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How does the therapist begin psychotherapy? How, that is, does she
conceptualize the needs of the patient while simultaneously
enlisting him or her as an active partner in formulating an
individualized working plan? And how should supervisors teach the
skills needed to make the intake procedure truly the beginning of
treatment? In Beginnings: The Art and Science of Planning
Psychotherapy Mary Jo Peebles-Kleiger tackles these and other
questions in an authoritative manner that draws on the cumulative
experience of the outpatient department of the Menninger
Psychiatric Clinic. Peebles-Kleiger's elegant synoptic discussions
of the major categories of psychological dysfunction and the
different treatment strategies appropriate to them are carefully
calibrated, with actual examples, to the limits and opportunities
of the first sessions. Of particular value is her unusual capacity
to articulate patients' various difficulties in forming and
maintaining an alliance, and then to show how such difficulties
feed back into the clinician's interventions in the first few
sessions. In this manner, she illustrates how potential treatment
obstacles-- difficulties in affect regulation, in reality testing,
in conscience formation, among others--can be assessed and
subjected to trial interventions from the very start. Skilled in
various psychodynamic and behavioral approaches, from
psychoanalysis to hypnotherapy, Peebles-Kleiger consistently
advances an integrative approach that cuts across specific
modalities and combines sophisticated psychodynamic understanding
with the fruits of empirical research. Both primer and sourcebook,
Beginnings: The Art and Science of Planning Psychotherapy fills a
niche in the literature so admirably that clinicians will find it
indispensible in planning humanely responsive treatment in an
increasingly complex therapeutic world.
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