Newsletter of the Society for Psychotherapy Research U.K.

Volume 6(2), July 1995

ISSN 1359-3706

Mounted by Chris Evans in October 1995, individual items separated for presentation as individual files to help people with slow connections 8.ii.96, slightly altered 15.ii.96

Editor: Chris Evans

Section of Psychotherapy, Dept. of Mental Health Sciences,
St. George's Hospital Medical School,
Cranmer Terrace, London SW17 0RE
Phone/fax: 0181-725 2540

Feedback greatly appreciated: Email [if your HTML browser doesn't support "mailto:" then use a mail package and send to:]

Inside This Issue

Autumn one day meeting 3rd Nov. "Quantitative and Qualitative Methods in Audit and Research Practice" [The conference has been entirely changed by subsequent events see ....]

The Service Evaluation Group, which gave rise to the S.P.R. (U.K.) one day autumn meeting has been formally wound up (aren't the perfect committees supposed to have the wisdom to be able to vote themselves no longer necessary?). It was felt that the dichotomy between audit and research had disappeared and that audit and routine evaluation were now respected parts of psychotherapy research in S.P.R. (U.K.) (see A.G.M. draft minutes for details).

However, the tradition of a one day autumn meeting will continue and we will be hosting the meeting here in St. George's. We hope to have an overall theme about the recognition of diverse methods for audit, evaluation and formal research and are looking for keynote speakers both familiar with the theoretical issues and (separately) familiar with the developing political agenda around this.

Submissions for shorter papers and poster presentations should be sent to me by September the 1st. About a page of A4 should suffice! That leads fairly smoothly into:

Chris Evans [Page 1 in printed version] [return to index]


This edition of Network is later than intended but dignified by an ISSN. We are getting formal! I've also changed the layout a little to make things easier for me.

One immediate apology to David Kennard, his excellent piece on conference research was submitted in time for the last issue and mislaid by me. Fortunately I have found it and I believe his observations are of timeless value and he has forgiven me.

One new development in this issue is the publication of a draft of the minutes of the A.G.M. from the Ravenscar meeting. This should give members who weren't at Ravenscar a better feel of what's going on in S.P.R. (U.K.) and how to change it. These are draft minutes provided by Else Guthrie and, of course, await amendments and approval at the next A.G.M. but we hope publishing them like this will enable members who aren't at Ravenscar to put things to the next meeting. Write to me if you want things put to the Steering Group in the light of what you see here.

Since reelection battles seem topical and as this is one item in the A.G.M. minutes please note that I will happily edit two more issues of Network after this one but that I think it would be healthy then to pass things on so we're looking for volunteers.

All submissions by mail should be sent to:

Section of Psychotherapy,
Dept. of Mental Health Sciences,
St. George's Hosp. Med. School,
Cranmer Terrace,
London SW17 0RE

Please put submissions on a DOS format 3½" or 5¼"diskette if you can. I can cope with most WP file formats though Word for Windows, RTF, Word Perfect 5.1 or ASCII are preferred. The 'phone and 'fax number is:

0181 - 725 2540

If you are 'faxing a submission please don't use italics and use a large font: nothing less than 14 point otherwise I have to laboriously retype everything. Above 12 point with a reasonable 'fax my O.C.R. software will make a stab at translating things for me..

My Email address has simplified to:

though the old:

should still work (afficionados will notice that we've moved from the old JANET name order to the INTERNET format, actually, either order will still work). My ability to cope with MIME attachments and enclosures is improving but is still suspect but try it if you've got it!

Get those submissions rolling in for the next issue!

Chris Evans [Pages 1 to 2 in printed version] [return to index]

Vice president's message

The people they are a changin'

Being back at Ravenscar in March after a two-year break was good: an enjoyable meeting with some excellent talks and weather. It would be wrong to try and identify 'highlights' from the meeting as the ethos is one of 'collaboration'. However, it seems to me that our ability to incorporate a diversity of research approaches and therapeutic 'foci' at the meeting is good and will increase the possibility of reaching to the wider professions. It also seems that we are finding the right balance in being able to acknowledge the contributions made to research by SPR members. I thought the presentation to Tony Ryle was just right: not too much and not too little, with a beautiful blend of humour and substance. My thanks to all who made it possible.

