including but not limited to special, incidental, consequential, or other damages.

This publication is designed to provide accurate and authoritative information in regard to the subject matter covered. It is sold with the understanding that the publisher is not engaged in rendering professional services. If legal, accounting, medical, psychological or any other expert assistance is required, the services of a competent professional person should be sought.

Designations used by companies to distinguish their products are often claimed as trademarks. In all instances where John Wiley & Sons, Inc. is aware of a claim, the product names appear in initial capital or all capital letters. Readers, however, should contact the appropriate companies for more complete information regarding trademarks and registration.

For general information on our other products and services please contact our Customer Care Department within the U.S. at [phone], outside the United States at [phone] or fax [phone].

Wiley also publishes its books in a variety of electronic formats. Some content that appears in print may not be available in electronic books. For more information about Wiley products, visit our web site at www.wiley.com.

Library of Congress Cataloging-in-Publication Data:

Twenty-first century psychotherapies: contemporary approaches to theory and practice / edited by Jay L. Lebow.

p.; cm.

Includes bibliographical references.

ISBN-13: 978-0-471-75223-3 (cloth : alk. paper)

1. Psychotherapy. I. Lebow, Jay.

[DNLM: 1. Psychotherapy. 2. Counseling. WM 420 T9716 2008]

RC480.T94 2008

616.89′14—dc22

2007015021

Contributors

Ruth A. Baer, PhD

University of Kentucky

Department of Psychology

Lexington, Kentucky

Laura S. Brown, PhD

Fremont Community Therapy Project

Seattle, Washington

Gary M. Burlingame, PhD

Brigham Young University

Department of Psychology

Provo, Utah

Mick Cooper, PhD

University of Strathclyde

Department of Educational and Professional Studies

Glasgow, Scotland, United Kingdom

Barry L. Duncan, PhD

Institute for the Study of Therapeutic Change

Tamarac, Florida

Robert Elliott, PhD

University of Strathclyde

Department of Educational and Professional Studies

Glasgow, Scotland, United Kingdom

Jerry Gold, PhD

Adelphi University

Department of Psychology

Garden City, New York

Leslie S. Greenberg, PhD

York University

Department of Psychology, Faculty of Health

Toronto, Ontario, Canada

James W. Griffith, PhD

Family Institute at Northwestern University

Evanston, Illinois

Debra B. Huss, MA

University of Kentucky

Department of Psychology

Lexington, Kentucky

Scott H. Kellogg, PhD

New York University

Department of Psychology Cognitive Therapy Center of New York/Schema Therapy Institute

New York, New York

Arnold A. Lazarus, PhD, ABPP

The Lazarus Institute

Princeton, New Jersey

and

Rutgers University

New Brunswick, New Jersey

Jay L. Lebow, PhD

Family Institute at Northwestern University

Evanston, Illinois

and

Northwestern University

Evanston, Illinois

Jeffrey J. Magnavita, PhD, ABPP

Glastonbury Psychological Associates, PC

Glastonbury, Connecticut

Debra Theobald McClendon

Brigham Young University

Department of Psychology

Provo, Utah

Scott D. Miller, PhD

Institute for the Study of Therapeutic Change

Chicago, Illinois

Alberta E. Pos

York University

Center for Addiction and Mental Health

Toronto, Ontario, Canada

Jacqueline A. Sparks, PhD

University of Rhode Island

Human Development and Family Studies

Kingston, Rhode Island

George Stricker, PhD

Argosy University—Washington DC

Arlington, Virginia

Margarita Tarragona, PhD

Grupo Campos Elíseos

México City, Federal District, Mexico

Universidad Iberoamericana

Departamento de Psicología

México City, Federal District, Mexico

Jeffrey E. Young, PhD

Schema Therapy Institute

New York, New York

and

Columbia University

Department of Psychiatry

New York, New York

Richard E. Zinbarg, PhD

Family Institute at Northwestern University

Northwestern University

Evanston, Illinois

Preface

Psychotherapy and counseling are ever evolving. The dominant methods of practice during each era have been challenged by both the development of new variations on that method and the remarkably different ways of seeing the nature and treatment of human problems. Some of the most prominent therapies of a generation ago are no longer widely practiced, while other theories and methods have developed and become well established.

