Escape from Babel: Toward a Unifying Language for Psychotherapy Practice.

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Miller, Scott D., Duncan, Barry L., And Hubble, Mark A. Escape from Babel: Toward a Unifying Language for Psychotherapy Practice. New York: W. W. Norton, 1997. xii+244 pp. $32.00.The purpose of this book is to highlight central factors common to a range of psychotherapeutic approaches. By focusing on four common factors (extratherapeutic change, the therapeutic relationship, hope, and therapeutic techniques), the authors attempt to provide, as the subtitle indicates, "a unifying language for psychotherapy practice."First, the authors encourage therapists to emphasize changes that occur as a result of chance events and of activities in which the client engages out of session. When possible, they advocate increasing the client's sense of self-sufficiency, particularly by noting ways that changes are the result of the client's own efforts.Second, in their chapter on the therapeutic relationship, the authors stress that in a good therapeutic relationship one finds a therapist who is sensitive to the client's current level of motivational readiness. In addition, and consistent with their overall theme of empowering the client, the authors particularly emphasize the importance of focusing on the client's goals for therapy.The third common factor is creating hope about the possibility of change. This can be facilitated by the therapist believing that the procedures used in the course of therapy have value and by the therapist showing interest in the results of using these therapeutic procedures.Having read repeatedly in this book that the specific techniques used by therapists are, typically, not very important, it seems somewhat strange to read in the same volume that the use of specific techniques and models of therapy is itself the fourth common factor. Simply put, the authors argue that it matters little which specific techniques or conceptualizations the therapist uses, as long as the therapist has faith in them and can use these techniques and models to provide a structure for therapy.Given that the authors focus on these four common factors, which have already been discussed in some detail by other writers, it is not always clear what original contributions they hope to make. As they point out, their unifying language "dictates no fixed techniques, no certainties or invariant patterns in therapeutic process, no prescriptions for what should or need be done in order to effect good treatment outcomes" (p. 18). In spite of these self-imposed constraints, the authors do indicate several specific ways that the therapist can intervene effectively.For example, as the authors discuss ways to foster hope in the client, they advocate making therapy more "possibility-focused" by directing the client's attention to goals for a desirable future. The authors clearly value a teleological approach to therapy, in which clients come to see themselves as approaching their personally valued goals. The authors believe that effective change requires a clear sense of possibilities and that the articulation of such possibilities is an important part of therapy. This strategy is certainly consistent with the common goal of engendering hope, and the authors make a noteworthy contribution by highlighting specific ways of furthering this end.For the novice psychotherapist, this book can serve as a useful first guide to the importance of common factors. The authors make use of ample clinical examples, which are always relevant to the factors being discussed.

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