How to Practice Brief Psychodynamic Psychotherapy: The Core Conflictual Relationship Theme Method

How to Practice Brief Psychodynamic Psychotherapy: The Core Conflictual Relationship Theme Method is a clinically based and clinically illustrated manual that walks the reader through the development of the Core Conflictual Relationship Theme (CCRT) focus that is necessary to practice this specific form of brief psychodynamic psychotherapy (BPP). The CCRT Method is a research-supported, easily operationalized, valid, and reliable form of conducting a strongly interactive form of brief therapy.

The CCRT method offers symptom relief and limited but significant character change in a 16-session format that focuses on and helps the client work through one crucial, circumscribed area of maladaptive personality style. Small changes in this one behavioral theme, or dimension, have been seen to be associated with larger more pervasive shifts in functioning. After presenting general background about the BPPs and specific discussion of the CCRT rationale and process, author Howard E. Book offers the reader a unique analysis of CCRT therapy in action. In an extended clinical vignette, the reader may follow therapist and client in a step-by-step manner, from initial session; to therapist formation, articulation, and presentation of the CCRT; through the tripartite 16-session course of therapy itself; and finally to termination and follow-up.

Foreword
Lester Luborsky, PhD

Preface

Acknowledgments

About This Book

1. Introduction to the Brief Psychodynamic Psychotherapies and the CCRT Method

I. Developing the Core Conflictual Relationship Theme

2. Identifying the CCRT Focus
3. Making the Unspoken Components of the CCRT Explicit
4. The Goal of BPP: Actualizing the Wish
5. How to Present the CCRT to the Patient
6. The Three Phases of Treatment

II. Practicing the CCRT Method of Brief Psychodynamic Psychotherapy: A Case Study

Introduction

7. Assessment Process: Capturing Relationship Episodes While Taking a History and Carrying Out a Mental Status Examination
8. Socialization Interview
9. Phase I (Sessions 1 to 4): Demonstrating the Ubiquity of the CCRT
10. Phase II (Sessions 5 to 12): Identifying and Working Through the RO
11. Phase III (Sessions 13 to 16): Termination
12. Epilogue

References

Index

About the Author

Howard E. Book, MD, Dpsych, FRCPC, is Coordinator of Brief Psychotherapy Training for psychiatry residents at the Clarke Institute of Psychiatry in Toronto; Director of the Post-Graduate Training Program in Brief Psychodynamic Psychotherapy, also at the Clarke Institute; and founding Executive Director of the Brief Psychotherapy Centre for Women associated with Women's College Hospital. He holds the rank of Associate Professor in the Departments of Psychiatry and Health Administration, Faculty of Medicine, University of Toronto. He has a private practice in brief and long-term psychotherapy as well as in psychotherapy supervision.

This book is an interesting manual for how to conduct brief psychodynamic psychotherapy along the lines proposed by Lester Lubrosky…It is impressive to me how Book has been able to rely on the whole tradition of the psychoanalysis in order to illustrate a technique that is substantially at odds with Freud's own technical recommendation and practice. One hopes that in the spirit of scientific tolerance, the approach that Book illustrates in this manual will seem welcome to practitioners of a variety of different schools of thought.
—The American Journal of Psychiatry, 156:2, February 1999

[How to Practice Brief Psychodynamic Psychotherapy] is well-written, logically organized, and a quick read…There are many aspects of this book to recommend. It provides a good introduction to the CCRT method and places it in the context of other forms of BPP. The use of a transcript makes it a manual that offers the reader a model for practicing this technique. Also helpful is the delineation of regressive from progressive wishes, the question and answer sessions at the end of chapters, and the addition of fictitious scenarios to demonstrate potential complications in the course of treatment…Overall, I highly recommend this book to therapists who already have a grounding in the principles of BPP and are looking to add the CCRT to their armamentarium.
—Daniel Weintraub, MD, Director of Landis Geriatric Center, Norton Hospital; Professor, University of Louisville

Audience: Therapists seeking an effective brief therapy; practitioners of long-term psychodynamic psychotherapy interested in practicing brief therapy…A comprehensive, user-friendly, detailed, clinical exposition of the Core Conflictual Relationship Theme method in brief psychodynamic therapy. Extremely useful for GPPS…In today's climate of intensifying accountability, not only must the patient accommodate to the limitations (and advantages) of brief therapy but so must the therapist; therefore psychotherapists of every stripe are well-advised to seek out Howard Book's book on the CCRT method and read it. It will greatly enhance your skills in brief psychotherapy.
—Psychotherapist, May 1998

Dr. Book is psychoanalytically oriented. Seeing the increasing demands for psychotherapy from clients and for cost containment from third-party payers, he turned to investigating the brief psychodynamic psychotherapies and adopted the well-known time-limited approach developed by Lubrosky, identified as "The Core Conflictual Relationship Theme Method," that seems to bring not only symptom relief but some significant characterological change as well. This work by Book serves as a fine introduction to this mode of doing brief psychotherapy, as Lubrosky himself recognizes in the Foreword…His dedication and skill as a teacher are evident in his structuring of this book, which he correctly describes as "a user-friendly, readable, clinically focused" presentation of this method.
—American Journal of Psychotherapy, Vol. 53, No. 2, Spring 1999

This carefully written book provides an excellent introduction to the Core Conflictual Relationship Theme (CCRT) Method of brief psychodynamic psychotherapy (BPP) originally developed by Lester Lubrosky…I would highly recommend it as an introductory text…It should be mandatory reading for every resident and, indeed, might be of interest to most clinicians…In short, this fine book exemplifies the development of a psychotherapy manual in that basic principles are clearly identified and their application described and illustrated. Moreover, a wealth of clinicians' wisdom is transmitted through the case examples…It is a pleasure to find a book that takes the concepts of time and termination seriously and turns into therapeutic virtue.
—The Canadian Journal of Psychiatry, April 2000

This slim volume should be read by every professional who practices psychotherapy…One feels as if in the presence of a wise and skilled psychiatrist…Dr. Book treats us to his own running commentary to the transcription, in an engrossing discussion of the technical hows and whys. It is hard to put this excellent book down…Dr. Book does a masterful job of meeting the objectives of his work and certainly demonstrates his own skill in the process. Useful references are also supplied. Even though he sets out to provide a manual on brief psychodynamic psychotherapy, he succeeds more broadly in emphasizing skills needed for psychotherapy of any duration.
—Psychiatric Services, August 1999, Vol. 50