And yet, from another equally valid vantage point, psychotherapy and counseling can also be viewed as a continuous course of development over the past century. A number of broad core viewpoints (such as psychoanalytic, cognitive, experiential, and behavioral) about the nature of human beings, the nature of human problems, and how to help clients have developed and attained recognition as core schools of treatment. Furthermore, over the past quarter century, the proponents of these methods have tended more and more to be in a dialogue with one another, leading to a widespread movement toward integrative and eclectic psychotherapy and counseling that crosses the boundaries of traditional schools of practice. Most psychotherapists and counselors today describe themselves as integrative/eclectic in their methods of practice, and even those who practice within schools of treatment increasingly include elements from other schools in their approaches. As readily can de seen in reading the chapters in this volume, differences across therapists can be considerable, but many of the same elements appear across theories and some, such as critical attention to the therapeutic alliance, transcend all methods.

This book discusses the theories and methods of psychotherapy and counseling that are most prominent in practice today. Each chapter presents a particular theory and its related approach to practice. The approaches chosen reflect the methods currently most widely chosen by psychotherapists and counselors as well as those that are most prominently taught in training programs and those more recently developed treatments that are gaining greatest attention. Because this book was built from the ground up based on today’s methods of practice, its Contents looks a bit different from earlier books treating this topic. Some methods such as mindfulness-based, postmodern, and feminist treatments are represented here whereas they are not represented in other volumes of this kind, while some older, now less widely practiced, methods such as psychodrama are not included. Moreover, this book includes three chapters dealing with variations of integrative/eclectic practice, presenting the various directions of this movement.

The authors of the chapters in this volume have been selected to represent twenty-first century views of the various theories of practice. Each set of authors includes at least one (and sometimes more than one) prominent expert in the school of practice covered in the chapter. Each set of authors brings the vantage point gained from many years of experience with those methods. Each set of authors also has been involved in the development of a specific variant of the approach, which is described in the latter part of the chapter along with a case example illustrating that method.

My hope is that this volume conveys the sense of breadth and excitement in the fields of psychotherapy and counseling today. I also hope the ideas and resources in this book can serve as the launching point for more in-depth examination of those ideas and methods that are of greatest interest to the reader.

ACKNOWLEDGMENTS

My thanks to Patricia Rossi at John Wiley and Sons for suggesting the idea for this book and helping with it at each step along the way toward publication. Further thanks to Isabel Pratt at John Wiley and Sons and to Jennifer Nastasi and Dèsirée Wagener at the Family Institute at Northwestern, who assisted with the preparation of the manuscript.

CHAPTER 1

INTRODUCTION

Jay L. Lebow

The field of psychotherapy and counseling is continuously evolving. Approaches to treatment change in the wake of the addition of new information, opportunities to test the impact of treatments over time, and the zeitgeist of the place and time where psychotherapy/counseling is practiced. The time has long passed when one method, psychoanalytic psychotherapy as described by Freud (Freud, 1966), dominated the scene. Even during Freud’s era, Jung (1935), Adler (Adler, Glueck, & Lind, 2006), and several other analysts offered competing visions of the core aspects of personality and psychopathology and the conduct of treatment. There has been an explosion in the number of psychotherapies over the past few decades with that number now reaching more than 1,000 different named therapies (Garfield, 2006). Moreover, although some of these treatments are only slight variations of others, many approaches have their foundations in an array of diverse philosophies concerned with the understanding of personality, ethical questions (e.g., how to live life well), and notions of how to most helpfully improve problems in living and psychopathology.

