Psychotherapy with Impossible Cases: The Efficient Treatment of Therapy Victims (A Norton professional book) [Paperback]

The book identifies the therapeutic conventions that trap therapists and clients in the wasteland of impossibility, from where there is no escape, and where no further growth can be anticipated. When both clients and professionals believe in impossibility, they tend to:
· anticipate trouble;
· elevate theory over the client's practical experience of living the therapy in the multi-contextual world outside the therapeutic hour;
· refuse to question the appropriateness of the models and techniques despite absence of improvement;
· neglect client motivation.
The authors report that successful outcomes can occur with even the most heartsink cases when therapy accommodates the client's worldview and informal 'theory of change'. They argue that practitioners have much to learn from placing their confidence in therapy veterans' own resources and capabilities. Rather than regret the loss of control and status that this might imply, the authors celebrate this new emphasis, "It is the unpredictability of client methods and accomplishments that makes this work fun". With due humility the authors quote the opinion of a 10 year old `impossible' client: "So, what I'm saying to all psychiatrists is we have the answers, we just need someone to help us bring them to the front of our head. It's like they're [the solutions] locked in an attic or something".
The authors discuss many cases and describe how to:
· optimise the client's participation in therapy;
· collaborate with the client and establish a co-therapy alliance;
· leverage the power of the client's resources and theory of change;
· honour the client's motivation.
The authors successfully argue that the practice of (frankly disrepectful) labelling de-humanises clients, and can insidiously legitimate a lack of optimism that the clients can expect alleviation of the conditions that distress them. As with their other work, their strongest argument is that clients are co-therapists, not cases to be managed with a pre-formulated care plan that resembles a manual of Standard Operating Procedures.

This book has many lessons for the field of performance coaching, both for teams and individuals. Recently I met an engineer who had been referred to me because his manager and colleagues claimed that he need coaching in both time-management and effective listening: I was warned that he had been sent for similar training on previous occasions, but had 'failed to learn anything'. Within 20 minutes of meeting him, it was apparent that although the engineer had unquestioningly accepted the labelling/assessment of his colleagues, the labels were wrong. He was overloaded with responsibilities, rather than incompetent, or incapable of learning.

Influenced by the arguments of this book, we outlined a programme that more closely reflected the engineer's own needs and motivation, and both broadened and built on the strengths that had so far been invisible to his manager and colleagues. The engineer acquired several new skills that vigorously contested the previous prediction that he would 'fail to learn'.

This book merits a wide audience and should be read for its application to several fields such as education, management practices, and personal development.