Oct 1, 2015 | Book Reviews
In Treating Psychosis: A Clinician’s Guide to Integrating Acceptance and Commitment Therapy, Compassion-Focused Therapy and Mindfulness Approaches within the Cognitive Behavioral Therapy Tradition, Nicola P. Wright et al. offer valuable knowledge and concrete, practical application of theory, interventions and strategies for clinicians looking to augment their work with individuals who experience psychosis. The authors do an excellent job of laying a foundation that explains how psychosis can cause problems for individuals suffering from it, while concurrently maintaining a compassionate stance.
The book is divided into nine modules that build upon one another sequentially and address different components of the counseling process, including initial conceptualization and group implementation, the therapeutic relationship, assessment, treatment planning, emotion regulation and resilience, treating distressing thoughts and voices, and recovery maintenance. Throughout the modules, Wright et al. include clinical examples and exercises to help the reader apply the text to clinical practice. The book also has an abundant appendix of forms that counselors can utilize in every stage of work with clients, from initial screening and assessment to more in-depth work after initial rapport occurs, such as emotion identification, core beliefs, coping strategies and voice management, in order to help clients minimize distress. Additionally, the authors provide a thorough collection of resources and further reading for clinicians to supplement their expertise and practice.
The authors are concise and craft a comprehensive strategy for working clinically with this population in only 159 pages. The text is approachable and conversational and the subject matter is explained with person-centered compassion and sensitivity. The interventions recommended are easy to apply and simple in their explanation. The overarching philosophy promoted by the authors is an intent focus on understanding clients’ experiences with voices and distressing thoughts. With this better understanding, clinicians can empower clients to establish more control in their lives using a blend of cognitive-behavioral, compassion-focused, mindfulness, and acceptance and commitment techniques—including commanding voices, bringing beliefs more in line with personal values, and ultimately establishing a more positive relationship with thoughts and voices—in order to enhance emotional regulation, build resilience, and increase overall congruence to decrease distress for clients experiencing psychosis.
The main limitation associated with the book is the breadth of approaches that the authors attempt to include in their comprehensive approach. While the blending of the four separate approaches of acceptance and commitment therapy, compassion-focused therapy, mindfulness, and cognitive-behavioral therapy is ambitious and often successful, at times the overarching strategy comes across as piecemeal and may benefit from a more fully integrated perspective. For example, while the authors utilize a variety of interventions from each of the approaches under the cognitive-behavioral umbrella, at times the integration of these four strategies does not feel fully realized. However, in terms of applying the information in everyday practice, the book is practical and easily applicable.
Treating Psychosis is a useful resource for counselors who work regularly with a clientele experiencing psychosis that interferes with everyday life. The book offers straightforward strategies, interventions and perspectives for decreasing distress around invasive voices and thoughts.
Wright, N. P., Turkington, D., Kelly, O. P., Davies, D., Jacobs, A. M., & Hopton, J. (2014). Treating psychosis: A clinician’s guide to integrating acceptance & commitment therapy, compassion-focused therapy & mindfulness approaches within the cognitive behavioral therapy tradition. Oakland, CA: New Harbinger.
Reviewed by: Allison Jeanne Agresti, NCC, McLeod Addictive Disease Center, Marion, NC.
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Sep 18, 2015 | Book Reviews
Working with adolescents is a challenge in any helping role. Teachers, counselors, volunteers and youth leaders all experience some of the same obstacles when working with this age group. “How do you communicate understanding to resistant teenagers? Do they respect me? Why are they always in a bad mood? Do they ever make eye contact? What are appropriate expectations for behavior?” In What Works with Teens, licensed social workers Britt Rathbone and Julie Baron address many concerns that face people working with adolescents by providing information on development as well as tangible ways to help build better relationships with young people.
