Short-Term Approaches to Psychotherapy
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BOOK REVIEWS Short· Term Approaches to Psychotherapy Edited by Henry Grayson, 284 pp, SI5.95, New York, Human Sciences Press, 1979. • A book's title is expected to allow a reasonable projection of its con- tent. This book stands as an excep- tion to that rule; as a book on short-term psychotherapy it is al- most a complete loss. As a collec- tion of independent essays it has merits, for many of the chapters are interesting and well written. The readers of Psychosomatics may be most interested in John F. Ostetritter's chapter on functional hypoglycemia, a condition that produces symptoms that "mimic neuropsychiatric disorders, includ- ing psychoneurotic anxiety and de- pressive reaction." Attention is drawn to the difficulty in diagnos- ing functional hypoglycemia, since the oral glucose tolerance test of functional hypoglycemia "does not fit the fixed curve of the other two forms of reactive hypoglycemia." Positive test results may be inter- preted as within the range of "a variation of the normal" and the accompanying somatopsychic syn- drome explained separately as a manifestation of psychoneurosis. Ostetritter calls for greater aware- ness of functional hypoglycemia, which he portrays as much more common than generally believed, and he demands that it be con- trolled on the physical level. Is this short-term psychother- apy? No, but it may be a short-cut to eliminate the need for psycho- therapy. The last segment of the book is somewhat more closely related to therapy but still does not address APRIL 1981 • VOL 22 • NO 4 what one might conventionally call "short-term psychotherapy." All three chapters of this section utilize concepts developed by proponents of transactional analysis (TA). One chapter focuses on organizational theory and structure, proposing the idea that institutional change pre- cipitates individual change. The second chapter praises the useful- ness of TA to classroom teachers, and the last one presents the suc- cessful development of a TA-ori- ented drop-in center in a public school setting. The same kind of criticism ap- plies to ten other chapters which report on different forms of ther- apy. Of these, three are based also on TA strategies, while others con- centrate on behavior, gestalt, and ego-state therapy, hypnosis, and assertive training. Except for the hypnosis approach (one to a few sessions) and the assertiveness training ( 15 sessions), the reader gains no insight into the intended length of the therapeutic interven- tion nor on how the described ap- proach is briefer than what is cus- tomary for the given modality. Only twice is the duration of ther- apy mentioned specifically, once in reference to an ego-state therapy patient who attended 50 sessions and once in citing a behavior-ther- apy client whose treatment lasted a year and a half. Is this short-term therapy? The book's theme is further ne- gated by the chapter on gestalt therapy; its author declares that he does not believe in short-cut ver- sions of therapy. Finally, two chapters do present information on short-term psycho- therapy. One depicts an inner-city walk-in clinic whose low socioeco- nomic status clientele is permitted to attend a maximum of six therapy sessions. In the other setting, hospi- talized psychotic patients receive six to eight weeks of group therapy. In both places effective strategies are followed that help to achieve optimal goals under time-limited conditions. Two issues reported in the hospital chapter deserve special mention. One is the usefulness of separating the psychotic patients into stylistic and functionally ho- mogeneous groups: (I) nonverbal, motorically oriented activity groups; (2) groups for patients with sealing-over defensive styles, and (3) groups for integrative types. The other is a prevention strategy. A therapist from the aftercare unit acts as a co-therapist of the inpa- tient group, and the rapport estab- lished between co-therapist and patient facilitates the client's tran- sition to the outpatient clinic at the time of his discharge. It supports the patient during a critical phase and diminishes the dropout rate. In summary, although the title is a misnomer, some chapters of this book are nevertheless well worth reading. Ericka Wick, Ph.D. St. John's University Jamaica, N. Y. Psychopharmacology Update Edited by Jonathan O. Cole. 195 pp. $18.95, Lexington. Mass., The Collamore Press, 1980. • Important developments in psy- chopharmacology of the past five years are reviewed and counterbal- anced by the editor's vast experi- 367
Transcript of Short-Term Approaches to Psychotherapy
BOOK REVIEWSShort·Term Approachesto PsychotherapyEdited by Henry Grayson, 284 pp, SI5.95,New York, Human Sciences Press, 1979.
