Product Details

• Amazon Sales Rank: #753690 in Books
• Published on: 1997-02-19
• Original language: English
• Number of items: 1
• Binding: Paperback
• 240 pages

Synopsis
Presents insights from the authors' five-year study of therapy veterans, or "impossible" patients, proving that the key to success with such patients is in accommodating their frames of reference and honoring their theories of change. Shows how to learn the client's theory of change, and offers clinical examples and full-length cases demonstrating

Customer Reviews

Stop Shifting Responsibility For The Failure of The Theory!
An inspirational follow-up to Escape from Babel: this book gives both a robust challenge to the phenomenon of resistance and the labelling of some therapy veterans as ‘impossible’ cases. Over the five-year study period, the authors encouraged other therapists and agencies to refer ‘impossible’ cases – known in the UK as ‘heartsink’ clients - to them. Anne Wilson Schaef argues that there would be fewer ‘impossible’ or ‘untreatable’ clients if those responsible for their care had to re-frame this impossibility as a personal deficit; e.g., “I do not know how to treat this client effectively”, rather than the more typical, “This client is impossible/untreatable”. In documenting case after case, the authors demonstrate that they have taken up Wilson Schaef's famous challenge to the therapy profession to stop locating the responsibility for intractability in the client, and that for success in the therapist.

The book identifies the therapeutic conventions that trap therapists and clients in the wasteland of impossibility, from where there is no escape, and where no further growth can be anticipated. When both clients and professionals believe in impossibility, they tend to:
· anticipate trouble;
· elevate theory over the client’s practical experience of living the therapy in the multi-contextual world outside the therapeutic hour;
· refuse to question the appropriateness of the models and techniques despite absence of improvement;
· neglect client motivation.
The authors report that successful outcomes can occur with even the most heartsink cases when therapy accommodates the client's worldview and informal 'theory of change'. They argue that practitioners have much to learn from placing their confidence in therapy veterans' own resources and capabilities. Rather than regret the loss of control and status that this might imply, the authors celebrate this new emphasis, "It is the unpredictability of client methods and accomplishments that makes this work fun”. With due humility the authors quote the opinion of a 10 year old ‘impossible’ client: "So, what I'm saying to all psychiatrists is we have the answers, we just need someone to help us bring them to the front of our head. It's like they're [the solutions] locked in an attic or something".

The authors discuss many cases and describe how to:
· optimise the client's participation in therapy;
· collaborate with the client and establish a co-therapy alliance;
· leverage the power of the client’s resources and theory of change;
· honour the client’s motivation.
As with their other work, their strongest argument is that clients are co-therapists, not cases to be managed with a pre-formulated care plan that resembles a manual of Standard Operating Procedures. They quote from a client who wrote to them after therapy, "...it was your [belief] in me, that I was a person and not a patient ... a person with potential and worth”. The authors successfully argue that, “[l]ooking beyond labels and giving clients the benefit of a doubt is critical with psychotherapy veterans".

This book deserves a wide audience. It has many lessons for the field of performance coaching, both for teams and individuals.