Book Review
Psychotherapy
Treatment Planning in Psychotherapy: Taking the Guesswork Out of Clinical Care. Sheila Woody, Jerusha Detweiler-Bedell, Bethany A Teachman, Todd O’Hearn. New York, London: Guilford Press; 2003. US$30.00. 242 p.
Reviewer
rating*: Good
Review by: Gilbert Pinard, MD, FRCPC
Montreal, Quebec
This relatively short book describes what is called the Planning Assessment in Clinical Care (PACC) approach to treatment planning. This system outlines a treatment-planning method guided by information about each client. It provides a step-by-step organizational structure for identifying and prioritizing problems, as well as a way to conceptualize the phases of treatment, to establish treatment aims, and to measure treatment progress. The PACC approach has 2 basic principles: evidence-based practice and eclecticism. This book aims to provide clinicians with a system of scientific tools for evaluating the degree to which therapy is progressing.
Because the system is eclectic, it is integrative and does not focus on a single approach to psychotherapy. It therefore also criticizes randomized clinical trials, which are essentially monotheoretical and rigid. It proposes that using several theoretical approaches is valuable as long as progress is measured. Assessment should be ongoing throughout treatment and should measure progress toward goals that are explicit, written, and agreed upon between client and therapist. Obviously, empirically tested treatments have priority, but the system borrows willingly from other strategies. The authors also propose that therapists should be accountable for offering procedures in routine practice.
Although the book does not propose a manualized approach, it does offer clear strategies. The first of these is to develop a problem list, and the relevant chapter contains several specific and helpful hints on how to develop this. The authors then describe treatment planning using a phase approach that moves from problem identification to problem solving. They recommend following clinical practice guidelines when these are available and also discuss effectiveness in the phase models of therapy. Again, it should be stated that this book does not propose a single therapeutic strategy or theoretical approach. The authors have used clinical vignettes generously to clarify their material—indeed, the last chapter is essentially a clinical demonstration carried through several phases of treatment with a single patient.
There are chapters to show how to measure progress, particularly idiographic single-case designs. A generous appendix offers different scales that are particularly well validated. The book also shows how to graph progress day-by-day for visual review by both patient and therapist. It illustrates the use of decision trees that help therapist and patient to know when to proceed to a new phase or, indeed, to a new approach.
This is essentially a “how to” book that contains little help for therapists looking for a specific approach to specific problems. Conversely, it does propose a structure that will help busy clinicians to develop a treatment plan that will assure each patient a thorough evaluation, an assessment of needs, a list of problems that need to be addressed with specific strategies, and tools to measure progress toward therapeutic aims. As such, it can be a useful tool for clinicians.
It is concise, well written, voluntarily atheoretical, and clear. The layout of the book is clutter-free, attractive, and easy to read. Its price is accessible.
*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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