Making Psychotherapy Work: Collaborating Effectively With Your Patient

by Steven A. Frankel;
Madison, Conn: Psychosocial Press, 2007
351 pages • $47.00 (softcover)

Making Psychotherapy Work: Collaborating Effectively with Your Patient is an engaging book that will interest most practicing psychotherapists. Steven A. Frankel is a psychiatrist as well as an effective, practicing psychotherapist with psychoanalytic training, and his book will be relevant for those who work with patients in a psychotherapy context.

Frankel uses Making Psychotherapy Work to embellish and expand on work from his earlier texts, Intricate Engagements: The Collaborative Basis of Therapeutic Change (2004, Jason Aronson)and Hidden Faults: Recognizing and Resolving Therapeutic Disjunctions (2000, Psychosocial Press). In this book, he stresses the importance of 4 key concepts: collaboration, not knowing, authenticity, and self-revelation.

Frankel refers to his overall approach to therapy as the "conjunctive model of therapeutic collaboration" and uses extensive case material to illustrate its application. A handful of case vignettes-Brittany, Marty, Dr Mark, Allison, and Natalie-appear in almost every chapter, allowing the reader to feel as if he or she knows these patients personally.

The cases illustrate the challenges that each of them presented in therapy and the frequently unconventional decisions Frankel made as their therapist. These discussions are embellished by references to the literature and discussions of the author's rationale for disregarding traditional wisdom and the techniques, methods, and values he has been taught in his own training (eg, he describes why he decided to hold Natalie's hand at one point in her treatment, and why he believes this was the right decision and an eventually therapeutic maneuver).

Frankel uses many unconventional methods to support the conjunctive model that will challenge the beliefs and practices of many readers-including flexible use of chair and couch; providing direct advice to patients (and accepting advice from them); extensive self-disclosure on the part of the therapist; accepting gifts from patients and giving them in return; and arranging for frequent contact with patients outside therapy sessions through e-mail, phone, fax, or home visits.

Making Psychotherapy Work forced me to reexamine many of my own assumptions about how therapy "should" be done. It caused me to reevaluate much of what I had been taught in a traditional clinical psychology graduate program and much of what I have been teaching my students. I suspect this is exactly what the author intended. While I am not likely to embrace the conjunctive model in toto, I am likely to use parts of the model to enhance my interactions with patients, and I think I will be a better therapist because of it.