By: Rubin Battino, M.S.
Crown House Publishing, Wales, Copyright 2006
Reviewed by: Judith E. Pearson, Ph.D.
Can change occur in a single session of therapy? Rubin Battino says, yes, it can, if both the therapist and client expect it. That's why Battino always conducts every therapy session "as if each session is the last one" in which he will see the client. In his latest book, Expectation, he writes that the crucial ingredient in the success of brief therapy is the expectation on the part of both the therapist and the client that rapid, meaningful change is possible and will occur, even in just one session.
Battino writes that brief therapy offers a departure from the medical model of psychotherapy. The medical model is ill fitted to psychotherapy because there is no direct correspondence between diagnosis and treatment. People who seek help from psychotherapists are not diseased; they are troubled and present concerns that can often be remedied without months or years of analysis or soul-searching. Battino advocates replacing the medical model with a contextual model in which the efficacy of treatment procedures is based on the meaning attributed to those procedures
Battino draws from Moshe Tolman's 1990 book, Single Session Therapy-a synopsis of a groundbreaking study of a California mental health organization in which the majority of psychotherapy patients reported benefit from a single session. Battino also cites the work of others, all of whom believe that people can solve their problems, when therapists offer client-centered rapport, a focus on the client's outcome, and a recognition of the clients unique personality traits, circumstances, strengths, and capabilities.
Hope imparts curative powers and gives people the strength to endure and overcome adversity. Battino reminds us "Hope and expectation are inextricably connected." We are all familiar with the placebo effect. In the same way, the expectation of change becomes a fulfilling prophecy. It is the game of "as if" that often makes imagined possibilities into real results.
Reframing can facilitate expectations as well, by changing the meaning of events and symptoms. Reframing helps people to interpret reality in new ways and grasp new possibilities.
Battino devotes a chapter to the value of rapport in creating a "therapeutic alliance" with the client. He gives an excellent summary of hypnotic language patterns ("the precise use of vague language") in brief therapy. Ericksonian hypnotherapists will enjoy his chapter on this subject, especially Battino's discussion of confusion techniques, metaphor, and "expectation language" (suggestions, implications and presuppositions phrased to enlist the client's cooperation and/or advance the client toward the outcome). Battino posits that all types of therapy involve trance-work in one way or another.
A Compendium of Brief Therapy Approaches
The remaining two-thirds of Expectation is a compendium of brief therapy approaches suitable for a single session. The common element of all is that both the client and the practitioner maintain the expectation of a positive result. Battino describes a dozen types of brief therapy and often presents several methods or variations within each type. Here is a sampling:
1. Jay Haley's Ordeal Therapy: The client is assigned an ordeal; the expectation being that the client will learn something worthwhile from the experience and, with that knowledge or skill, solve his problem. A well-designed ordeal must be a) more severe than the problem, b) related to the symptom, c) a healthy or beneficial behavior, d) within the client's range of capability, e) safe, and f) linked to the occurrence of the symptom.
2. Ambiguous Function Assignments: The client agrees to carry out a task, with the understanding that doing so will create new thinking and lead to new behaviors. Examples are to carry an object, climb a mountain, take a walk in the woods, read a particular book or poem, visit a museum, write a letter, etc. The assignment evokes the client's curiosity, and causes her to take some action in regard to the problem at hand.
3. Rituals and Ceremonies: The client and therapist design a ritual or ceremony to signify an end to a problem, the beginning of a change, or the celebration of an accomplishment. The ritual or ceremony attaches meaning and significance to the client's progress.
4. The Miracle Question: The client is invited to describe how his life is different, after "a miracle has occurred" and the problem is solved. This method is a hallmark of "solution-oriented" therapy.
Other approaches include Erickson's Utilization approach, Burn's Nature-Guided Therapy, Metaphor, Rossi's Rapid Methods of ideomotor signaling, Neuro-Linguistic Programming, Narrative Therapy, and Derks' Social Panorama.
The Author
Rubin Battino is an adjunct professor at Wright State University in the Department of Human Services and President of the Milton H. Erickson Society of Dayton, Ohio. He has a private practice and serves as a facilitator of The Charlie Brown Exceptional Patient Support Group at Dayton.
Conclusion
Battino expresses what many practitioners have suspected for a long time. It isn't our methods or disciplines that matter; it's the relationship we maintain with clients, our confidence in what we do, and our faith in our clients---these are what truly matter in counseling and psychotherapy.
This book is such a handy reference tool, and it should be on the desk of every brief therapy practitioner. Battino continues to inspire and teach with candor, elegant simplicity, and an obvious passion for his subject matter. Expectation is a welcome addition to Battino's previous books on guided imagery, healing metaphor, and Ericksonian hypnotherapy. Once more, thank you, Rubin, for sharing with your readers how you do your work!
Expectation can be purchased at www.chpus.com (in the U.S.) or from www.crownhouse.co.uk in the U.K.
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Judith E. Pearson, Ph.D. is a licensed counselor and psychotherapist with a private practice in Springfield, Virginia where she specializes in Hypnotherapy and Neuro-Linguistic Programming. She is Executive Director of the National Board of Certified Clinical Hypnotherapists and a trainer with the American Hypnosis Training Academy. She is also a free-lance writer and speaker. Her web site is www.engagethepower.com.
