Book Review
Psychotherapy
Psychotherapy: An Introduction for Psychiatry Residents and Other Mental Health Trainees Phillip R Slavney. Baltimore (MD): The Johns Hopkins University Press; 2005. 153 p. US$16.95.
Reviewer
rating*: Good
Review by: Laura Stovel, MD, FRCPC
Edmonton, Alberta
Phillip Slavney has written this book for psychiatry residents commencing the practice of psychotherapy during their residency training. He states in the preface that his goal is “to help beginners get started” (p xiii). In keeping a relatively restricted focus on the difficult task of orienting beginning residents to psychotherapy, he has written a volume that his anticipated resident readership is likely to find helpful.
Slavney declines to align himself with a particular modality of therapy, choosing instead to discuss elements of psychotherapy and supervision that are fundamental to all modes of psychotherapy. He notes in the epilogue that “[t]heory and technique are important, but they are less important than common sense and character” (p 132). It is common sense and character that he concentrates on in this volume. In “Life Story Reasoning,” the first of 4 chapters, he addresses the tasks of gathering information from the patient, making meaningful connections in the patient’s life story, and developing narrative truths that help the patient to understand himself or herself. He notes that the patient’s life story may be understood in several ways, according to different schools of thought, and cautions beginning therapists to avoid maintaining a particular theoretical view at the expense of considering the patient as an individual with a unique history and situation.
In the book’s second chapter, “Personality: The Patient’s and Yours,” Slavney reviews the concept of personality and discusses ways in which the patient’s personality may influence the course of therapy. Here, he supplies brief sketches that give readers a sense of likely dilemmas encountered with various personality styles. Slavney concludes this chapter with a consideration of ways in which the resident’s personality may shape the psychotherapy. He is noncommittal about the importance of a resident’s own therapy, which is surprising, because this book otherwise clearly values self-awareness in psychotherapy and supervision.
As their titles indicate, the third and fourth chapters discuss “The Psychotherapeutic Relationship” and “Psychotherapy Supervision,” respectively. In the first, Slavney reviews characteristics of responsive patients and effective therapists and discusses the concepts of the therapeutic alliance, transference, and countertransference. Slavney is at his best in the final 15 pages of this chapter: he considers practically the subject of creating boundaries with patients, including matters of the use of first names, residents’ dress and grooming, the office environment, chance meetings with patients outside therapy, and receiving gifts. In this section, he gives sensible advice that residents can use. The final chapter deals with the supervisory situation and includes the purposes of supervision. Slavney also delineates potential difficulties in supervision. Again, he is at his most helpful when counselling residents about how to handle potential obstacles in supervision, including supervisor insensitivity, supervisor impairment, and sexual involvement with the supervisor. In addressing these difficult matters, Slavney contributes to the literature on learning psychotherapy during residency training and offers guidance that residents may welcome.
Slavney evidently has a great deal of experience supervising and mentoring residents. He is most compelling and, I suspect, most helpful to residents when he draws on this experience for clinical material and wisdom. Indeed, the book would be strengthened by further material of this type. Passages in which he carefully references source material and research studies are less valuable and less relevant. These diversions also lessen the book’s accessibility. It is otherwise concise, clear, coherent, and informal in style. In balance, however, this is a helpful book and one that has a place as a first volume for residents beginning to practise psychotherapy. Supervisors would benefit their residents and themselves by recommending it as initial reading. In this, Slavney has fulfilled his aim of helping beginners get started in psychotherapy and supervision.
*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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