As you will see in this issue, we are including the 'draft' minutes of the 1995 AGM held at Ravenscar. These minutes will not be approved until the 1996 meeting but we felt that including them in NETWORK would help communicate to all members the areas discussed. Obviously the annual meeting is the main focus for each year but the more we can pass information around using NETWORK, the better.

You will also find enclosed with this issue information relating to the election of the incoming UK Vice-President. At the AGM, three names were nominated and seconded. The three were, in alphabetical order, Mark Aveline, Chris Evans, and Jane Knowles. Information on each of the candidates is contained in the election material. Securing a successor is a major task of any incumbent UK Vice-President and it seems to me that, what ever else I do (or don't do!), I will have achieved this one task whoever is elected. All three candidates will do an excellent job. Whatever happens, it seems that to find three candidates of this calibre is a fairly good indicator of the strength of SPR(UK). My only plea to members is to vote. The candidates have come forward very willingly and it would be good to secure a high 'turnout'.

In the meantime, I hope everyone has a good summer.

Michael Barkham [Pages 3 and 4 in printed version] [return to index]

Research Menu

Being one of the two York residents who belong to S.P.R., I was asked to provide the three hundred delegates at last summer's international conference with a local guide to good eating places. Failing to obtain a research grant for a systematic study (sigh!) I had to make do with a literature review and such anecdotal evidence as I and fellow clinicians in the field could offer. This multi-instrument approach yielded a finding of 4 recommendations: 2 quality, one traditional and one convivial. The finding were duly reported in a brief handout to all delegates. The unexpected is always illuminating.

Reporting error resulted in several delegates turning up at the wrong address for one of the restaurants, much to their frustration and the bemusement of the hotel concerned. Moreover I had failed to anticipate an important difference between psychotherapy and good food research. To the best of my knowledge the publication of psychotherapy research, even with the best results, has not sent people out in walleted droves queuing at the doors of the most successful therapists on the offchance of a cancelled session. With food it's different. If I had anticipated the few thousand pounds I put the way of three restaurants in York I might have had my research grant after all, in kind for the next year. Am I in the right business?

David Kennard [Page 3 in printed version] [return to index]

Report on the Ravenscar Conference 1995

Ravenscar '95 will be remembered by me at least for its unmemorability. That is not to say it was uninteresting - it wasn't ; or that it was less enjoyable - it wasn't ; but that it felt like a year of consolidation rather than change.

Its predecessor Ravenscar '93 was a sudden uncomfortable jolt, a change of direction, new blood, new ideas, controversy, excitement for some, a fall in standards for others. We couldn't be expected to keep up that pace, could we?

Some of the things we tried out reappeared this year: the one minute poster presentations, admirably chaired by Glenys Parry, the panel discussions on a group of papers with a similar theme - and were judged to be sucessful. Other things like the clinical video and brainstorming workshops did not reappear, although may not be dead and buried.

Perhaps the most notable consolidation was in the change of emphasis away from hard quantifiable data towards a methodology for researching the softer areas of psychotherapy - dreams- religious bias - birth stories - therapist abuse of their patients - which more closely reflect the clinical activities and concerns of psychotherapists in practice. This change recieved a mixed reception. I heard animated discussion triggered by these presentations but also critical comments regarding lack of rigour or doubtful methodology.

Perhaps this is the time to invite an exchange of views in Network regarding future directions for the conference. Have we got the balance between clinicians and full time researchers about right? Do you have other suggestions regarding the format of the conference or bright ideas we might try out? Speak now or for ever hold thy peace.

Content-wise there were many interesting presentations with a strongly pragmatic flavour. The keynote address by John Clarkin was a clear and erudite appeal for integration of the biological and psychological in psychiatric practice.

A group of papers on therapeutic communities had more than an eye on their future survival which can no longer be taken for granted. Similarly the referral patterns for C.A.T.,specialist psychotherapy and in primary care settings carry implications which we would do well to note. It was even suggested that psychotherapists could ultimately be replaced by computers although a computer's ability to monitor its own countertransference must be in some doubt!

The conference dinner marked a presentation of the Career Achievement Award to Tony Ryle whose C.A.T. baby continues to flourish and mature within the portals of S.P.R.

