Mental Help Net
Basic InformationMore InformationLatest NewsQuestions and AnswersBlog EntriesVideosLinksBook Reviews
Maximizing Effectiveness in Dynamic Psychotherapy Self-Compassion in Psychotherapy101 Healing Stories101 Things I Wish I'd Known When I Started Using HypnosisA Primer for Beginning PsychotherapyA Therapist's Guide to Understanding Common Medical ProblemsACT With LoveAlready FreeAssessment and Treatment of Childhood Problems, Second EditionBad TherapyBecoming MyselfBefore ForgivingBeing a Brain-Wise TherapistBiofeedback for the BrainBody PsychotherapyBody SenseBoundaries and Boundary Violations in PsychoanalysisBrain Change TherapyBreaking ApartBuffy the Vampire Slayer and PhilosophyBuilding on BionCare of the PsycheChoosing an Online TherapistClinical Handbook of Psychological DisordersClinical Intuition in PsychotherapyClinical Pearls of WisdomCo-Creating ChangeCompassion and Healing in Medicine and SocietyConfessions of a Former ChildConfidential RelationshipsConfidentiality and Mental HealthConfidingContemplative Psychotherapy EssentialsCouch FictionCounseling with Choice TheoryCritical Issues in PsychotherapyCrucial Choices, Crucial ChangesDecoding the Ethics CodeDepression 101Depression in ContextDo-It-Yourself Eye Movement Techniques for Emotional HealingDoing CBTDoing ItE-TherapyEncountering the Sacred in PsychotherapyEnergy Psychology InteractiveEssays on Philosophical CounselingEthics in Psychotherapy and CounselingEveryday Mind ReadingExercise-Based Interventions for Mental IllnessExistential PsychotherapyExpressing EmotionFacing Human SufferingFairbairn's Object Relations Theory in the Clinical SettingFamily TherapyFavorite Counseling and Therapy Homework AssignmentsFlourishingFlying ColorsGod & TherapyHandbook of Clinical Psychopharmacology for TherapistsHandbook of Counseling and Psychotherapy with Lesbian, Gay, and Bisexual ClientsHealing the Heart and Mind with MindfulnessHealing the Soul in the Age of the BrainHeinz KohutHow and Why Are Some Therapists Better Than Others?How People ChangeHow to Give Her Absolute PleasureHow to Go to TherapyIf Only I Had KnownIn SessionIn Therapy We TrustIn Treatment: Season 1Incorporating Spirituality in Counseling and PsychotherapyIs Long-Term Therapy Unethical?Issues in Philosophical CounselingIt’s Your HourLearning from Our MistakesLetters to a Young TherapistLogotherapy and Existential AnalysisLove's ExecutionerMan's Search for MeaningMeditations on Self-Discipline and FailureMetaphoria: Metaphor and Guided Metaphor for Psychotherapy and HealingMindfulnessMindfulness and AcceptanceMindfulness-Based Cognitive Therapy for DepressionMindworks: An Introduction to NLPMockingbird YearsMomma and the Meaning of LifeMotivational Interviewing: Preparing People For ChangeMulticulturalism and the Therapeutic ProcessOf Two MindsOn the CouchOne Nation Under TherapyOur Inner WorldOutsider Art and Art TherapyOvercoming Destructive Beliefs, Feelings, and BehaviorsPhilosophical CounselingPhilosophical MidwiferyPhilosophical PracticePhilosophy and PsychotherapyPhilosophy for Counselling and PsychotherapyPhilosophy PracticePhilosophy's Role in Counseling and PsychotherapyPlato, Not Prozac!Process-Based CBTPsychologists Defying the CrowdPsychology, Psychotherapy, Psychoanalysis, and the Politics of Human RelationshipsPsychosis in the FamilyPsychotherapyPsychotherapyPsychotherapy As PraxisPsychotherapy East and WestPsychotherapy for Children and AdolescentsPsychotherapy for Personality DisordersRational Emotive Behavior TherapyRational Emotive Behavior TherapyRationality and the Pursuit of HappinessRecovery OptionsRent Two Films and Let's Talk in the MorningSaving the Modern SoulSecond-order Change in PsychotherapySelf MattersSelf-Compassion in PsychotherapySelf-Determination Theory in the ClinicSexual Orientation and Psychodynamic PsychotherapyStrangers to OurselvesTaking America Off DrugsTales of PsychotherapyThe Art of HypnosisThe Case Formulation Approach to Cognitive-Behavior TherapyThe Compassionate ConnectionThe Crucible of ExperienceThe Education of Mrs. BemisThe Fall Of An IconThe Gift of TherapyThe Great Psychotherapy Debate: The Evidence for What Makes Psychotherapy Work The Husbands and Wives ClubThe Love CureThe Making of a TherapistThe Mummy at the Dining Room TableThe Neuroscience of PsychotherapyThe Neuroscience of Psychotherapy: Healing the Social BrainThe New PsychoanalysisThe Philosopher's Autobiography The Portable CoachThe Portable Ethicist for Mental Health Professionals The Present Moment in Psychotherapy and Everyday LifeThe Problem with Cognitive Behavioural TherapyThe Psychodynamics of Gender and Gender RoleThe Psychotherapy Documentation PrimerThe Real World Guide to Psychotherapy PracticeThe Schopenhauer CureThe Talking CureThe Therapeutic "Aha!"The Therapist's Guide to Psychopharmacology, Revised EditionThe Therapist's Ultimate Solution BookThe UnsayableThe Wing of MadnessTheory and Practice of Brief TherapyTherapyTheraScribe 4.0Thinking about ThinkingThriveToward a Psychology of AwakeningTracking Mental Health OutcomesTreating Attachment DisordersWhat the Buddha FeltWhat Works for Whom? Second EditionWhy Psychoanalysis?Yoga Therapy
Therapist Search
Find a Therapist:
 (USA/CAN only)

