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Book Review

Textbook of Psychotherapeutic Treatments

Steven S. Sharfstein, MD

Published: September 15, 2010

Textbook of Psychotherapeutic Treatments

edited by Glen O. Gabbard, MD. American Psychiatric Publishing, Inc, Washington, DC, 2009, 875 pages, $99.00 (hardcover, with online access).

Glen O. Gabbard, MD, the editor of Textbook of Psychotherapeutic Treatments, is an extraordinary clinician, teacher, and leader for American psychiatry. He is the Brown Foundation Chair of Psychoanalysis and Professor of Psychiatry at Baylor College of Medicine in Houston, Texas, and is nationally and internationally known as an integrator and builder of bridges between psychoanalysis, psychotherapy, and the fields of modern scientific psychiatry, including psychopharmacology, brain science, genetics, ethics, and health economics as it applies to health policy. This welcome textbook reflects the breadth of his vision and his capacity to synthesize the old and the new in the theory and practice of psychotherapy in the context of the diversity of practice and the growing science in the field.

Dr Gabbard has recruited a superb group of section editors who cover the terrain of psychotherapy today. He has collected contributions from experts in all of the major psychotherapeutic approaches. The volume begins with a section that he edited on psychodynamic psychotherapy, which is followed by sections on cognitive-behavioral therapy, interpersonal psychotherapy, and individual supportive psychotherapy. Each of these 4 sections is presented in a consistent format, with chapters on theory, technique, indications and efficacy, and the combination of psychotherapy with medication. These first 4 sections are followed by a section on group, family, and couples therapy. The final section is about forms of psychotherapy integration and includes chapters on dialectical behavioral therapy, mentalization-based therapy, and the brain and a penultimate chapter by Dr Gabbard on professional boundaries and ethics in the practice of psychotherapy. Dr Gabbard has assembled 56 contributors, the list of which reads like a Who’s Who in American psychiatry today. They include not only prominent researchers in psychotherapy but prominent psychopharmacologists as well. The many clinical vignettes are interspersed with the latest scientific studies demonstrating the efficacy of various psychotherapies. Psychotherapy, in its variations, is "evidence-based" today.

For the clinician, the chapters on practice, techniques, and the application of each psychotherapy to specific disorders are extremely useful. In psychiatric practice today, where the mode is often combining therapy with medication and where efficacy studies have shown the most robust outcomes, this volume is unique in providing the practicing clinician with useful approaches for difficult-to-treat patients. I particularly commend the chapter by Edward S. Friedman and Michael E. Thase on the combining of cognitive-behavioral therapy with medication, in which they are able to expand the theoretical basis of cognitive-behavioral therapy with a molecular understanding of how medications will be helpful, especially in major depressive disorders and bipolar illness. These authors conclude that the combination of pharmacotherapy with cognitive-behavioral treatment is the treatment of choice for patients with bipolar illness. Similarly, the chapter by Gerald Kay on combining psychodynamic psychotherapy with medication underscores that the therapeutic alliance is critical to increasing the likelihood of medication compliance. The sections on interpersonal psychotherapy and supportive psychotherapy are excellent, giving new meaning to psychodynamic concepts of transference and therapeutic alliance as well as the therapeutic uses of empathy.

This wonderful textbook confirms that psychotherapy in its theory, practice, and research is alive and well. Psychiatric residents should especially appreciate this textbook as they learn the craft and science of psychotherapy to complement their growing skills as biological-based clinicians. As health care reform is implemented in the next period of time, one would hope that the reimbursement systems through insurance exchanges (Medicaid and others) will recognize the ability of psychotherapy alone or in combination with medications to relieve human suffering.

Steven S. Sharfstein, MD

Author affiliation: University of Maryland School of Medicine, Baltimore.

Potential conflicts of interest: None reported.

Volume: 71

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