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Transforming the Internal World and Attachment reviews and discusses four theories about what makes psychotherapy effective across forms of treatment, treatment settings, and diagnostic categories: mindfulness, mentalization, psychological mindedness, and the attachment relationship. Geoff Goodman offers some provisional hypotheses about therapeutic effectiveness and suggests some ways of testing these hypotheses empirically, using sophisticated assessment instruments that measure psychotherapy process and outcome. Managed-care companies are withholding reimbursements for treatments not considered'empirically supported.'Instead of engaging in horse races with randomized controlled trials (RCTs), Geoff Goodman suggests that we need to establish an empirical basis for the therapeutic effectiveness of all forms of treatment, move beyond examining common factors such as the therapeutic alliance, and turn our collective attention to common factors that psychotherapy researchers often erroneously promote as specific factors. Perhaps these so-called specific factors produce therapeutic change regardless of the brand-name treatment packages through which they are typically delivered. These specific factors might also work better for particular groups of patients with specific problem areas such as affect dysregulation and impulsivity. In Volume II, Goodman demonstrates how these specific factors can be implemented in a variety of therapeutic settings with a variety of patients.

Transforming the Internal World and Attachment reviews and discusses four theories about what makes psychotherapy effective across forms of treatment, treatment settings, and diagnostic categories: mindfulness, mentalization, psychological mindedness, and the attachment relationship. Geoff Goodman offers some provisional hypotheses about therapeutic effectiveness and suggests some ways of testing these hypotheses empirically, using sophisticated assessment instruments that measure psychotherapy process and outcome. Managed-care companies are withholding reimbursements for treatments not considered'empirically supported.'Instead of engaging in horse races with randomized controlled trials (RCTs), Goodman suggests that we need to establish an empirical basis for the therapeutic effectiveness of all forms of treatment, move beyond examining common factors such as the therapeutic alliance, and turn our collective attention to common factors that psychotherapy researchers often erroneously promote as specific factors. Perhaps these so-called specific factors produce therapeutic change regardless of the brand-name treatment packages through which they are typically delivered. These specific factors might also work better for particular groups of patients with specific problem areas such as affect dysregulation and impulsivity. In Volume I, Goodman explores the empirical and clinical bases of these specific factors and outlines their various influences on psychotherapy process and outcome.

The 75 years that span the writings of Sigmund Freud and John Bowlby_two minds that have significantly shaped thinking about the processes of change in psychotherapy and psychoanalysis_have yielded dramatic changes in the ways in which we conceptualize human relationship as curative. Their different positions reflect changes in our culture, in the philosophy of science, and in contemporary views of human subjectivity. Heisenberg's uncertainty principle_the principle that the position of an electron cannot be determined because the observation of its position affects its position in an indeterminate way_has been appropriated as a metaphor for human interaction. Freud's foundational, technical recommendations, such as abstinence and neutrality, have yielded to mutuality and subjectivity within the therapist-patient dyad. Attachment theory and research have begun to specify the variety of therapist-patient interactions and the relation between the quality of these interactions and patient outcomes. The goal of this book is to contribute to our understanding of these interaction structures and their influence on therapeutic changes in the patient. Geoff Goodman invites the reader to consider the attachment relationship as an often-overlooked specific factor that nevertheless plays a key role in all therapeutic processes. Therapeutic Attachment Relationships explores the attachment relationship as an effective ingredient in all therapeutic change.