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Book Review: Concise Guide to Marital and Family Therapy   |    
The Crowded Bed: An Effective Framework for Doing Couple Therapy • 101 More Interventions in Family Therapy
William Vogel, Ph.D.
Psychiatric Services 1999; doi:
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by Leslie B. Kadis, M.D., and Ruth McClendon, M.S.W.; Washington, D.C., American Psychiatric Press, 1998, 245 pages, $21.95 • by Toby Bobes, Ph.D., and Barbara Rothman, Ph.D.; New York City, W. W. Norton, 1998, 203 pages, $27 • edited by Thorana S. Nelson, Ph.D., and Terry S. Trepper, Ph.D.; Binghamton, New York, Haworth Press, 1998, 511 pages, $69.95 hardcover, $39.95 softcover

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The first of these three books is part of the American Psychiatric Press' Concise Guides series, meant "to complement the more detailed information to be found in lengthier psychiatry texts." The authors of this particular guide are Leslie B. Kadis, a psychiatrist and family therapist, and Ruth McClendon, a social worker and marital family therapist.

The introduction states that the book is "invaluable reading for psychiatry residents, psychologists, social workers, and marital and family therapists." In fact, in attempting to cover every aspect of the field in just 245 pages, the authors' coverage of any particular topic is too cursory to be of clinical use. Consequently, the book would not be particularly helpful to anyone who is familiar with the field; it would be of most use to persons who are unfamiliar with the field, and who wish a brief, nontechnical introduction to it.

No topic receives more than several pages. Thus "marital and sex therapy" is covered in seven pages, "gay and lesbian issues" in six pages, "children and adolescents in family therapy" in seven pages, and "families with substance abuse" in four pages. Each of these topics receives one case example. All of the myriad techniques available to the field are covered in 45 pages. The theoretical material receives no more extensive coverage than the clinical matter; the review of all of the many theoretical approaches to the field, taken together, is covered in fewer than 20 pages.

The book may be regarded as appropriate reading for those with no prior knowledge of the field who wish a once-over-lightly introduction to it.

The authors of The Crowded Bed, Dr. Bobes and Dr. Rothman, are licensed marriage, family, and child therapists with therapy and consultation practices. Their book, based on the 25 years of experience each has in the field of family and couples therapy, is offered "as a practical guide for students and therapists working in today's complex health-care arena." The authors also expect "that clinicians will find it a useful refresher." Their book proposes to demonstrate that, living as we do in the world of managed care, "briefer therapy and good therapy are indeed compatible."

The first of the book's three parts presents the authors' theoretical position, which synthesizes systems theory, Bowen theory, object relations theory, and postmodern constructivism and blends them into their "developmental family life cycle paradigm." In regard to technique, they proceed to present a highly structured, programmatic, ten-session therapy format that may, in practice, involve more than ten sessions.

Part 2 is a case study ("Laura and Michael") in which the authors apply their theoretical and methodological model. In part 3 they describe the use of their treatment format with various populations or situations such as mixed marriage; blended marriage; couples facing aging, illness, and death; sexually distressed couples; couples experiencing domestic violence; and lesbian and gay couples.

The Crowded Bed is well written and thought provoking; it is very clearly a "good read." My major problem with it is that while it is one of the better books of this genre, our field has been inundated with books in which experienced, capable therapists present models based on their clinical experience, without providing reason or evidence as to why we should regard their model as superior to any of the scores of others presented in similar books. Any clinician attempting to sort these books out would have time for nothing else, given that virtually none of them provide any evidential or logical basis to choose one model over the other.

A lesser problem, but still a problem, is that the authors present their book as a "brief therapy" model, but in the case example the couple and the therapist have 20 agreed-on sessions—hardly brief therapy by most definitions.

Given these considerations, I cannot recommend a high priority for this book.

101 More Interventions in Family Therapy is a collection of 101 articles offering innovative techniques for a wide variety of clinical problems. Each of the articles follows the same format: a brief paper, generally between three and six pages, starts by presenting a highly specific problem situation in family or couples therapy, followed by a description of an innovative intervention, followed (usually) by a case study, and then a discussion of the situations in which the technique would be most useful and when it would be contraindicated.

This is the editors' second volume of this type; the first, logically enough, was 101 Interventions in Family Therapy. Dr. Nelson is director of the marriage and family therapy program at Utah State University, and Dr. Trepper is director of the Family Studies Center and professor of marriage and family therapy at Purdue University Calumet.

The editors' conception, which is an excellent one, falls short in its execution. As might be expected in a book consisting of 101 articles by different authors, the quality of the work is quite uneven, ranging, in composition and scholarly merit, from ordinary to very well written and intellectually provocative. A more serious problem, I feel, is that the book seems to consist of 101 articles in search of a common theme.

The articles range across the clinical spectrum, and the book's structure provides no organizing principle. Following each other in random sequence are articles dealing with families, couples, individuals, adolescents, adults, children, women's issues, blended families, divorce, marriage, remarriage, physical abuse, clinical training, and community service intervention. The titles of the articles are more often eye catching than indicative of content.

The last nine pages of the book do provide a combined "topical index" for the two volumes, but it reflects the lack of structural organization of the work. The index lists 55 different topics, but 15 of the topics include only one article, while three of the topics—children and adolescents, couples, and family of origin—encompass a third of the articles in the two volumes.

Given the rich diet of books currently available in the field of marriage and family therapy, I cannot honestly say that I would accord this work a high priority.

Dr. Vogel is associate professor of psychiatry at the University of Massachusetts Medical School in Worcester.




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