States of Mind: Analysis of Change in Psychotherapy

Some will wonder why this book, with its specific focus on the pro- cess of change in psychotherapy, was chosen for inclusion in "Crit- ical Issues in Psychiatry: A Series for Residents and Clinicians" as our books are generally devoted to a broad topical survey of some im- portant clinical area in the practice of psychiatry or a related mental health discipline. The answer will become rapidly apparent to the reader, for Dr. Horowitz has developed an exciting, creative, and practical method whereby any psychotherapist can understand, monitor, conceptualize, and evaluate the process of change in psychotherapy. His method of "configurational analysis" utilizes direct clinical observations of emotional states, role relationships, and information processing to systematically, in a step-by-step fashion, organize and describe clinical data. It can be employed at any point in the therapeutic transaction, from the time of initial presentation to the time of termina- tion or follow-up. This method of organizing information about a person, his problems and resources, and the nature of the psychotherapeutic transaction provides the therapist with a powerful tool with which to both understand and communicate how and why change occurs, or does not occur, in psychotherapy. It can be applied all the way from the description of large-scale patterns to the microanalytic dissection and understanding of a small segment of a therapy session.