The experienced chef has an armamentarium of favorite dishes, each tested and proven to produce a meal that suits particular occasions. The recipes spring from years of experience developing a sense of how to combine seasonal ingredients and hints of spices to delight the eater’s palate.
But even for someone skilled, when you make meals day after day, it is easy to become a creature of habit or fall into bland routines. It is then that the wise cook reaches for a new recipe or wanders the farmer’s market in search of new produce to reinvigorate the kitchen.
Likewise for mental health practitioners. In that case, reaching for The Therapist’s Treasure Chest can provide the right fresh ingredients to fuel your therapeutic creativity.
Written by experienced child and adolescent psychiatrists Andrea Caby and Filip Caby, the book covers a lot of territory. It begins with a brief overview of Caby and Caby’s theoretical framework, which they describe as “systemic, solution oriented, resource oriented, and constructivist,” as well as important topics, including techniques for using questions during the therapeutic process and the art of making a therapeutic connection.
On these topics, the authors provide a number of thoughtful ideas, such as pointing out that the “most important task of the therapist is not to understand too quickly” as this leads the patient to “lean back and relax” rather than do the work required to develop new ideas on his own.
This theme emerges again later as Caby and Caby point out that, rather than feel pressured to talk during the session, the therapist should “see it as your job to get the client to work” and to “do things differently, to develop new ideas.”
While I found this noteworthy, other topics in the book felt overly ambitious. For example, a section called “Establishing a Bond with a Client” runs under five pages. Five pages on the skills we spend our whole career developing?
To be fair, however, although that seems paltry, it may be an appropriate level of detail given that this is not the focus of the book. Indeed, the real meat of the text comes in the second section, which offers a wide range of therapeutic interventions.
Here, the descriptions are concise, running one to three pages, and each is broken into five parts. Labeled for easy navigating, there is the idea part, with an overview of the intervention; the method, with a description of how it is executed; tips to help with the process; indications/contraindications to help focus on the best use of the technique; and setting, the part that explores whether an intervention is appropriate for individual, family, or couples therapy.
Many of these interventions are quite creative and have a certain playfulness, possibly stemming from the authors’ specialty in child and adolescent therapy.
For instance, one of the ideas is called “The Change Detective.” For this technique, a client is asked to decide on a change to institute at home. He writes it down, but tells no one else in the family. The others then have the task of observing during the week to try to determine what difference has been made. At the next therapy session, the other family members share what they have observed — and the intended change surfaces as well. Caby and Caby describe how this can lead to useful discussions and actual behavioral change.
The authors next go over specific indications for the application of these techniques. For easy reference, this portion is organized alphabetically by issue. After a brief description of the problem — which range from DSM diagnoses of anxiety and post-traumatic stress disorder to other behavioral issues such as sibling rivalry and lack of motivation — there is a list of suggested interventions and specific recommendations for how to incorporate them.
The final portion of the book offers suggestions for dealing with challenging therapeutic scenarios, such as when a client is skeptical. Here, the authors maintain their reference-manual style, devoting no more than a page to most of the issues.
This section felt over-simplified at times. Often the page dealing with a problem focuses on a list of questions that the reader might ask during a session, but without any guidance on following up once the client offers an answer. This makes the last part of the book less about providing solutions and more about how to simply move forward with a tricky conversation.
Still, the overall format and each topic’s brevity make the book a good quick reference guide for different therapeutic approaches to common issues. While many of the techniques and clinical examples have a child and adolescent focus, the strategies can be used across the lifespan and in a range of clinical settings.
At times, the brief descriptions did leave me wanting more, in much the same way as a cookbook that says simply, “Make a béchamel.”
But even without reading how to put the sauce together, the experienced chef, or therapist, once prompted to use a fresh flavor, will know what to do from there.
The Therapist’s Treasure Chest: Solution-Oriented Tips and Tricks for Everyday Practice
W. W. Norton & Company, April, 2014
Paperback, 368 pages