book review

What Therapists Say and Why They Say It: Effective Therapeutic Responses and Techniques

• review by Irena Domachowska

The title of this book, What Therapists Say and Why They Say It: Effective Therapeutic Responses and Techniques. might be a bit misleading. At first I thought that this book is dedicated to patients trying to better understand their therapists and I found it quite amusing. However, the subtitle “Effective Therapeutic Responses and Techniques” better catches the essence of the book. It is a compendium of therapeutic techniques, one that catalogs, describes and provides examples of potential responses and interventions used in therapy, such as paraphrasing or mirroring.

The authors, Bill and Jim McHenry, have worked both as therapists and supervisors for counselors-in-training. Along teaching various theories of psychotherapy, they were often confronted with questions as to how to translate the theoretical concepts into the practical language of therapy. Their students favorite question seemed to be "Can you give me an example of that?". With this question in mind, the authors created a book with practical examples of various interventions used at different stages in therapy. A therapy is different from a normal conversion in the sense that it is aimed at changing the client. Therefore simply listening to client's concerns is not enough. The therapist has to be more engaged in the dialog and express his or her involvement in a way that builds trust and mutual attachment that is necessary for the healing to occur. Psychotherapists learn to use a variety of listening and interpreting techniques during their training, but it is great to have all the techniques organized in one book and backed up with practical examples.

The book is structured around therapeutic skills necessary at different stages of therapy development. The first chapters are dedicated to skills supporting understanding of the client's problem and building rapport, such as paraphrases, summaries and reflections of client's feelings. The second part concentrates on deepening the understanding of client's problems for both the client and the therapist, so that a solution to the problems can be worked out. Finally, the third part of the book concentrates on the actual behavior change, i.e. how the discussed changes can be applied in the everyday life.

Every part consists of various techniques and for each technique there is an explanation, including the purpose of the technique and what the therapist does, followed by some practical examples. There is also information whether a technique is specific for one psychotherapy school or if it is a more universal skill. For example, calling for being in here and now is more usual in Gestalt and in group therapy, whether identifying client's core beliefs is practiced mainly by therapists using Cognitive-Behavioral approach. Techniques such as reflecting the meaning of what the client said or asking open questions are used universally by therapists from different approaches.

At the end of the book, the authors prepared some practical exercises in a form of short descriptions of patients’ problems and a fictional dialog where the therapist's part is left blank. It is a great opportunity to practice potential answers without the pressure of an actual client waiting for help. Beginning therapists can discuss their answers with a supervisor or other therapists-in-training. I would definitely recommend this book to every practicing psychotherapist and psychotherapist-to-be. It is a concise and practical guide that can be used both to develop new skills and expand the usual repertoire of techniques.  Techniques that can enhance the therapy process and help clients benefit more from it.