The hotel complained that we had not drunk suficient malt whisky since they had bought in stocks specially. This was in marked contrast to '93 when we drunk them dry of both malts and bitter! Whether this reflects a more sober atmosphere, I'm not sure but the charades on Tuesday evening lacked the inebriated spontaneity of previous years.

I am sure we can look forward to many more years of rewarding meetings in what remains a uniquely friendly informal event, distinguished by the ability of psychotherapists from a wide variety of backgrounds to find areas of common ground and shared interest.

Rex Haigh and Debbie Kirby-Myers are due our grateful thanks for another sucessful and enjoyable event, with record numbers of participants.

Ian Macilwain [Pages 3 and 4 in the printed version] [return to index]

Career achievement award to Tony Ryle

One highlight of Ravenscar 1995 was the presentation of the career achievement award to Tony Ryle. Glenys Parry gave a fulsome eulogy and kindly donated her A5 notes so that I could capture something of this for people who weren't there.

She noted that he had a wartime adolescence, studied medicine at Oxford and U.C.H. and worked as a G.P. for 12 years before working as a clinical assistant at the Royal Free then in Sussex for 20 years before the recent 10 years in St. Thomas's and his current three years in semi-retirement between South London and Italy. He has been publishing on psychological disturbance since 1960, in the 70s he was publishing on Repertory Grids and Dyad Grids, in 1978 about a common language for psychotherapy, in 1979 about "dilemmas, snags and traps" and in 1990 his book about C.A.T.

She had canvassed others for their views of Tony and quoted "intellectualy towering/daunting/stimulating", "elegance of thought", "geometry and psychology at the speed of light" as well as comments on his pragmatic humanity, commonsense and advocacy of the "N.H.S. punter": "sensible psychotherapy for ordinary people". She paid particular tribute to his courage particularly in confronting cant but noted that a number of people had linked this with Tony's ability to show no pomposity, arrogance or even self-importance as well as his generosity and encouragement of other researchers. Some had commented that Tony sometimes underestimates his importance to others.

Photo of Tony Tony looking inimitably Tony (difficult to convey the height on the Net!)

In summarising his achievements Glenys noted that Tony was a lonely figure in supporting psychotherapy integration 20 or more years ago but that the world seems to be catching up. She argued that C.A.T. is the only approach to come near to a genuine integration of Cognitive Behavioural and Psychodynamic psychotherapies. She argued that C.A.T. practice was also fundamentally linked with its theory unlike some other schools of therapy and that its integrative language allows a common language and makes it researchable. She noted that C.A.T. has shown extraordinary growth in the last five years.

She finished by noting that Tony has a passionate commitment to the public sector on behalf of patients, therapists and S.P.R. and that he holds a unique place in U.K. psychotherapy services and research.

Rather to Tony's horror, the reformulation being critically a joint production of patient and therapist, a diagrammatic reformulation of Tony was offered in his honour and I hope it will be explained by those who can do so from the accompanying graphic. I, who have the advantage of having been there at the time can make out the snag around trying to retire but failing and the well known trap of being stimulated by writing a paper into more thoughts that lead to more papers as well as the dilemma of chosing between Italy and London. I liked the core characterisation of a "good egg". (Photos courtesy of John McKenna)

Tony's S.D.R. Tony's "S.D.R."

Tony responded with a superb speech about his views of psychotherapy and psychotherapy research on the "Just so" menagerie model and gave an impassioned plea for continuation of the values that have underpinned so much good N.H.S. psychotherapy and psychotherapy research in the U.K.

Chris Evans [Pages and 5 in printed version][return to index]

M.H.F. initiative: who were the lucky ones?

The Mental Health Foundation's Psychotherapy Initiative began with a research conference in Oxford in September 1993, whose proceedings were published in a book edited by Mark Aveline and David Shapiro, Research Foundations for Psychotherapy Practice, published by Wiley earlier this year. Three areas for development were identified: a 'core battery' of outcome measures; therapist competencies; and health-economic evaluation of psychotherapy. Specifications were developed for each of these in a workshop held prior to the International SPR meeting at York in June last year. The subsequent call yielded an excellent crop of applications; funds were unfortunately so tight that only four projects could be supported. The successful applicants are to be congratulated on winning through very tough competition. They were:

David Shapiro [Page 8 in printed version][return to index]

Meeting of the 'Northern Group'

