The Heart & Soul of Change: Delivering What Works in Therapy

by Barry L. Duncan, Scott D. Miller, Bruce E. Wampold

Updating the classic first edition of The Heart and Soul of Change, editors Duncan, Miller, Wampold, and Hubble, have created a new and enriched volume that presents the most recent research on what works in therapeutic practice, a thorough analysis of this research, and practical guidance on how a therapist can truly "deliver what works in therapy." This volume examines the common factors underlying effective psychotherapy and brings the psychotherapist and the client–therapist relationship back into focus as key determinants of psychotherapy outcome.

The second edition of The Heart and Soul of Change also demonstrates the power of systematic client feedback to improve effectiveness and efficiency and legitimize psychotherapy services to third party payers. In this way, psychotherapy is implemented one person at a time, based on that unique individual's perceptions of the progress and fit of the therapy and therapist.

Readers familiar with the first edition will encounter the same pragmatic focus but with a larger breadth of coverage—this edition adds chapters on both youth psychotherapy and substance abuse treatment. Through reading The Heart and Soul of Change, Second Edition: Delivering What Works in Therapy clinicians of varied levels of experience will improve their understanding of what is truly therapeutic in the diverse forms of psychotherapy practiced today.

Genres: Psychology, Counselling, Nonfiction, Mental Health, Professional Development, Social Work, Self Help

462 pages, Kindle Edition

First published March 31, 1999

Reviews

[Laura Wood · Rating 4 out of 5]

The ideas and research presented are solid, but the delivery is dry and tedious. I didn’t enjoy reading it and wish it were written on a more popular level since it presented important theories on the effectiveness of therapy and what makes a therapist effective.

[Selena (Fae✨inmysparetime) · Rating 5 out of 5]

Excellently researched. This is a solid body of work proving the hypothesis again and again. Some of the research, on early responders how 65% of people respond get well after the first session of therapy, blew my mind. The research on personality disorders is also fascinating. But wow this is not delivered in an interesting way. It’s academic and dry the why science can be dry. Took me ages to get through. While the book is the evidence for Irving Yalom’s gift of therapy, which is a much easier hearty read.
That said 5 stars for the solid research, captivating and original!

[Autumn · Rating 4 out of 5]

Excellent, and I can truly say that reading this book changed my practice. I began opening issues of autonomy and agency with my clients, with great discussions and new pathways in-session. This also helped me feel "unstuck" with some clients, as I began to open sessions with progress/strengths from last session, ask them where they had accessed those strengths in other areas of their lives, and what else needs to happen for them to feel like they can fly the proverbial "coop."

Adding to my wish-list. A bit regretful that I had to skim through some of the final chapters because of the due date, and hoping to use the pieces from the outcomes chapter for my agency.

Highly recommended.

[Katie · Rating 5 out of 5]

A must read for all psychotherapists. Gives great suggestions on how to connect/get on the same page with even the most challenging/difficult clients.

[Lesanddan90 · Rating 4 out of 5]

Relationship, relationship! Great book that reinforces the common factors of therapy and importance of continually checking in with the client. With all the push for EST or EBP, the authors remind us what the research proves over and over again-Relationship and Client factors are what bring about change.

[Allison · Rating 2 out of 5]

There's some good material in here, but it's nothing you won't get drilled into you by the professors in your Master's program. It's dry and mentions a ton of studies so if you like research this will be a good book to read. It really wasn't my cup of tea.

[Michelle · Rating 5 out of 5]

This is a much-needed addition to psychology, as it provides an invaluable perspective on outcome-based treatments. The authors and research shift the focus back to who therapy is all about in the first place: the client. What is therapy about, besides applying models and using techniques? Oh yah- that's right- improving someone's quality of life! The textbook is grounding while diving deeper into psychology and research. It takes a look at the bigger picture and the point of it all.

[Daniel Polansky]

I read this book.