DEFINING PSYCHOTHERAPY

Orlinsky and Howard (1987) define psychotherapy as “(1) a relation among persons, engaged in by (2) one or more individuals defined as needing special assistance to (3) improve their functioning as persons, together with (4) one or more individuals defined as able to render such help.” That is, psychotherapy (and the closely related activity of counseling) essentially consists of a socially constructed relationship in which one person (with the appropriate credentials and training) is seen as able to help others through the process of relating with that person or persons. The form and content of that relating can and does vary enormously.

GOALS OF PSYCHOTHERAPY

Psychotherapy and counseling are complex activities because both typically focus on the alleviation of symptoms and psychological disorders and on individual growth and goal attainment. Furthermore, psychotherapies and methods of counseling encompass working with a range of process goals (e.g., improving insight, cognitions, or the client’s behavioral repertoire) that are seen as crucial in achieving the ultimate goals of treatment. A consideration of the field is further complicated because different treatments aim toward these respective process and ultimate goals to different extents, although almost all treatments make some claim to help attain each set of ultimate goals.

In considering the variety of treatment models in books of this kind, we are left with many difficult and complicated questions, such as:

How do we compare treatments such as behavior therapies that almost entirely focus on change in behavior as both the process and ultimate goals of treatment with treatments (e.g., experiential psychotherapies) that primarily aim to deepen client experience?

How do we compare the outcomes sought in a psychoanalytic treatment that are focused on increasing individual understanding with those of mindfulness therapies that aim to increase the ability to defocus from problems?

How do we compare the outcomes of individually oriented treatments that focus exclusively on change in the individual with family treatments that prioritize family change?

These sorts of questions are widely debated by authors committed to diverse positions about what works best and about how psychotherapy/counseling can best benefit clients.

VIEWS OF HOW TO LIVE LIFE

Questions as to what constitutes the life best worth living have been discussed at least since the time of Aristotle and competing visions have evolved. Originally, these discussions were the province of philosophy and religion, but in the past century, such issues concerned with the best and most effective way to live have come to occupy a central place in psychotherapy and counseling. As Messer (Messer & Winokur, 1980, 1984, 1986) has highlighted, therapies differ considerably in their core view of human existence. Some psychotherapies feature a basically optimistic view of life. (Messer describes these in the tradition of literature as comedic.) Treatments such as cognitive-behavioral therapies and experiential therapies see hard work and personal improvements as leading to good outcomes if the client participates as prescribed. Other treatments have a more tragic focus. Freud (1966) viewed the result of psychoanalysis as coming to terms with the limitations imposed by the world and envisioned a world filled with trouble. Existential therapists and most psychoanalytic therapists have shared a similar vision.

CORE DETERMINANTS OF HUMAN EXPERIENCE

Beyond implying a world vision, there also are ideas at the core of most therapy approaches that specify which aspects of human experience are most important and crucial to address in treatment. The schools of psychotherapy summarized in the chapters in this book vary considerably in their core view of human personality and social psychology and in how to be most helpful. Is it best to be fully in touch with our emotions as experiential therapists suggest, or to maintain a stoic view of the world that highlights using the human cognitive capacity to keep emotion under control as in cognitive therapy? How important is it to gain insight versus achieve behavior change? Is it best for clients to see themselves as separate individuals or as connected to families and larger social systems? Where theories stand with regard to such questions to a great extent shapes the focus of intervention.

TREATMENT OF DISORDERS AND DIFFICULTIES

If one thread in psychotherapy is concerned with how to live, another is concerned with improving individual functioning so that problems in living are alleviated. In the past few decades, more and more specific therapies have been developed to reach the ultimate goal for treatment of reducing specific sets of dysfunctional behaviors and increasing functional ones.

There are actually two variants of such approaches:

1. Treatments that center on building competencies and overcoming difficulties; that is, they aim to change behavior patterns.

2. Treatments that specifically aim to impact on the disorders catalogued in the Diagnostic and Statistical Manual of Mental Disorders (DSM) published by the American Psychiatric Association (First, France, & Pincus, 2004).

