Book Review
Psychotherapy
Psychotherapy and Counselling in Practice. A Narrative Framework. Digby Tantum. Cambridge (UK): Cambridge University Press; 2002. US$35.00. 334 p.
Reviewer
rating*: Excellent
Review by: Paul KB Dagg
Ottawa, Ontario
In a subtle way, this is a challenging book—not so much by the content or the ideas expressed therein as, more than anything, by its timing. In content, it is a solid, well-written description of the practice of psychotherapy. It focuses on the dialogue that occurs with a patient rather than on a theoretical framework, although it does build on a narrative approach, as the subtitle suggests. In the preface, Dr Tantum describes his approach as “practical psychotherapy”; this captures well the essence of his work, which incorporates ideas from many modalities, including short-term psychodynamic psychotherapy, existential therapy, strategies and systems approaches, and others. His clear description of psychotherapy is thus widely relevant. He writes of client concerns, of values, of emotional meaning, of beliefs, and of demoralization in language that is accessible and free of jargon. This book will be useful for many working in the mental health field, whether they be social workers providing short-term psychotherapy in community mental health clinics, psychiatrists providing supportive therapy in the context of the biological management of a patient, or psychologists providing longer-term care in a psychotherapy practice.
The challenge is that this is the age of reductionism in psychotherapy. As we try to improve the scientific basis of our psychotherapies and better prove their efficacy through high-quality research, the focus has shifted to further refining and narrowing technique in the quest for rigorous, replicable, and controllable research designs. This movement is of course important, because psychotherapy has often seemed to be more religion than science, with schools of belief rather than schools of thought. Tremendous gains have been made with the increasing quality of psychotherapy research. At the same time, the focus has often been on what separates approaches to psychotherapy rather than on what unifies different modalities—an imiportant distinction if one is to demonstrate a differential effect. The search for that which distinguishes treatment A from treatment B leads to a tendency to ignore the rather formidable base of technique common to most forms of psychotherapy. Yet, this base is itself probably an active treatment component, encompassing such concepts as the therapeutic alliance, the communication of hope, and the provision of a new belief system for understanding experience and symptoms. If anything, Tantum’s book focuses on the base of necessary technique that underlies much psychotherapy, and hence, I suggest that it is valuable to anyone who practises the talking cure, regardless of ultimate technique.
The value of this base technique is not neglected. Many certification programs in psychotherapy, for example, the Beck Institute for Cognitive Behavioral Psychotherapy program or the National Group Psychotherapy Certification Program, require certificants to have a masters degree in a relevant mental health field as a prerequisite to training. This requirement recognizes that one needs to start with a firm base in the common techniques of therapy before developing the specific skills of a modality, and yet, with the focus on the end methodology, we often neglect the body of work that comprises this base.
Tantum writes well and clearly. He uses frequent, well-designed case illustrations to clarify the preceding theoretical discussion, and consequently, the reader is never overwhelmed by theory. He does not introduce any revolutionary ideas, but his smooth referencing of works from many eras and from greatly diverse authors gives the book an impressive breadth. I suspect few psychotherapists will read this without gaining new perspectives from authors they had previously not recognized.
This book is valuable to many who talk to their clients with a goal of helping them. It is especially valuable now to remind us that we need good basic technique, well grounded in the broad literature of psychotherapy and incorporating ideas from many sources, before we build the specific, empirically supported techniques that receive so much attention today.
*Reviewer
Rating Scale/ Échelle d’évaluation du réviseur
Excellent / Excellent
Very Good / Très bon
Good / Bon
Fair / Passable
Not recommended / Pas recommandé
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