November 1st, 2017

“Managing Therapy-Interfering Behavior: Strategies from Dialectical Behavior Therapy”

“Managing Therapy-Interfering Behavior: Strategies from Dialectical Behavior Therapy”

By Alexander L. Chapman and M. Zachary Rosenthal

American Psychological Association

Washington, D.C., 2016

 

Navigation of therapy impasses is focus of ‘helpful’ volume

Reviewed by Kerry Morrison, Psy.D.

Authors Alexander L. Chapman and M. Zachary Rosenthal address a topic with which many therapists are quite familiar: the clients who just seem to get in their own way and prevent treatment from progressing.

These are clients that display excessive talking, have serial crises, arrive late to sessions, “forget” to do homework and “forget” what was discussed at the last session. Any behavior that interferes with the client benefitting from psychotherapy can be considered a therapy-interfering behavior (TIB) according to the authors.

They assert that TIB is common, predictable and not unique to any specific diagnostic type. If these behaviors are not addressed within the therapeutic relationship, treatment can feel stalled or stuck.

However, many therapists hesitate to address these behaviors because they are trained to listen and be a supportive, professional ear. Chapman and Rosenthal assert that TIB needs to be addressed and can be seen as an opportunity to “mine for therapeutic gold,” and deepen clinical work.

This book was written expressly to help clinicians navigate impasses in therapy, when the behavior in the treatment room arrests client progress.

The focus is on ways to conceptualize and strategically manage TIB. Although the book is written from a dialectical behavior therapy framework, clinicians of all theoretical orientations can utilize these tools and techniques.

The authors suggest orienting clients to TIBs in the initial stages of treatment and explaining that noticing and exploring these behaviors will be part of therapy. Useful techniques drawn from DBT are offered to address TIB, such as mindfulness, functional analysis or chain analysis of behavior, radical genuineness, choice-less awareness, DEARMAN and diary cards.

Clear examples from in-session conversations between therapist and client help highlight this approach.

I found this book to be especially helpful. It is well written and easy to read. I think it is a must read for both beginning and seasoned therapists. In fact, it was so enjoyable that I didn’t feel like reading it was work even though I was reading about what I do for work. This volume will be a welcome addition to any practitioner’s reference library. I highly recommend it.

Kerry Morrison, Psy.D., is a psychologist for the Department of Developmental Services in the Central/West Region of Mass., who also has a private practice, consults, teaches and provides training on a range of mental health topics.

By Kerry Morrison, Psy.D

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