Part 1 of the book, “Welcome to the World of Adolescence,” gives a succinct summary of adolescent development. Rathbone and Baron set the foundation of adolescent socio-emotional behavior by giving a brief overview of teens’ brain structure. Rathbone and Baron discuss neuroscience in a way that makes the information attainable and understandable to people of any profession, including those with limited background in this type of science. They then discuss the priorities of adolescents, their emotional needs, and stereotypes that adults may have about young people that cause barriers in their work and in connecting with adolescent clients. While detailing components of adolescence that adults may have forgotten, the writers also highlight many similarities that adults and teens have in the ways they think and the things they value. The authors state that everyone values respect and authenticity; the expression of those qualities may just look different in adults and teens.
In part 2 of the book, “Putting Skills to Work,” the authors discuss important qualities needed when building relationships with young people, while giving tangible ways to improve and to measure success in work with youth. The book discusses respect, authenticity, kindness, predictability, acceptance and change. In each chapter there are anecdotes of times when adolescents experienced as well as failed to experience these qualities in their relationship with adults. These stories help emphasize the importance of relationship in creating change within young people as well as provide a context for readers when thinking about their own work with youth.
Although not specifically written for counselors, What Works with Teens is a very useful resource for professional counselors in school, clinical mental health or college settings. The skills discussed in part 2 complement the strength-based approach that counselors take when working with others. What Works with Teens highlights the importance of building relationships with teens and empowering them to make their own change, much like counselors do in their work with others in any setting. This book aims not to teach adults on how to tell young people what to do, or what they should do, but rather is an aid to adults in building better alliances with adolescents. The qualities discussed in What Works with Teens are valuable in not only working with teens, but in any therapeutic relationship. The authors emphasize meeting all adolescents where they are, an approach that counselors often take with any client.
What Works with Teens is a comprehensive resource for any professional working with young people. Beginning with adolescent development, the authors outline how and why adolescents often behave and feel the way they do. The authors then proceed to discuss ways to help build positive relationships with youth, and how to incorporate teens into discussion of the relationship and ways to improve. An authentic and trusting relationship between youth and adults is essential to healthy growth and development. What Works with Teens gives adults attainable goals in building relationship with youth. Using these values to build a therapeutic alliance, adults will be better equipped to empower teens to take ownership of their own growth and development.
Rathbone, B. H., & Baron, J. B. (2015). What works with teens: A professional’s guide to engaging authentically with adolescents to achieve lasting change. Oakland, CA: New Harbinger.
Reviewed by: Hannah Kirby, NCC, Creative Counseling and Learning Solutions, Rowan County, NC.
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Aug 18, 2015 | Book Reviews
With a recent surge in empirical support for mind–body approaches, many counselors are hungry for tools to assist them in learning to effectively use mindfulness and yoga for self-care and in clinical practice. Catherine P. Cook-Cottone offers just such a tool with her well-researched book, Mindfulness and Yoga for Self-Regulation.
The book is organized into four carefully developed sections. The author begins by weaving a conceptual framework from current literature, anecdotal experience, and both Hindu and Buddhist teachings. The primary focus is on self-regulation and dysregulation in the context of mental health as well as mindfulness and yogic philosophy. For example, the author describes how her conceptualization of embodied self-regulation differs from more traditional approaches. She identifies the risks associated with dysregulation and the corresponding mental health issues. She distills the major tenets guiding mindfulness and yogic philosophy into twelve principles termed “embodied practices” for living, and discusses the application of these practices in clinical settings.
In part two, “The Mindful Self,” Cook-Cottone elaborates on the clinical relevance of the philosophy of mindfulness. She provides information about formal and informal mindfulness practice in the context of counselor self-care and applications in clinical practice. The structure of part three mirrors part two, with an emphasis on yoga. The author presents the foundation of yogic philosophy and guidelines and tips for formal and informal practice, as well as information about creating a practice, including finding yoga teachers, different styles of yoga and possible risks involved. In the fourth and final part of the book, topics such as treatment protocols, contradictions and self-care are addressed. Cook-Cottone concludes the book by addressing mindful self-care as a self-regulating practice.