Use our Advanced Search to locate a therapist outside of North America.

Related Topics

Psychological Testing
Mental Disorders
Mental Health Professions
Treatments & Interventions

by J. Scott Fraser and Andrew D. Solovey
American Psychological Association, 2007
Review by Rosemary Cook on Oct 14th 2008

Second-order Change in Psychotherapy

Research has determined that psychotherapy does indeed work. The question at hand now is "How does it work?" The authors of this book submit that the answer to this question has ramifications for all those involved in the practice of psychotherapy including professors, students, policy makers, insurance providers, and practitioners of all sorts.  To answer the question the authors set out to provide a theoretical framework that cuts across all of the therapeutic approaches that have been empirically shown to be effective. 

In the past, those claiming to answer the question of how psychotherapy works have polarized into two opposing groups.  These are referred to as the "best practice" group and the "common factors" group.  The best practice group argues for specific therapy protocols for specific therapy populations, whereas the common factors group maintains that a positive client-therapist relationship, among other factors, is most significant in issuing forth positive change in therapy.  Since each side presents a compelling argument the authors were (themselves) compelled to find a unifying factor that each side might share.

In Greek mythology, the golden thread helped the warrior Thesus safely find his way to the center of a labyrinth and back.  The tread traced his pathway through seemingly endless disorienting corridors in which his movement was (at times) contrary to intuition.  Today there are a large and growing number of different, purportedly effective psychotherapies.  However, their differences in approach and suggested mechanisms for change appear to contradict each other, creating a modern-day labyrinth for all those interested.  What makes these treatments effective? What do they have in common? What pathways do they share, and what thread, if any, connects them?  Those encountering this dilemma cry out for a modern golden thread to find their way (pp. 8-9). 

The authors contend that "second-order change" is that golden thread.  They submit that the unifying perspective on "change" unites all effective psychotherapy.  "First order change is defined as a class of resolutions that do not change a problem or make a problem worse.  In Contrast, second-order change is a change of those first-order resolutions, which results in a resolution of the problem" (p. 15).   First-order change is related to stability, while second-order change is related to transformation. 

Clearly, there is more to these brief definitions, and the authors do a fine job at preparing a presentation that could have gone way beyond the scope of this book.  But, Frazer and Solovey draw upon their extensive clinical and theoretical backgrounds to offer this unifying theory.   And by keeping the subject concise they make their point clear, understandable, and practical. 

Each clinical chapter follows a format where the authors formally define a problem to be addressed, and then analyze the "best practice" recommended for the clinical scenario, including a synopsis of the practical goals, steps, and research supporting it.   Then, they examine the situation showing how second-order change operates as an underlying pathway to improvement in that therapeutic setting.  In this way, case examples and comparisons with current therapeutic approaches place "second order" change in a practical light.  Beyond this, the text offers recommendations for making the second-order shift in both practice and policy.

While dealing with a fairly high-minded meta-analysis of psychotherapy, the authors have managed to keep this text at a very readable level (i.e., college level).  Professors and researchers of clinical psychotherapy might benefit from reading this book.  It would make a worthy addition to any graduate level clinical course.  Given the unifying principle of second-order change, students might refrain from getting caught-up in the undue process of determining a best-practice approach to therapy, and thusly focus their attention on the process of change that is so essential to effective psychotherapeutic treatment.  However, it is this reviewer's opinion that reading this book would benefit researchers, practitioners, and students alike.  I will read it again, and I will probably refer to it often.  

© 2008 Rosemary Cook

Rosemary Cook is a Psychotherapist in private practice living on Long Island, NY. 

Follow us on Twitter!

Find us on Facebook!

This website is certified by Health On the Net Foundation. Click to verify.This site complies with the HONcode standard for trustworthy health information:
verify here.

Powered by CenterSite.Net