Following a brief meeting at the Ravenscar meeting this March to discuss the possibility of people in the Northern area collaborating in research, a group of about 20 SPR members met at the 'Kremlin' (the locals' name for Quarry House in Leeds) in late May. Of course we all wanted to meet there to see the vast sums of money 'wasted' on this outpost of the NHS, but alas the meeting room we ended up in could have been anywhere. We didn't even get an invite to Roger Corey's leaving 'do' (sorry - in joke). What we did do was to define parameters for data set linking Manchester, Leeds, York, Wakefield, Bradford, and Sheffield. Our aim is to collect data over 6-12 months which will enable us to address simple questions of interest to us all. This is no NIMH Collaborative study, but it is a beginning of active data collection and, more importantly, data analysis and data use. If anyone in the 'north' is interested in hearing more information about this venture (and who was not at the meeting), please contact me. We have arranged to meet again at the Kremlin from 11 until 2 on Friday, 29 September, which just happens to be St. Michael and All Angels day. Now there's a 'group' to conjure with!

Michael Barkham [Page 8 in printed version][return to index]

Campaign Corner

I haven't had any submissions nor have I noticed anything that I've cut out for this section this time around. However, I thought it was worth reporting that I've had two reporters, one writing for the Sunday Times asking about psychotherapy and the Internet and about psychotherapy by computer. There has been a heated correspondence on one of the psychotherapy related lists on the Internet about the fact that some people are offering Internet counselling or psychotherapy. This really raises the fascinating reality of the Turing test: can you tell whether the person replying to you by Email is a human counsellor/psychotherapist or a well written piece of artificial intelligence?

I pointed out to one reporter that this raised the interesting possibility that Psychotherapy Research may yet hit the capitalist big time for funding: if you can mass produce psychotherapists or counsellors as pieces of LISP or PROLOG code (or whatever) and if there is, as there seems to be, a market out there then there are millions or even billions to be made and some R&D might be financed on a scale to match that of pharmacological R&D. Oddly enough he cut this bit of my suggestion!

Chris Evans [Page 9 in printed version] [return to index]

... and that seems to lead fairly easily into...

I.T. Corner

Network is at last on the Internet. All the issues I have edited (4(1) in 1993 to this) are now on the WorldWideWeb (WWW) at the Universal Resource Locator (URL):

The WorldWideWeb is based on a fairly simple network protocol (HTTP hence the first word of that URL) which allows interlinking of pieces of text or other data between different computers on the Internet. You can look at one of these (a "home page" and it can point you to others so that you can find yourself looking at a composite whose pieces might all be on one computer or actually distributed between a number of different computers. Following links from one piece to another you can be jumping around the globe, a practice called "surfing (.. the web)"

I think our Psychotherapy Section home page here in St. George's is actually the first devoted to psychotherapy and psychotherapy research anywhere in the world and I think that Network is the first Psychotherapy publication to appear in this form as well as on paper. I won't mount the A.G.M. minutes as it seems only right that they should only be sent to S.P.R. (U.K.) members but I will be mounting all the rest of this issue and one of the nicer things is that I can put pointers from an article to an earlier one that might seem pertinent and the reader only has to click on that highlit line of text to jump to the earlier article. There's a lot of hype about all this going around and surfing the web can seem pretty like surfing the most polluted local stream at times but there is some potential here. Watch this space and if you have anything psychotherapy related you want posted on the Web send it to me. The usual requirements for submissions to Network apply (see editorial - there, that's the sort of thing you make a hypertext link that will just take someone there or to a box that immediately enables them to Email me directly). Make it clear whether you are submitting something for Network and the Web or just for the latter.

If all this whets your appetite to get onto the Internet then read the last I.T. Corner, as predicted, Compuserve now have Internet access up and running.

Chris Evans [Page 9 in the printed version] [return to index]

... from hypertext hype to something more in keeping with psychotherapy perhaps... (P.T.O.)

Watercolour Exhibition

Mary Burton

Mary Burton is holding her first exhibition of paintings at St. Botolph's Church, Aldgate (adjacent to the Aldgate Tube Station) in the autumn. The private view is on Sunday afternoon, the 29th of October. Members of SPR are especially invited to attend at that time, although the exhibition will remain open until Thursday the 16th of November. It you are visiting London during that three-week period, you are warmly invited to call in. The church is open on weekdays, 10 to 4.

