| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ALL ISSUES | SEARCH | TABLE OF CONTENTS |
|
|
|
|||||||
|
|||||||||
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Book Reviews |
Key Words: Books Reviewed
Clinicians and researchers study the treatment process as a way of understanding therapeutic action in group psychotherapy. When Fuhriman and Barlow1 reviewed the extant group process measures in group psychotherapy research, they noted: "Missing here are the various perspectives on the same moment, event, response. Most measures identify behaviors; few describe emotions, and none catalogue cognitive processes. The dynamic interplay of these three most likely overlies the dynamic interpersonal qualities of the group members. The lack of detail in various dimensions and across varying levels of functioning surely calls for increased interactional instrumentation capable of such measurement." Fuhriman and Barlow systematically examined a number of measures addressing general utility, validity and reliability, and ability to link process to outcome. An exciting next step has occurred, shedding empirical light on some of the questions we raised in 1994.
The excellent text of Beck and Lewis allows us a peek into this process. These authors gave identical transcripts of one particular time-limited group session, with accompanying descriptions of prior sessions, to a number of experts on process measures. As each representative assessment system (or lens) allows us a protean glimpse, the arrangement of altering views presents us with a kaleidoscope, as changing forms (people, time, space), patterns (repeated behaviors and relationship patterns), and colors (various affects) continually shift with each new measuring system. As a professor who teaches group theory and practice to clinical psychology graduate students and psychiatric residents, as a researcher of both group process and outcome, and as a human invested in relieving human suffering by promoting good mental health through legitimate treatments, I believe this book is the next step on our understanding of the interplay between group research and theory.
The strengths of this text include clear descriptions from the group process experts regarding their particular process measure, general descriptions, correspondence to theory, and direct application to the session. Most exciting is the comparison of systems and what each reveals about the group process. (This is also a possible weakness, however. There is so much data to sift through that the reader must be patient. Figures, tables, and summary chapters help.) Such direct comparison allows readers to see the strengths and weaknesses of the various process measures.
It becomes even more evident, however, why there are no real frontrunners in group process measurement: those measures that reveal important information about emotional, cognitive, and behavioral processes are prohibitively difficult to learn though data-dense; those measures that leave out an important part of this triad are superficial, although easy to learn and score; and most of these measures have not been used consistently in the research to sustain their viability in linking process to outcome. This is, of course, de rigueur for most therapy process measures: rich detail is often sacrificed for ease of learning and scoring.
But this is not a fault of Beck and Lewis. If anything, they have clearly illuminated the needs in this particular field of research. Their complex handling of an admitted conundrum in group psychotherapy research brings us one step closer to establishing the link from process to outcome. Individual psychotherapy researchers have been struggling with this for decades. Certainly it will be no easy task to attempt to study the exponentially more complex arena of groups. Perhaps a follow-up text by Beck and Lewis will demonstrate if and how each measure was linked to particular patient outcome.
This will no doubt take us into the more problematic area of research design. Often, process measures are not at fault in the inability to link them to outcome; rather, research hypotheses are not stated directly enough to provide the framework to establish this link. In addition, all good researchers know that various sources of process and outcome must be assessed: self-report data along with expertly rated behavioral systems.
As the next generation of researchers considers process, outcome, and methodology, many of these important questions will be answered. The Beck and Lewis book is a good start. For anyone serious about studying group psychotherapy, this is a must read.
FOOTNOTES
Dr. Barlow is Professor of Psychology, Brigham Young University, and Adjunct Associate Professor of Psychiatry, University of Utah School of Medicine.
REFERENCES
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ALL ISSUES | SEARCH | TABLE OF CONTENTS |