[Dave Courtney · Rating 4 out of 5]

Accordingly a ground breaking first edition, the revamped edition has the opportunity to look back on the progress of it's ideas. Set in the general progression of the practice, the evidence seems to suggest that the arguments given towards common factors and the impact of the client-therapist relationship have had a transforming affect on the field. The book itself does get a bit repetitive by the end, but perhaps this is part of expressing the common factors throughout a complex practice. It sets the history in play, specifically in examining the realities of a medically dominated approach and research, and then contrasts this with what it believes should be a necessary move towards approaches that recognize the uniqueness of the individual persons involved in determining the best course of action and best opportunity for success.

This becomes the general contrast that motivates the ideas of an outcome oriented, evidence based practice rooted in ongoing and expansive feedback as opposed to a medical field that defines treatment based on empirically defined singular methods. The book acknowledges the complexities of the field of therapy as well as the current challenges it faces in a world still heavily anchored in a medical approach. When the common factors that a truly EBP can evaluate and recognize are incorporated in to the reality of the relationship (the single most affecting contributer to therapeutic success), it can allow therapists to become more precise, more aware and effective. As well, it can allow the client to set and control the outcomes within an atmosphere that allows them to measure mutually agreed upon directions and methods with the specialized and well informed guidance of the therapist themselves. Again, the issue is a field that is so complex (from depression to psychosis, from family, marriage, child, individual issues, from bipolar to ADHD) attempting to be filtered through singular, medical responses, which when measured against the most indepth research are proving to be less than effective in a field that is admittedly business oriented and politically charged. Swinging the emphasis on to the relationship allows the practice to be humanized and centralized on the largest contributing factor to success. And a therapist that can utilize the methods and discoveries of the medical and research field, and affectively apply it to the realm of relationship in which all research can be set against what "actually works" in that particular situation, can lead to the best means of success for the client.

[Chuck · Rating 4 out of 5]

One of the most stimulating books on therapy that I have ever read. The authors systematically demonstrate that "what works in therapy" is largely dependent upon the client and not the therapist. An estimated 70% of the change in therapy is client generated. Some tidbits in The Heart & Soul of Change: "Most reviews conclude there is little evidence to indicate differences in effectiveness among various schools of therapy;" or "most theories of therapy are in reality theories of psychopathology;" and finally: "Setting aside the intellectual appeal of diverse models of psychotherapy, the allure of quick psychotropic fixes, and the seductiveness of so-called 'treatment of choice,' the common factors research suggests that successful outcome occurs largely by (a) creating a space for clients to use their resources and (b) ensuring clients' positive experience of the alliance." Be prepared to be challenged in how you viewed therapeutic change; and excited for the possibilities of what this means for the future of counseling and therapy.

[Robert Bogue · Rating 5 out of 5]

I’ll be the first to admit that my reading list isn’t always the most mainstream. I can’t tell you how few people would find a book on effectiveness in psychotherapy interesting – but I know that it’s possible I’m in the minority here. However, I’ve been to a few counselors over the years. I’ve read more than my fair share of “self-help” books on psychology over the years and I began to become intrigued by the differences between different approaches and what different practitioners – whether authors or counselors – thought worked.

Click here to read the full review

[Bryon · Rating 4 out of 5]

The research on common factors can be frustrating and confusing, but the authors, like Frank before them, are able to show how exciting and applicable they can be. This is a great read and a welcome contrast to the manuals and articles of empirically supported treatments.

[Rhonda · Rating 3 out of 5]

Heavy read, but some good concepts on the importance of Common Factors

[Jenn · Rating 3 out of 5]

Eye opening, though very repetitive after a while. I felt like the information could have been condensed quite a bit, especially in the later chapters.

[Tamara · Rating 4 out of 5]

I loved this book. Very thought provoking on how we do therapy and learning to do what works instead of being stuck on theory. Would highly recommend to therapists, especially beginner therapists.

[Jeff · Rating 2 out of 5]

Not too bad for a professional book, but started getting repetitive and preachy in later chapters.

[Kipi (the academic stitcher) · Rating 4 out of 5]

Very good discussion of the counseling microskills.