Mary Burton, Ph.D.,

Chartered Clinical Psychologist & Psychotherapist,

Flat 1, 40 Belsize Park, London NW3 4EE

[Page 10 in the printed version] [return to index]

Psychotherapy researcher seeking paradigm: must be reflexive, feminist & interested in psychodynamic material. Qualitative replies only please

The aim of this article is to begin to introduce readers to the potentials and pitfalls of adopting a discourse analytic approach to psychotherapy research. I say 'begin' because I am a beginner but also because adopting this type of framework can open up ways of thinking which get quite diverse and distracting. It is easy to reduce discourse analysis to a simple methodology or a variation on therapeutic analysis but it is much more complex and challenging than this. I'd like to keep flagging up the discursive nature of discourse analysis because I think this is the most exciting aspect of it and why I chose this as part of the framework for my psychotherapy research project.

Discourse analysis is part of the post-modern challenge to the notion that language reflects meaning. It is concerned with the way in which meaning is constructed in and through language, while at the same time being constrained by language. Embedded within this is the question, 'Which social conditions give rise to or make available, particular discourses'? It is concerned with understanding the social production of subjectivities.

Burman and Parker (1993) describe three main discourse analytic 'interests' in Britain:

1) The first is associated with Potter & Wetherell's (1987) use of 'interpretative repertoires' to describe the way speakers "draw on shared patterns of meanings and contrasting ways of speaking". They highlighted 3 important aspects of language: there is greater variety than consistency in peoples' accounts, the function of talk is greater than its role of transmitting information, and we construct spoken and written text from existing resources. In turn, Billig (1988) chose the term 'ideological dilemmas' to describe "those contrasting public and collective ideas that people negotiate when they weight up, refer to and then discount alternative accounts".

2) The second emphasis draws on Garfinkel's ethnomethodological studies of how people make sense of the world and cautions against the idea that ideology is fixed. Instead, the suggestion is that discourse analysis only discovers that which it creates. So, "identity is negotiated through talk". This form of discourse analysis organises itself around two questions: "What problems are presupposed by the statements made here?" and "What are the solutions that are being posed to those problems?".

3) The third 'group' offers a poststructuralist perspective and is associated with Parker (1989), Hollway (1989) and Burman (1991). It is suspicious of the belief that world exists outside language or that we can experience any aspects of ourselves outside language. This is a thoroughly deconstructive approach, questioning the 'truths' we take for granted.

Although discourse analysis focuses on language, it is not just a synonym for it. 'A/The discourse' is also used to describe "a system of statements which constructs an object" (Parker, p.5). It draws on Foucault's account of the ways in which studies of the individual are historically and culturally possible, rather than 'true'. By attending to the discursive nature of various disciplines, we are able to highlight the assumptions on which they are based and to explore how these are used to maintain and reproduce their particular discourses. Finally, discourse analysis is inherently reflexive which adds to the accountablility of research by making the enterprise more public, by drawing attention to the way in which the researcher participates in the process and the factors which may influence interpretation. It highlight the dynamic and shifting nature of power.

I see discourse analysis as having many similarities to psychodynamic psychotherapy in its concern with text, with its reflexive and inclusive framework which attends not just to the subject but to the inter-relationship between the two (or more). Moreover, there is a shared understanding of the shifting, contradictory nature of human identity. However, it goes further than this by attending to the discursive nature of psychotherapy which is itself a product of a particular cultural, historical and gendered process. This enables us to contextualise the subjectivities being negotiated within psychotherapy in a much broader way than has been done.

I will come back to the 'how's' of discourse analysis in my next piece.

A very good place to start exploring discourse analysis is Potter, J. & Wetherell, M. (1987) Discourse and Social Psychology - Beyond Attitudes and Behaviour. London:Sage.

For a more post-modern and Foucauldian approach to discourse analysis, see Parker, I. (1992) Discourse Dynamics: Critical analysis for Social and Individual Psychology. London: Routledge.

The gendered nature of available discourses as well as the role of psychodynamic processes is clearly explicated in Hollway, W. (1989) Subjectivity and Method in Psychology: Gender, Meaning and Science. London: Sage.