Although there is a wealth of information presented in this primer, there are also some areas that may be ripe for further exploration. For instance, there is little information provided about the use of specific yoga asanas (poses). However, to address this, the author provides a rationale for this choice and points the reader to excellent resources for learning poses and sequences (e.g., teachers, books, Web sites). Also, though cultural context is provided throughout the text, cultural sensitivity is not the focus of this book. It would be useful for future publications to offer a more in depth look at multicultural issues related to integrating mindfulness and yoga in clinical practice. Though it is not possible to cover everything in just one book, there are many areas that are thoughtfully addressed in this primer.
The in-depth attention that is given to each topic makes this book a robust resource for counselors. The author provides a host of strategies and resources to use both during and between sessions, including tips, cautions, worksheets, meditation scripts, assessment tools, and suggested open-ended questions for intervention and assessment. For example, when describing the philosophy of mindfulness, the author not only outlines concepts of the Eightfold Path, but also provides links to clinical practice, including questions for clients such as, “What does the phrase ‘pain is inevitable, suffering is optional’ mean to you?” She also includes case studies and instructional stories to help the reader understand key points and how these concepts translate into clinical practice.
Cook-Cottone suggests that utilizing mindfulness and yoga in clinical practice requires counselor commitment to personal practice, acceptance of clients on their unique path, and development of mindfulness and yoga-informed clinical knowledge and skills. This book is a rich resource to guide counselors toward that end.
Cook-Cottone, C. P. (2015). Mindfulness and yoga for self-regulation: A primer for mental health professionals. New York, NY: Springer.
Reviewed by: Jamie E. Crockett, NCC, Wake Forest University
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Aug 14, 2015 | Video Reviews
This video presents a close exploration of three psychotherapy sessions between Dr. Otto Kernberg and a mock client with a personality disorder, with commentary and exploration of important issues facilitated by Victor Yalom. The premise and definition of personality disorders is established to set the tone for the psychotherapist’s focus toward the client’s motivations, distortions in close relationships and view of the self within those relationships through an approach called Transference-Focused Therapy.
The video explores the projections that are driven by such clients’ recurrent fears of being traumatized and provides a clear picture of the manner in which those with identity diffusion struggle to hold a balanced perspective. In these cases, emotion overwhelms them, creating the split view of the self or others as either completely idealized or utterly negative. Focusing on the interpersonal experience of the here and now, the conscious meanings are illuminated through an intensive approach to exploring the interpersonal experience through structural interviewing. The interview, as Victor Yalom points out, moves from a traditional interview toward examination of the interpersonal exchange between the client and the therapist.
The interview process exemplifies an exploration of symptoms, personality, and normal or diffused identity, then reality testing to draw out the fullness of the interaction transference and exploration. Dr. Kernberg illuminates the concept of identity diffusion. Continued discrepancy exploration uncovers the client’s levels of paranoia, suspicion, anger and controlling behavior as this video presents a client who seeks to protect himself from fear of further discomfort or rejection. By interpreting the client’s difficulty with reality openly, a counselor can determine the level of reality acceptance versus the presence of paranoia toward others. The video later demonstrates how to move the interview toward exploring how the client may begin to understand the transference between client and counselor.
The video provides effective commentary by Dr. Kernberg and a continued dialog between Victor Yalom and Dr. Kernberg throughout the mock sessions to emphasize his focus and methods. Dr. Kernberg is respectful, honest and direct with his client while also pointing to the discrepancies he experiences. The video moves through three sessions to show the client’s further exploration of his areas of denial along with his progress toward integrating his inner concept of self.
One limitation of the video is that the first session is lengthy and the second is quite short, which may leave the learner wondering how to structure typical 50-minute sessions with these clients. There are times when the diagnosis is unclear as to whether the client is showing borderline personality disorder or being a borderline patient, which can be confusing to those learning to diagnose clients. Reference to the DSM-5 would be helpful to clarify the diagnosis and the symptoms displayed by the client.
Strengths of this video include the demonstration of continuing assessment if the client presents a new issue, such as potential substance abuse, while maintaining the continued focus on transference. Dr. Kernberg is artful in exemplifying an approach that remains open and honest but neutral in tone, whether the client feels willing to share more information or seeks to control the topic or shift the focus from the most important areas of assessment or counseling. By appealing to the trustful part of the client’s personality, Dr. Kernberg skillfully shows how to draw out this side of the client in order to help gain commitment to the treatment process. The potential for overcoming the problem of distrust and suspicion is modeled to show therapists how to appeal to the part of the client that does trust in order to create more balance in personal responses toward others.