The aim of this latter group of treatments, which incorporate the medical model of disorder at the foundation of DSM, to reduce or eliminate psychopathology. From the time of Freud, it has been clear that psychotherapy was one method for alleviating the sorts of disorders catalogued in the DSM (and for some time, the only available; in the past 50 years, medications have also been readily available). Recently, there have been numerous treatments developed with such a specific syndrome focus that have been empirically tested and demonstrated to be effective in treating the designated disorder and labeled as empirically supported treatments (ESTs). Although ESTs clearly work (they have been demonstrated to do so), they have been highly controversial in the field of psychotherapy. There is considerable debate about whether the movement to specific evidence based treatments for specific DSM disorders is a positive or negative change in the world of psychotherapy (see the discussion in Chapter 14 in this book for one side of this argument and Chapter 13 for the other).

SCHOOLS OF PSYCHOTHERAPY

The chapters in this book each describe a broad school of psychotherapy. Most of these theoretical approaches have been in existence for many years and each has many variations.

The behavioral approach described in Chapter 2 builds on the traditions derived from Pavlov and Skinner of classical and operant conditioning, accentuating the building of behavioral skills along with processes of learning. In this approach, rather than there being various branches in this school of treatment, there is essentially one behavioral technology applied in different ways to a variety of presenting situations and problems.

The cognitive approaches described in Chapter 3 prioritize thoughts, theorizing that thoughts come before and affect emotions. The most prominent methods in this school of approach, such as Beck’s cognitive therapy (Beck, 1976) or Ellis’s rational emotive therapy (Ellis, 1962), examine thoughts for logical errors and look to enable more sensible and balanced thinking.

Behavior therapy and cognitive therapy derive from quite different traditions in the fields of psychology and psychotherapy, respectively accentuating behavior and thoughts as the central focus in the change process. Given the vast difference in the roots of these methods, the behavioral and cognitive methods are presented in this book in separate chapters. However, it should be highlighted that the integration of cognitive and behavioral approaches into cognitive-behavioral treatment is almost complete among the psychotherapists who practice these methods so that few therapists today utilize behavioral interventions without cognitive ones or cognitive interventions without behavioral ones.

The experiential approaches described in Chapter 4 prioritize the role of emotion in human functioning. Experiential strategies focus on becoming more in touch with emotions and learning to express clearly those emotions so as to free the client from the residue of a stuck emotional life.

Mindfulness treatments, such as that of Kabat-Zinn (2003), described in Chapter 5 emanate from a much different tradition, that of Eastern philosophy, most prominently, Zen Buddhism. These approaches accentuate freeing of the self from the distractions imposed by daily life. Strikingly, perhaps because of the shared utilization of relaxation techniques or the latent focus in these methods on training the brain, mindfulness techniques now also are often included in the cognitive-behavioral treatment repertoire. In Chapter 5, the authors describe two treatments that mix cognitive-behavioral and Eastern traditions that draw heavily on mindfulness, Linehan’s dialectical behavior therapy (Linehan, Cochran, & Kehrer, 2001), and Hayes’s (2004) acceptance and commitment therapy.

Narrative and postmodern therapies, such as the narrative treatment (White & Epston, 1989) described in Chapter 6, apply the postmodern ideology to psychotherapy. These approaches typically assume a position at a meta level to the therapy experience and remove the privileged position typically associated with therapist. Instead, each individual in the therapeutic dyad is viewed as having an equally important narrative. The goal of treatment therefore becomes to engage in conversation rather than strategies to work to promote change. Many of the postmodern therapies also accentuate the politics of freeing treatment from the social-cultural prejudices that are prevalent in the larger society.

Psychoanalytic therapies, including psychoanalysis and the many variants that followed from the work of Freud, described in Chapter 7, accentuate the internal process occurring within individuals and most especially the conflicts within individuals. These also are treatments that accentuate transferences, the carryovers from earlier relationships that appear in the relationship between client and therapist, and the value of insight as a vehicle for change.

The existential approach, including the methods of Yalom and Yalom (1998) described in Chapter 8, derives from existential philosophy. The accent here is on fully experiencing the meaning of being in the world, especially a world in which wars and death are realities. The existential approach aims for living in the moment and accentuating a profound search for meaning in existence.