The following text indicates the way in which the authors have developed their original understanding of discourse analysis, Wetherell, M. & Potter, J. (1992) Mapping the Language of Racism: Discourse and the Legitimation of Exploitation. London: Harvester Wheatsheaf.

For an example of research projects which draw on the various 'schools' of discourse analysis, see Burman, E. & Parker, I. (eds) (1993) Discourse Analytic Research - Repertoires and Readings of Texts in Action. London: Routledge.

Finally, this text is really one of the best places to start in gaining an understanding of the post-modern challenge of Foucault, Lacan, Derrida, Irigaray and others, to contemporary psychological and psychotherapeutic discourses: Henriques, J. et al (1984) Changing the Subject: Psychology, Social Relations and Subjectivity. London: Methuen. (out of print)

Colleen Heenan

11 Milford Place,
West Yorkshire
BD9 4RU, England

[Pages 10 to 11 in the printed version] [return to index]

Dialectical Behaviour Therapy

Cognitive-Behavioural Treatment of Borderline Personality Disorder. (1993) Marsha M. Linehan, New York, Guilford. £30.95, 550pp, ISBN 089862-183-6

Skills Training Manual for treating Borderline Personality Disorder (1993) Marsha M. Linehan, New York, Guilford. £20.50, 180pp, ISBN 089862-034-1.

Borderline personality disorder (BPD) is difficult to treat; especially when it gives rise to self-harming behaviours. There is something about repeated, deliberate self-harm which is not only treatment resistant, but also alienates health care professionals. The many reasons why this might be are not discussed by Linehan in her otherwise comprehensive book, and its accompanying skills manual. However, her account of BPD acknowledges the effects that these patients have on therapists, and she clearly believes that previous treatment approaches to BPD have failed because of negative therapeutic attitudes.

The starting point of Linehan's approach therefore is validation of the patients' account of themselves and their feelings, while at the same time, challenging dysfunctional cognitions and beliefs which impede therapy. This combination naturally produces a tension between two opposing tendencies, which Linehan refers to a "dialectic" hence, her title for her therapeutic approach, "Dialectical Behaviour Therapy" (DBT).

The book contains a rationale for DBT, an account of a course of treatment and detailed discussions of problems which can arise in therapy. Linehan is keen to emphasise that the relationship with the therapist is of crucial importance for the process and progress of therapy. In this way, her theoretical position overlaps with dynamic accounts of BPD treatment, without the use of analytic language. For example, there is an extensive discussion of the attributes of DBT therapists and the need for on-going supervision during the work. Failures in therapy are attributed first to the therapist's control of the therapy course and content, rather than failures in the patient. In this sense, Linehan offers a quite radical view of BPD treatment, in acknowledging the degree of psychopathology in BPD patients, without "blaming the victim".

Is DBT effective? Linehan gives some account of some studies, suggesting that DBT is better than standard treatments (not involving psychotherapy), and is as good as individual psychotherapy. Treatment can be given in a group setting, and gains seem to be maintained at 2 year follow-up, although Linehan is at pains to point out that patients are still clinically symptomatic, and that her sample sizes are small. What her studies cannot account for at this stage of the research is the specific effect of a therapeutic approach which offers validation of distress and disorder, within agreed boundaries. For example, Linehan asserts that "there is no such thing as unconditional positive regard", a major step from traditional counselling/therapy which takes account of the real difficulties which BPD patients pose.

The book is enormous, and thus not terribly user-friendly at first glance; the manual is more accessible, contains much of the same material, and is very clinically oriented. Nevertheless, the book contains little redundant material, and the reader will find that persistence pays off. The quality of the writing is good, and the material fascinating and practically helpful. Even if one is not carrying out DBT as described in the manual, there is much here to stimulate and inform the therapist who works with BPD patients. This therapist would heartily endorse Linehan's recommendation that no discussion of childhood trauma take place with these patients until there has been considerable work on interpersonal effectiveness, and regulation of both emotion and distress. All these skills (and suggestions for how they can be taught in groups) are described in the manual.

I suspect that many of Linehan's patients are less disturbed (and have less concurrent pathology) than those patients with BPD who present to general psychiatry or psychology services in the U.K. N.H.S. Even so, Linehan's DBT offers an approach to therapy which could be modified for more disturbed patients, as well as offering a clear and coherent model for use in out-patient settings. Perhaps the most useful contribution made by Linehan's book is the belief that patients with BPD can engage in treatment, and with therapists; and that perseverance on the part of the therapist and patient can bring rewards. Given the therapeutic nihilism which sometimes envelops the personality disordered patient, a breath of therapist optimism, backed up by detailed accounts of treatment and empirical research, is most welcome.

