Book Review: Escape from Babel
In reading Escape from Babel By Scott D. Miller, Barry L. Duncan, and Mark A. Hubble my first reaction was the strong connection to more post-modern therapies. Narrative and solution focused therapy are very much exemplified by the tenants of this book. The emphasis on treatment having an average of 9 sessions, a focus on the future with an emphasis on depersonalizing the problem are examples of how the authors incorporate all methods of treatment into a more unifying language of successful psychotherapy.
I was impressed by the amount of research and precision that went into creating this book. The field of psychology is generally thought of as a scientific based field which places great emphasis on the medical model. This model it that prides itself on research, thus it was a surprise that after 40 years of research no one theory, model, or method has been determined to be significantly more effective. Many clients only attend an average of nine sessions, thus treatment is brief no matter which therapy model is used. Also data suggests that the model of therapy does not make a difference in treatment outcome. However, the point I took home was that the model employed is important to the clinician than the client. It is important for the clinician to believe in the model they subscribe too because it is a general reflection of how the therapist engages with the client as well as reflecting the therapist’s vales. I found it interesting that the similarities rather than the differences account for most change that the clients experience. It seems very intuitive that this would be the case, however, because what seems to be effective for changing human behavior would be similar across all cultures and individuals-i.e. the same variables such as “being respected, being understood, and being cared for.”
Moreover, the client’s participation is the most important determinant for the client’s outcome. Thus, the therapeutic alliance is a major contributor to the client’s sense of engagement, enjoyment, and benefit from therapy. The therapist should show the client empathy, respect, and be genuine. From the therapeutic relationship the clients then should have a greater chance of creating change in their lives. Clients need to be able to view change that results from something they did, and can do again. This gives the client a sense of empowerment and hope for the future. To this end, it is important for the therapist to be positive, and treat clients as if they are capable and posses the strengths to change their problems.
An important quote and standard that a therapist should be aware of, is “treatment should accommodate the clients motivational level or state of readiness for change.” I think it is important for all therapists to remember that client’s cannot be pushed to meet the goals on the therapists timeline, but rather meet the client where they are in the process. Thus, it is important to recognize the movement through changes of stage. Many clients generally relapse and recycle through stages of change. The therapist needs to create a safe environment, that fits with the client’s sensibilities and frame of reference, for these stages of change to occur.
The importance of hope and expectation plays a major role in therapy. These factors are generally known as placebo factors and account for 15% of the change. Even more interesting is the 58% percent of clients identified the instillation of hope as a curative factor in psychotherapy. And moreover when therapists stop looking to cure problems of their clients they generally begin to focus on client’s strengths and how clients can obtain their goals. Therapy should be oriented toward the future. Giving clients a sense of hope for the future resolves the clients demoralized feelings of not being able to resolve problems in their lives.
To enhance optimism and hope it is important for the therapist to focus on client strengths. People who feel they have a sense of personal control tend to cope better and adjust more successfully when those events are negative or stressful. The therapist should also help the client to depersonalize their problems. The problem is the problem.
Another important factor to consider is client’s culture, morals, and values. Understanding the client’s world view may help treatment by allowing the client to facilitate change from their own point of reference rather than by traditional individualized western ideals. The most common helpful interpersonal event was the clients’ feeling that the therapist either understood or was sympathetic to their situation or difficulty. The hope to relieve suffering both by the client and the therapist can create therapeutic benefits and long term change for the client.
I found this book helpful in realizing the importance of client and therapist relationship over certain prescribed technique or theory. As the field of psychology becomes more accessible to people of diverse ages, cultures, socioeconomic status, and values it will be important to realize a more unified language for psychotherapists.