Feminist approaches described in Chapter 9 assume a much different perspective. These approaches do not privilege one particular way of seeing personality or psychopathology or a particular strategy for promoting change. Instead, these approaches center on the belief that whatever the method chosen for intervention, therapy must actively promote an understanding of gender and the often-unstated beliefs that emerge in treatment having to do with gender bias as well as equality of the sexes. Chapter 9 also describes the parallel position of therapies fully grounded in the client’s culture. Because understandings of the impact of gender and culture are crucial not only to feminist- and culture-based treatments but also to all twenty-first century treatment, each chapter in this volume includes some discussion of gender and culture in relation to the particular approach to treatment.

Couple and family therapies, such as structural family therapy (Minuchin, 1974) described in Chapter 10, focus not on the treatment of the individual but on the system. From the systemic perspective, individual behavior is viewed as nested in the exchanges between individuals. There are numerous forms of couple and family therapy, most of which integrate a systems viewpoint with one of the theories already discussed in this chapter. Couple and family therapy is both a set of specific ways for working with couple and family problems, such as distressed marriages, and a view that accentuates the importance of the family system broadly in individual life.

Group therapy, such as the interpersonal method (Yalom & Leszcz, 2005) described in Chapter 11, like family therapy, has numerous variations derived from combining theories and methods of group practice with each of the traditions described earlier in this section. What brings these approaches together is the use of a group to deliver the treatment, adding a number of special group therapy curative factors such as group cohesion to the impact of treatment, as well as building on the additional cost-effectiveness compared to individual therapy of these methods.

Finally, many of today’s therapies are becoming more and more integrative and eclectic, bridging the earlier distinctions between theories and strategies of intervention. There now are many of these integrative/eclectic treatments. As theories assimilate interventions and methods from other treatments (Lazarus & Messer, 1991), it becomes harder and harder today to find a pure form of therapy that has not in part been influenced by other therapies (in this book, some footprints of other schools of therapy typically are seen in the detailed descriptions provided in each chapter of one of today’s specific approaches within each broad school of practice). Three chapters of this book are devoted to variations of integrative/eclectic methods. Chapter 12 presents an overview of the integrative/eclectic field as well as describing approaches that fully attempt to integrate treatment approaches. Chapter 13 describes the philosophy of what is called technical eclecticism consisting of choosing the best specific treatment(s) for a problem, highlighting multimodal therapy (Lazarus, 1989). Chapter 14 describes approaches that accentuate the common factors that are essential in all good treatment, and today, sometimes are fully the focus of therapy. The presence of these three chapters reflects the increasing movement of the psychotherapy/counseling toward integrative/eclectic practice.

FOCUS OF THIS BOOK

The focus of this book is on the most popular and widely practiced methods in psychotherapy today. In considering the approaches in this book, you may notice that its content differs some from the content of earlier books treating this topic. Although the psychotherapy of today incorporates the insights of previous generation of treatments, some of the treatments that were most popular a generation ago are now rarely practiced and other treatments such as mindfulness-based, postmodern, and feminist approaches have grown exponentially. Therefore, mindfulness and narrative treatments are covered in this book, whereas other once-popular approaches such as the Adlerian approach (Adler, 1989) and Morena’s psychodrama (Yalom, 1985) are not. (Some of these now less-widely practiced approaches continue to have powerful legacies, such as Adler’s influence on today’s cognitive therapies or Moreno’s influence on group therapy.) This book also emphasizes those variants of schools of approach that are most prominent today, so that some of the forms of the older schools covered (e.g., in the psychoanalytic and experiential approaches) also vary from the particular forms emphasized in older books (a section of each chapter places current methods of practice in its historical context). The goal has been to make this a twenty-first century book of psychotherapies—one that is about treatments that have emerged as prominent today and that are likely to stay prominent over the first half of the century.