Gwen Adshead

Lecturer in Forensic Psychiatry,
Institute of Psychiatry,
De Crespigny Park,
Denmark Hill,

[Congratulations and thanks to Gwen for providing this review when well into pregancy and on successful delivery]

[Page 12 in the printed version][return to index]

Person-centred counselling

Mearns, D. (1994) Developing Person-Centred Counselling. London: Sage. Pp.139. £9.95. Paperback. sbk 0-393-31240-2

This book is another welcome addition to Sage's Developing Counselling series edited by Windy Dryden. As with all the other books in the series, it is very accessible, succinct and therefore a book I would highly recommend to counselling trainees as well as those who need reminding that person-centred counselling consists of relating, not just appearing to be empathic or understanding.

What comes across most in Mearns' book is person-centred counselling's commitment to the quality of the counsellor-client relationship. Although he tends to be a bit dismissive of 'clever' approaches to therapy which focus on understanding, explaining and offering 'grand' interpretations, his reminder of the 'necessary and sufficient' conditions for therapy, are just as clever. They are clever simply because they are applicable to all models of counselling and psychotherapy; that is, listening not just to words but to what is being said or not said; going beyond language as the only vehicle for communicating; seeing power as a dynamic as opposed to possessive force; being congruent. Although I disagree with some structural and theoretical aspects of this particular counselling model, for the most part Rogers' attention to the qualities of the therapeutic relationship, can always be transferred to any other approach.

The book is split into five sections, the first four extending our understanding of issues around the quality of the therapeutic conditions, counsellors' personal development, the therapeutic alliance and process. Brian Thorne adds an interesting dimension in terms of the relevance of spiritual development. The final section which is co-authored, provides an interesting consideration of psychopathologies from a client-centred perspective, again focusing on the alliance and process but also considering technique.

Throughout the book there are some suggested areas for psychotherapy research such as the therapeutic role of dissonance in changing self-concepts or the use of interpersonal process recall in understanding factors influencing the therapeutic alliance. However, the value of Mearns book is that it gives us a taster of a number of issues which need expanding in greater depth than this series aims for.

Colleen Heenan

11 Milford Place,
West Yorkshire

[Pages 12 and 13 in the printed version][return to index]

Books for review

I am accumulating books sent by publishers for review. It's a motley collection. I'm also passing on specific requests from readers to publishers when they're sent in. Publishers very rarely provide books that were published more than two years ago and British based publishers are easier than American but if you have requests, pass them on. For the remainder, listed below, my system hasn't changed. Send me a cheque for the cost of the book made out to:

S.G.H.M.S. MHGP RNFB account

That's my research account. When you do the review, I pay you back and you have the kudos of a publication! Write to the address shown in the editorial. Please, no matter how eminent you are, don't just write saying you'll do one of the books on the list without a cheque. When you've got a track record of delivering I may start sending books out without the cheque, until then, no go! All this is done in my free time so if you ask me to chase a book and don't hear from me, that's because I haven't been sent it by the publishers.

[HTML readers. I can only offer books for review to SPR(UK) members (though I might bend on that for books that have been around my office for say eighteen months!). If you are an SPR(UK) member then please find your way to the latest issue {1kb} for the current state of what's available.]

O.K. now who wants to do Advances in the neurobiology of schizophrenia for £70.00? (I didn't specifically request that one I'm sure!)

Paris, ?.?. (1994) Borderline personality disorder A.P.A.:? £26.95 hback, ISBN 0-88048-655-4

Scharff, ?.?. & Fairbairn-Birtles, E. (1995) From instinct to self. Vols I & II Jason aronson: ? £72.00 hback, ISBN 1-56821-366-2

Stake, R.E. (1995) The art of case study research. Sage:London £12.95 pback., ISBN 0-8039-5767-X

Simon, ?.? (1994) Psychotherapy. Theory, practice, modern & postmodern influences. Praeger:? £53.95 hback., ISBN 0-275-94690-8

Mann, D.W. (1994) A simple theory of the self. W.W. Norton & Co. Ltd.:London, £21.00, ?back., ISBN ??