Finally, this video reminds counselors of ways to engage in the therapeutic process through a grounded response to clients, trained awareness of client unconscious projections, and their own well-developed self-awareness in order to manage counter-transference. This video successfully explores the issues vital to understanding the therapeutic relationship through a psychodynamic and psychoanalytic process that helps clients to reconcile polarities by achieving a more integrated view of others. With a video scrolling script format that is easy to understand and follow, counselors can learn effective methods for addressing challenging client issues.
Psychotherapy.net (Producer). (2013). Psychoanalytic psychotherapy with Otto Kernberg, MD. (Available in DVD and video streaming from http://www.psychotherapy.net/video/psychoanalytic-psychotherapy-otto-kernberg)
Available in DVD and streaming format as part of video subscription at www.psychotherapy.net/subscriptions.
Reviewed by: Adele Logan O’Keefe, Walden University, Minneapolis, MN.
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Aug 5, 2015 | Book Reviews
In Community Mental Health: Challenges for the 21st Century, Jessica Rosenberg and Samuel Rosenberg provide a comprehensive overview of the most up-to-date research on best practices in community mental health in today’s culture and political climate. The quality of information that this book provides is strengthened by the unique contributions of experts from numerous mental health-focused disciplines, including social work, psychiatry, psychology, nursing, public health and law. Infused into each chapter is an emphasis on the importance of addressing the stigma associated with mental health concerns and promoting a recovery philosophy that empowers individuals to pursue lives that go beyond simply resigning themselves to living unresponsively with mental illness.
Community Mental Health is a 320-page book that covers a range of topics and unfolds into six major sections. In Part One, chapter authors describe how stigma impacts persons with mental health issues in general and how being a part of a marginalized group often compounds that stigma. The authors then describe a recovery philosophy that emphasizes mental health treatment founded on hope, respect and humane treatment. Part Two of the text focuses on emerging trends in mental health care, including work with veterans returning from active combat and developments in forensic mental health. In Part Three, community mental health is approached from a developmental perspective, with authors examining work carried out with children and adolescents, families, and an elderly population that is increasing due to the aging Baby Boomer generation. Part Four explores considerations related to counseling diverse populations, ranging from the historical and present racism experienced by African Americans, to ways of providing mental health services that account for differing cultural perspectives. In Part Five, chapter authors describe up-to-date best practices for working in community settings with varying populations, including assertive community treatment and treatments for adults experiencing both mental and substance use disorders. Finally, Part Six analyzes the circumstances that influence how public policy and the changing landscape of our society impact community mental health.
Community Mental Health possesses many strengths. Each chapter concludes with discussion questions, learning assignments, suggested readings and Internet resources that facilitate continued conversation about and exploration of each chapter’s respective theme, making this book especially valuable for use in a dialogical setting. The text carries a message for students and professionals alike—advocacy remains an essential component of the activity of mental health practitioners. It also serves as a compelling reminder of how much of counseling work necessitates addressing the stigma of mental health, both with clients and within the society in which clients live.
A potential limitation of Community Mental Health is that, because the book addresses a number of different topics and populations, it does not always provide great detail about the evidence-based treatment practices cited. The text also does not always provide its reader with case studies to further describe how community-based treatments work in actual application with clients. Although one merit of the book is providing a strong overview of each of the different topics presented, readers who desire more in-depth information may need to seek out further resources. However, the chapter authors address this issue by suggesting both additional readings and Internet resources.
Community Mental Health: Challenges for the 21st Century is a valuable resource for current and future mental health professionals, policy makers and advocates, and represents an important resource for those engaged in increasing the effectiveness and humaneness of mental health service provision.
Rosenberg, J., & Rosenberg, S. (Eds.). (2013). Community mental health: Challenges for the 21st century. New York, NY: Routledge.
Reviewed by: Adam Miller, graduate student, Florida State University, Tallahassee, FL.
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