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How to Practice Brief Psychodynamic Psychotherapy: The Core Conflictual Relationship Theme Method

Howard B. Roback, Ph.D.

Key Words: Brief Psychodynamic Psychotherapy • Relationship Theme

This volume is true to its title in providing a "clinically based and clinically illustrated manual that walks the reader through the development of the Core Conflictual Relationship Theme [CCRT] focus that is necessary to practice this form of brief psychodynamic psychotherapy." The author, Howard Book, is a psychiatrist, a psychoanalytically oriented psychotherapist, and an educator. Motivated by several factors—including findings from psychotherapy research literature, residency training needs, and a recognition of health care's growing emphasis on briefer therapies—Book sought additiona1 training in short-term psychodynamic psychotherapy from Lester Luborsky, professor of psychology at the University of Pennsylvania. Dr. Luborsky is one of the major architects and researchers of CCRT. Book is currently associate professor and coordinator of the highly regarded Brief Psychotherapy Training Program at the Clarke Institute of Psychiatry, University of Toronto School of Medicine.

Part I of this interesting and instructive book introduces the brief psychodynamic psychotherapies, and more specifically the CCRT approach. Inclusion and exclusion criteria for these treatment methods are addressed. Issues such as identifying the CCRT focus and its three components are covered extensively. That is, the patient's wish (W) in the context of a relationship, the actual or anticipated response from others (RO), and the patient's response from self (RS) are explained in depth and with clear clinical vignettes. The author also discusses the three phases of treatment: the first phase (sessions 1–4), in which the therapist helps the patient to identify the repeated occurrence of the CCRT in the patient's relationships; the working-through phase (sessions 5–12), in which the patient works through the childhood roots of the RO; and the termination phase (sessions 14–16), in which the therapist and patient process the upsurge in the patient's RO and RS.

Part II illustrates how to practice the CCRT method by reference to verbatim transcripts (as well as alternative scenarios) of the case of "Ms. Benton." Chapters in Part II conclude with a question-and-answer section.

There is much to admire in this thoughtful and far-reaching volume. It is as if the author were engaging the reader in a running conversation—a dialogue that is always instructive. One gets the impression that one is being taught by a master psychotherapist and clinical supervisor. Dr. Book's richly documented clinical vignettes and insightful comments reflect both his knowledge of and his fascination with the CCRT method. The book is well organized, and the presentation of this complex material is easy to follow and does not overwhelm the reader. The chapter summaries are excellent. Although I would have welcomed a chapter dealing with the scientific aspects of CCRT (e.g., whether independent evaluators agree on a patient's primary CCRT; objective data demonstrating the efficacy of the intervention), that was clearly not Book's intent in writing the manual. Apart from the absence of such material, there is little to fault.

I would recommend this volume strongly to psychotherapy supervisors, psychotherapy-oriented clinicians, and mental health trainees regardless of professional affiliation. For the clinician trying to keep informed of brief therapy models of treatment, this important reference source is a must.

Footnotes

Dr. Roback is Professor of Psychiatry and Psychology, Vanderbilt University School of Medicine, Nashville, TN. He is also Training Director of the Vanderbilt Adult Psychiatry component of the Vanderbilt-VAMC Predoctoral Internship Program in Psychology.

This Article Alert me when this article is cited Alert me if a correction is posted Services Similar articles in this journal Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Roback, H. B. Search for Related Content PubMed Articles by Roback, H. B. Related Collections Psychodynamic Therapy