Stone, M. (1994) Abnormalities of personality. W.W. Norton & Co. Ltd.:London, £37.50, ?back., ISBN 0-393-70127-1

Yankura, J. & Dryden, W. (199?) Albert Ellis. Sage:??, £9.95, pback., ISBN ??

Powell, T.J. (199?) Understanding self-help organisations. Sage:??, £20.50, pback., ISBN ??

Barker, A. (199?) Arson: a review of the psychiatric literature. O.U.P.:Oxford, £25.00, ?back., ISBN ??

Hammersley, M. (199?) Politics of social research. Sage: ??, £11.95, pback., ISBN ??

Moustakas, C. (199?) Phenomenological research methods. Sage: ??, £17.95, ?back., ISBN ??

Den Boer, ?.?. (199?) Advances in the neurobiology of schizophrenia. Wiley: ??, £70.00, ?back., ISBN ??

Wiley, ?.?. (199?) Semiotic self. ??:London, £12.95, ?back., ISBN 0-7456-1503-1

Habermas, J?. (199?) The new conservatism. ??:London, £12.95, ?back., ISBN 0-7456-1411-6

Benvenuto, ?.?. (199?) The rites of psychoanalysis. ??:London, £11.95, ?back., ISBN 0-7456-1530-9

Tedeschi, R.G. & Calhoun, L.G. (1995) Trauma & transformation. Growing in the aftermath of suffering. Sage:London, 176pp, ISBN 0-8039-5256-2 £29.50 hbk, £14.95 pbk.

Connor, A. & Black, S. (eds.) (1994) Performance review and quality in social care. Jessica Kingsley: London 262pp., ISBN 0-85302-017-6, £??.?? hdbk.

Sanderson, C. (1995, 2nd ed.) Counselling adult survivors of child sexual abuse. Jessica Kingsley: London 304pp.,
ISBN 1-85302-252-7, £??.?? pbk.

Birtchnell, J. (1993) How humans relate. A new interpersonal theory. Praeger: Westport, Connecticut, 302pp., ISBN 0-275-94405-0, £51.95 hdbk.

Sorry, just don't have time to clear up the missing data, I had to do this from the invoices for speed.

Chris Evans [Not actually the list that was on Pages 13 and 14 in the printed version, updated to reflect books available as of 8.x.95][return to index]

Correspondence at last!

From Question Mark Designer's Designers

I have left all the garbage that Email puts about how the message got to in in italics here for the amusement of those who might like to compare it with reading the franking on a letter to see when it was sent!

Received: from by (SGHMSV1.0) ID AA14148; Thu, 27 Apr 95 13:39:30 BST
Received: from ( []) by (8.6.9/8.6.9) id NAA17964 for; Thu, 27 Apr 1995 13:38:59 +0100
Date: Thu, 27 Apr 95 13:38 BST-1
From: (Kinna Patel)
Subject: Re: feedback & NETWORK
Message-Id: <>
X-UIDL: 799005635.002
X-PMFLAGS: 33554560
In-Reply-To: <>
Dear Chris
We enjoyed reading your review of Question Mark Designer for Windows v 2 in September's Network.
We would however point out that we have never claimed that any Question Mark product is for anything other than the delivery of on-line tests either by floppy or the hard disk, over a network or - latterly - on the internet. To "generate really nice paper questionnaires" you surely just need a DTP or Word Processing package incorporating graphics - just like you always have. Designer for Windows incorporates the facility to print out questions, including graphics, but that is not its primary purpose.
Your point about validated input and export to .DBF format or the like is well taken - we're working on it!
Thanks again and good luck. DAVID HALL

[Page 14 in the printed version][return to index] Their excellent home pages are: Question Mark Computing home page

If you live in Britain and you're interested in joining SPR(UK)

Please pick up the 'phone now and ring:

01734 561250

or write to:

S.P.R. (U.K.) membership dept!
53-55 Argyle Road,
Reading RG1 7YL
Fax.: 01734 561251

Sue Clarke or Sue Robinson will give you the details and send you an application form. Then write to me and tell me what you think of Network, or better still, write an article, a book review or a response to anything in this edition and send that to me [contact details]. [Page 14 in printed version] [return to index]