In an era in which evidence-based practice has become increasingly important to the field, How Master Therapists Work by Len Sperry and Jon Carlson is an invaluable resource for both trainees and clinicians who aspire to grow in their clinical practice. In part, motivated by the recent research interest on expertise across various fields, the authors aim to define and delineate what a “master therapist” is, how master therapists perform their work, and how one can become a master therapist. To this aim, the authors clearly achieved their objectives by providing the reader with a general profile of what constitutes a master therapist. Seminal qualitative research was used to provide the readers with 11 characteristics that represent a prototype of the ideal therapist. This was followed by a useful description of how expert therapists function when contrasted to a therapist with less mastery in the practice of psychotherapy. The authors postulate that the highly effective work completed by master therapists can be found in their enhanced therapeutic alliance with clients, high positive expectations and client motivation, increased client awareness, as well as their ability to facilitate corrective experiences in the lives of their clients. Furthermore, when coupled with the ability to clearly identify patterns and maintain treatment focus, master therapists can provide the directionality needed to change maladaptive patterns of functioning with more adaptive ones.
To exemplify and appreciate the manner in which master therapists use the stages of change in the context of therapy, the authors elaborate on three fundamental stages or orders of change. In the first stage, clients are assisted with symptom reduction, increasing functioning, and returning to a baseline level of functioning. During the second order of change, clients, along with the assistance of the therapist, are supported in changing maladaptive patterns to more adaptive ones. The authors introduce and elaborate on a myriad of potent and useful strategies aimed at effecting deep and lasting change involving corrective therapeutic experiences, exposure, and skill training used during the second order of change. The third and final order of change involves a more self-directed pattern of change. In this stage, the patients’ drive toward autonomy enable them to recognize and change maladaptive patterns without direct assistance from their therapist. As such, the clients effectively strive to become their own therapist. The impetus of the third order of change rests on clients learning how to use their heightened level of self-awareness in difficult situations to recognize similar patterns in the future and respond adaptively to them. The authors also cite the importance of effecting clinical change through the implementation of structured monitoring of treatment progress and efficacy, measuring treatment outcomes in a practical manner, as well as preparing clients for the important process of termination.
One of the most useful and novel gems of this book rests on the actual transcripts provided throughout the chapters exemplifying a master therapist’s transformational treatment of a difficult client. This approach enabled the reader to be both engaged and enthralled in the step-by-step processes of their integrated work, along with the privilege of knowing what they were thinking and doing at important junctures of treatment. More importantly, the transcripts reflected the ascending trajectory of clinical change, from the first order to the third order in their clients, and allowed the reader to appreciate the master therapist’s ability to integrate interventions in response to new problems. In summary, How Master Therapists Work is a superbly written book, whose content can be of interest to a broad range of therapists spanning from the novice graduate student to the well-seasoned clinician.
René Hernandez Cardenaché PsyD
Division of Neuropsychology
Leonard M. Miller School of Medicine
University of Miami
The author declares no conflict of interest.