Zindel V. Segal

Jeremy Safran

Cognitive therapy, with its clear-cut measurable techniques, has been a welcome innovation in recent years. However, the very specificity that lends itself so well to research and training has minimized the role of the therapeutic relationship, making it difficult for therapists to respond flexibly to different clinical situations. What is needed is an approach that focuses on the underlying mechanisms of therapeutic change, not just on interventions. In this practical and original book, two highly respected clinician-researchers integrate findings from cognitive psychology, infant developmental research, emotion theory, and relational therapy to show how change takes place in the interpersonal context of the therapeutic relationship and involves experiencing the self in new ways, not just altering behavior or cognitions. Making use of extensive clinical transcripts accompanied by moment-to-moment analyses of the change process, the authors illustrate the subtle interaction of cognitive and interpersonal factors. They show how therapy unfolds at three different levels—in fluctuations in the patient's world, in the therapeutic relationship, and in the therapist's inner experience—and provide clear guidelines for when to focus on a particular level. The result is a superb integration of cognitive and interpersonal approaches that will have a major impact on theory and practice. A Jason Aronson Book

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