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Ryle, A. (1987). An Outline of Psychotherapy for Medical Students and Practitioners edited by Harold Maxwell. Published by John Wright: Bristol 1986; 106 pages; £6.25 paperback.. Brit. J. Psychother., 4(2):190-191.

(1987). British Journal of Psychotherapy, 4(2):190-191

An Outline of Psychotherapy for Medical Students and Practitioners edited by Harold Maxwell. Published by John Wright: Bristol 1986; 106 pages; £6.25 paperback.

Review by:
Anthony Ryle

This book lives up to its title, providing an outline of a number of forms of psychotherapy in a language accessible to the uninitiated and conveying the differences between therapies carried out in different contexts and under various theoretical flags. The essentials are clearly stated, the complexities adequately indicated and most chapters end with appropriately short lists of references to more extended accounts.

Six of the eight contributors are doctors and the emphasis is on work in medical contexts. I particularly liked the chapter by Elder on work in general practice; possibilities and limits are well described and excellent case vignettes offer illustrations of the points made. I found the chapter on liaison psychiatry by Thomas less satisfactory; in concentrating on patients' responses to physical illness, too little attention is paid to the mutually created and sustained problems between doctors and patients reflected in poor treatment compliance, excessive physical treatment and investigation and in various forms of illness behaviour. Sklar offers four pages on medical students' feelings; as students are likely to be the main readers of this book it is a pity that this pungent appetizer was not expanded to a main dish. Group, family and behaviour therapies all receive satisfactory treatment, and Alexander's summary of psychodynamic therapy is a tour de force of accurate, non-dogmatic condensation.

One serious omission is cognitive therapy which is covered in twenty-five lines in the behaviour therapy chapter. This approach, in particular the use of patient self-monitoring and the identification of maladaptive thoughts and their relation to moods and symptoms, is easily taught to doctors with no therapy experience and can be safely and effectively applied to many problems. Another omission is the neglect of timelimited therapies. Most NHS patients receive a small number of sessions, usually as a result of unplanned early termination, and the efficacy and economy of planned brief work on psychoanalytic or other lines deserve emphasis.

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