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Title: The Heroic Client by Barry Duncan, Scott Miller ISBN: 0787947253 Publisher: Jossey-Bass Pub. Date: May, 2000 Format: Hardcover Volumes: 1 List Price(USD): $40.50 |
Average Customer Rating: 5
Rating: 5
Summary: To a different approach to helping people
Comment: Barry Duncan and Scott Miller are with Marc Hubble directors of The Institute for the Study of Therapeutic Change (...). These people play an important role in improving and renewing therapy. In this book, the authors explain how therapy has for too long been been neglecting, ignoring, and depersonalizing clients, by its over-emphasis on methods and techniques, by following the medical model, by its emphasis on pathology, by hegemony of biological approaches, and so on.
The authors first debunk the myths of:
1) PSYCHIATRIC DIAGNOSIS:
a) it lacks reliability,
b) it lacks validity,
c) it puts the blame on the client, and
d) it is often motivated by self-interest, fueled by greed, and blows with the winds of fashion,
2)DRUG TREATMENT OF MENTAL PROBLEMS:
a) they work no better than therapy in the short term
b) changes brought about by medication are less likely to persist over time
c) there often are severe adverse effects,
d) drug studies often look better than they are because they rate improvement by looking to clinicians' perceptions, not clients'
e) the relationship between drug companies and psychiatry is an unholy alliance, making most of the drug-effectiveness research very suspect
3) THE MAGIC APPROACH:
a) there is no special magic silver bullet approach which is much better than another approach
b) the role of the competence and experience of the therapist is rather unimportant
According to the authors, four decades of outcome research have shown that there are four main factors of change, being:
1. Client factors (percentage contribution to positive outcome: 40%).
2. Relationship factors (percentage contribution: 30%).
3. Hope and expectancy (percentage contribution: 15%).
4. Model and technique (percentage contribution: 15%).
Some conclusions:
1. Thoughts, ideas, actions, initiatives, traits of clients are the most important predictor of therapy success!
2. Next to what the client brings to therapy, the client's perception of the therapeutic relationship is responsible for most of the gains resulting from the therapy.
3. Models and techniques are much less important than generally thought.
The authors advocate a new and refreshing approach characterised by:
1) Client-directedness. Clients' beliefs, values, theories and goals are repected, close attention is being paid to clients' initiatives, interventions and perceptions. Much attention is given to establishing the quality of the relationship, and to monitoring the clients' perception of the quality of the relationship.
2) Outcome informedness. Progress is measured from session to session using paper and pencil questionnaires. By the way: the client's experience of meaningful change in the first few visits is emerging as one of the best predictors of eventual treatment outcome.
Two thoughts come up after having read this book. First, this book is refreshing indeed and a shock to the therapy system. Second, the ideas ventilated in this book might be relevant for work outside the therapy field as well. Consider for instance what management consultancy and managing coaching could learn from this......
Rating: 5
Summary: A Heroic Book About Heroic Clients
Comment: In The Heroic Client, Barry Duncan and Scott Miller consider the whole field of "mental health," the roles of client and therapist, and the central question of what helps in therapy. They address mental health mythologies that affect the practice of therapy, including a pervasive reliance on medication, diagnosis, the medical model and priveleging the therapist's expertise. The book asks us to reflect on why we have lost confidence in the person-to-person collaboration of talk therapy, curious in light of the fact that research continues to show that talk therapy is more effective and enduring than medication for most of the problems people bring to therapy.
Duncan and Miller present an exciting, well-researched and thought-provoking argument for client-directed, outcome-informed therapy, which they call "co-therapy." Based on the research on what makes for success in therapy, Duncan and Miller propose we place greater reliance on the theories of change, experiences and strengths clients bring and less on our preferred causal theories and techniques.
This is a courageous and challenging book. Every mental health professional and consumer should read it. It can make a difference. Tobey Hiller MFT and Phillip Ziegler, MFT, co-authors of Recreating Partnership: A Solution-Oriented, Collaborative Approach to Couples Therapy (W.W. Norton, 2001)
Rating: 5
Summary: Attention Mental Health Professionals!
Comment: This book is a must-read for all mental health professionals! Based on 40 years of outcome research regarding "what works in therapy," Barry Duncan and Scott Miller have articulated a way of being with clients that emphasizes collaboration, respect, and honors their theories of change. The authors challenge many of the dominant theoretical, political, and social discourses that have been privileged in society and unfortunately have informed psychotherapy practice in ways that tend to alienate and stigmatize clients and lead therapists astray. What they advocate for is therapy that is client-directed and outcome-informed, thereby honoring clients' voices and perspectives. This in and of itself has been a long time coming and is worth the price of admission. The Heroic Client is a thoroughly-researched book, and one that I have and will continue to recommend to my students and colleagues. It's a must for all mental health professionals!
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Title: The Heart & Soul of Change: What Works in Therapy by Mark A. Hubble, Barry L. Duncan, Scott D. Miller ISBN: 155798557X Publisher: American Psychological Association (APA) Pub. Date: April, 1999 List Price(USD): $49.95 |
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Title: Escape from Babel: Toward a Unifying Language for Psychotherapy Practice by Scott D. Miller, Mark Hubble, Barry Duncan ISBN: 0393702197 Publisher: W. W. Norton & Company Pub. Date: January, 1997 List Price(USD): $32.00 |
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Title: Psychotherapy With "Impossible" Cases: The Efficient Treatment of Therapy Veterans by Barry L. Duncan, Mark A. Hubble, Scott D. Miller ISBN: 0393702464 Publisher: W.W. Norton & Company Pub. Date: April, 1997 List Price(USD): $35.00 |
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Title: Handbook of Solution-Focused Brief Therapy by Scott D. Miller, Mark Hubble, Barry L. Duncan ISBN: 0787902179 Publisher: Jossey-Bass Pub. Date: May, 1996 List Price(USD): $54.00 |
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Title: Staying on Top and Keeping the Sand Out of Your Pants : A Surfer's Guide to the Good Life by Scott Miller, Mark Hubble, Seth Houdeshell, John Byrne ISBN: 0757300332 Publisher: Health Communications Pub. Date: May, 2003 List Price(USD): $10.95 |
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