Given the importance of evidence for treatments that is part of accountability of therapies and therapists/counselors in the twenty-first century, the status of evidence for each treatment is also highlighted. Although the field of psychotherapy research has certainly not reached the point that established treatments are left behind simply because they have not as yet been studied to establish their effectiveness, such evidence is now more important than before.

A word as well about what is not covered in this book. This book is about theories of psychotherapy, strategies of change, and intervention techniques. It does not describe (except perhaps in Chapter 14 on common factors) the personal characteristics that make up a good therapist, even though psychotherapy research clearly indicates that such factors are at least as important as theory and technique (Lambert & Hill, 1994). It also does not describe how to train therapists; the nuances of how to conduct specific intervention strategies and techniques; or how to carry out treatment in various treatment settings; nor does it speak much to differences in technique in the treatment of adults, adolescents, or children. Its emphasis is on theory and technique, and most especially on providing an overview of today’s best and most widely practiced psychotherapies. The reader is referred to the numerous additional resources suggested in each chapter for further examination of such topics and to learn more about each of the specific theories. The best use of this book is as a launching point for further exploration.

Each author was asked to utilize the same foundational outline for their chapter. Although the headings may vary across the chapters, the core information needed to understand each treatment model is admirably covered. Each chapter includes both an overview of the territory of the school of practice and a section in which one specific approach in the overall school of approach (usually the one with which the authors are associated) is more thoroughly explained. Each chapter also includes a Case Illustration that indicates how that specific method is practiced in real-life treatment settings.

REFERENCES

Adler, A. (1989). Fundamentals of individual psychology. TACD Journal, 17(1), 23–33.

Adler, A., Glueck, B., & Lind, J. E. (2006). The neurotic constitution: Outlines of a comparative individualistic psychology and psychotherapy. New York: Kessenger Publishing.

Beck, A. T. (1976). Cognitive therapy and the emotional disorders. Oxford, England: International Universities Press.

Ellis, A. (1962). Reason and emotion in psychotherapy. Oxford, England: Lyle Stuart.

First, M. B., France, A., & Pincus, H. A. (2004). DSM-IV-TR guidebook. Washington, DC: American Psychiatric Publishing.

Freud, S. (1966). The standard edition of the complete psychological works of Sigmund Freud (J. Strachey, Ed. & Trans., Vols. 1–24). London: Hogarth Press.

Garfield, S. L. (2006). Therapies—Modern and popular: PsycCRITIQUES 2006. Washington, DC: American Psychological Association.

Hayes, S. C. (2004). Acceptance and commitment therapy, relational frame theory, and the third wave of behavioral and cognitive therapies. Behavior Therapy, 35(4), 639–665.

Jung, C. (1935). Basic principles of practical psychotherapy. Zentralblatt fur Psychotherapie, 8, 66–82.

Kabat-Zinn, J. (2003). Mindfulness-based stress reduction (MBSR). Constructivism in the Human Sciences, 8(2), 73–107.

Lambert, M. J., & Hill, C. E. (1994). Assessing psychotherapy outcomes and processes. In A. E. Bergin & S. L. Garfield (Eds.), Handbook of psychotherapy and behavior change (4th ed., pp. 72–113). Oxford, England: Wiley.

Lazarus, A. A. (1989). The practice of multimodal therapy: Systematic, comprehensive, and effective psychotherapy. Baltimore: Johns Hopkins University Press.

Lazarus, A. A., & Messer, S. B. (1991). Does chaos prevail? An exchange on technical eclecticism and assimilative integration. Journal of Psychotherapy Integration, 1(2), 143–158.

Linehan, M. M., Cochran, B. N., & Kehrer, C. A. (2001). Dialectical behavior therapy for borderline personality disorder. In D. H. Barlow (Ed.), Clinical handbook of psychological disorders: A step-by-step treatment manual (3rd ed., pp. 470–522). New York: Guilford Press.

Messer, S. B., & Winokur, M. (1980). Some limits to the integration of psychoanalytic and behavior therapy. American Psychologist, 35(9), 818–827.