• A book's title is expected to allowa reasonable projection of its content. This book stands as an exception to that rule; as a book onshort-term psychotherapy it is almost a complete loss. As a collection of independent essays it hasmerits, for many ofthe chapters areinteresting and well written.
The readers of Psychosomaticsmay be most interested in John F.Ostetritter's chapter on functionalhypoglycemia, a condition thatproduces symptoms that "mimicneuropsychiatric disorders, including psychoneurotic anxiety and depressive reaction." Attention isdrawn to the difficulty in diagnosing functional hypoglycemia, sincethe oral glucose tolerance test offunctional hypoglycemia "does notfit the fixed curve of the other twoforms of reactive hypoglycemia."Positive test results may be interpreted as within the range of "avariation of the normal" and theaccompanying somatopsychic syndrome explained separately as amanifestation of psychoneurosis.Ostetritter calls for greater awareness of functional hypoglycemia,which he portrays as much morecommon than generally believed,and he demands that it be controlled on the physical level.
Is this short-term psychotherapy? No, but it may be a short-cutto eliminate the need for psychotherapy.
The last segment of the book issomewhat more closely related totherapy but still does not address
APRIL 1981 • VOL 22 • NO 4
what one might conventionally call"short-term psychotherapy." Allthree chapters of this section utilizeconcepts developed by proponentsof transactional analysis (TA). Onechapter focuses on organizationaltheory and structure, proposing theidea that institutional change precipitates individual change. Thesecond chapter praises the usefulness of TA to classroom teachers,and the last one presents the successful development of a TA-oriented drop-in center in a publicschool setting.
The same kind of criticism applies to ten other chapters whichreport on different forms of therapy. Of these, three are based alsoon TA strategies, while others concentrate on behavior, gestalt, andego-state therapy, hypnosis, andassertive training. Except for thehypnosis approach (one to a fewsessions) and the assertivenesstraining (15 sessions), the readergains no insight into the intendedlength of the therapeutic intervention nor on how the described approach is briefer than what is customary for the given modality.Only twice is the duration of therapy mentioned specifically, once inreference to an ego-state therapypatient who attended 50 sessionsand once in citing a behavior-therapy client whose treatment lasted ayear and a half. Is this short-termtherapy?
The book's theme is further negated by the chapter on gestalttherapy; its author declares that hedoes not believe in short-cut versions of therapy.
Finally, two chapters do presentinformation on short-term psychotherapy. One depicts an inner-city
walk-in clinic whose low socioeconomic status clientele is permittedto attend a maximum ofsix therapysessions. In the other setting, hospitalized psychotic patients receivesix to eight weeks ofgroup therapy.In both places effective strategiesare followed that help to achieveoptimal goals under time-limitedconditions. Two issues reported inthe hospital chapter deserve specialmention. One is the usefulness ofseparating the psychotic patientsinto stylistic and functionally homogeneous groups: (I) nonverbal,motorically oriented activitygroups; (2) groups for patients withsealing-over defensive styles, and(3) groups for integrative types.The other is a prevention strategy.A therapist from the aftercare unitacts as a co-therapist of the inpatient group, and the rapport established between co-therapist andpatient facilitates the client's transition to the outpatient clinic at thetime of his discharge. It supportsthe patient during a critical phaseand diminishes the dropout rate.
In summary, although the title isa misnomer, some chapters of thisbook are nevertheless well worthreading.
Ericka Wick, Ph.D.St. John's UniversityJamaica, N. Y.
Psychopharmacology UpdateEdited by Jonathan O. Cole. 195 pp. $18.95,Lexington. Mass., The Collamore Press,1980.
• Important developments in psychopharmacology of the past fiveyears are reviewed and counterbalanced by the editor's vast experi-
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