Some will wonder why this book, with its specific focus on the pro- cess
of change in psychotherapy, was chosen for inclusion in "Crit- ical
Issues in Psychiatry: A Series for Residents and Clinicians" as our
books are generally devoted to a broad topical survey of some im-
portant clinical area in the practice of psychiatry or a related mental
health discipline. The answer will become rapidly apparent to the
reader, for Dr. Horowitz has developed an exciting, creative, and
practical method whereby any psychotherapist can understand, monitor,
conceptualize, and evaluate the process of change in psychotherapy. His
method of "configurational analysis" utilizes direct clinical
observations of emotional states, role relationships, and information
processing to systematically, in a step-by-step fashion, organize and
describe clinical data. It can be employed at any point in the
therapeutic transaction, from the time of initial presentation to the
time of termina- tion or follow-up. This method of organizing
information about a person, his problems and resources, and the nature
of the psychotherapeutic transaction provides the therapist with a
powerful tool with which to both understand and communicate how and why
change occurs, or does not occur, in psychotherapy. It can be applied
all the way from the description of large-scale patterns to the
microanalytic dissection and understanding of a small segment of a
therapy session.