Messer, S. B., & Winokur, M. (1984). Ways of knowing and visions of reality in psychoanalytic therapy and behavior therapy. In H. Arkowitz & S. B. Messer (Eds.), Psychoanalytic therapy and behavior therapy: Is integration possible? (pp. 63–100). New York: Plenum Press.

Messer, S. B., & Winokur, M. (1986). Eclecticism and the shifting visions of reality in three systems of psychotherapy. Journal of Integrative and Eclectic Psychotherapy, 5(2), 115–124.

Minuchin, S. (1974). Families and family therapy. Oxford, England: Harvard University Press.

Orlinsky, D. E., & Howard, K. I. (1987). A generic model of psychotherapy. Journal of Integrative and Eclectic Psychotherapy, 6(1), 6–27.

White, M., & Epston, D. (1989). Literate means to therapeutic ends. Adelaide, Australia: Dulwich Centre.

Yalom, I. D. (1985). The theory and practice of group psychotherapy (3rd ed.). New York: Basic Books.

Yalom, I. D., & Leszcz, M. (2005). The theory and practice of group psychotherapy (5th ed.). New York: Basic Books.

Yalom, I. D., & Yalom, B. (1998). The Yalom reader: Selections from the work of a master therapist and storyteller. New York: Basic Books.

CHAPTER 2

BEHAVIOR THERAPY

Richard E. Zinbarg

James W. Griffith

The central defining feature of behavior therapy is that it involves the application of the laws of learning theory to the modification of problematic behavior. At the time that behavior therapy was first beginning to gain momentum, another aspect that distinguished it from the prevailing Freudian school of therapy was the recognition of the need to distinguish etiological factors from maintaining ones. This distinction no longer can be claimed as being unique to behavior therapy because it is also central to cognitive therapy; however, this distinction still lies at the heart of behavior therapy. We wish to emphasize from the outset that behavior therapy has (not surprisingly) evolved significantly since its inception. Perhaps one of the two most fundamental ways in which behavior therapy has changed is its integration with cognitive therapy such that these days there are probably many more therapists who identify themselves as cognitive-behaviorists (as we do) than behaviorists. The other most fundamental change is that there is more recognition now of the importance of the therapeutic relationship than there was in the beginning.

Whereas contemporary cognitive-behavioral therapy (CBT) almost always combines the behavioral and cognitive traditions, this chapter focuses on the behavioral tradition. Chapter 3 by Scott Kellogg and Jeffrey Young provides an overview of the cognitive tradition. Similarly, Arnold Lazarus, one of the pioneers of the integration of the behavioral and cognitive traditions, writes about multimodal therapy, his approach to CBT, in Chapter 13.

THEORETICAL CONCEPTS OF BEHAVIOR THERAPY

Key theoretical concepts in behavior therapy are classical conditioning, instrumental conditioning, generalization, extinction, and functional assessment. Behavior therapy also gave rise to a key methodological concept: the single case design in psychotherapy.

Classical conditioning is the learning that occurs when two stimuli are presented in close temporal proximity and with some degree of contingency or correlation between them. A form of classical conditioning that is particularly important for behavior therapy occurs when the first of these stimuli (the conditioned stimulus) is affectively neutral prior to being paired with the second (the unconditioned stimulus), whereas the second already has some emotional valence for the individual and elicits some form of response (the unconditioned response) indicative of this valence. In this case, the contingency between the conditioned stimulus and the unconditioned stimulus typically leads to the conditional stimulus acquiring at least some of the emotional valence of the unconditioned stimulus and the capacity to elicit a response (the conditioned emotional response). The conditioned emotional response sometimes resembles the unconditioned response, but does not necessarily need to do so and often does not. As discussed in more detail later, Pavlov (1927) is often credited with being the father of the modern study of classical conditioning, and Watson (1994/1913) and his student Mary Cover Jones (1924) are usually credited for pioneering the application of classical conditioning to the understanding and remediation of problem behaviors in humans.