دانلود کتاب Psychotherapy for better or worse: the problem of negative effects

The debate on the effectiveness and place of the psychotherapies rages on. In the 1970s, Strupp and his colleagues set out to address one issue that lies centrally in that debate, and their efforts resulted in this book. The author's concept of negative effects in psychotherapy incorporates the possibility that therapy may, at times, not simply fail to improve a patient's condition but may lead directly to a sustained deterioration. Inevitably, large sections of the book are taken up with conceptual and pragmatic considerations as to how changes in therapy are evaluated, and how negative effects can he identified. This is the crux of the matter, and it is in their thorough and thoughtful review of such basic questions that much of the value of this book still lies, nearly two decades later. A review of the then-current research and clinical literature is of interest, in spite of being out of date and, not surprisingly, results in calls for systematic controlled research into the potential harmful effects of therapy, as well as the need for a comprehensive, multifaceted perspective in the use of outcome measures. The book incorporates a survey of 70 expert clinicians and researchers in psychotherapy on their opinions on the prevalence, and origins, of treatment-related patient deterioration. This provides a valuable, detailed analysis of the forms of negative therapeutic reactions, and of the patient, therapist and technical factors that may be associated with them. A 120-page appendix provides the detailed replies of many of their respondents-an absorbing mixture of discourse and readable case-material from well-known "names". Strupp et al. consider the psychotherapies broadly as a category, but seem primarily to address individual dynamic psychotherapy. Now, the debate would surely lie in the differing effects and effectiveness of separate models of psychotherapy in different settings.