Brief but Comprehensive Psychotherapy: The Multimodal Way

Who Is the Briefest of Them All? Brief but Comprehensive Psychotherapy: The Multimodal Way Arnold A. Lazarus. New York: Springer Publishing Company, 1997, 177 pp., $35.95 (hardcover) In Brief but Comprehensive Psychotherapy: The Multimodal Way, Lazarus provides a comprehensive but brief overview of his influential multimodal approach with a particular focus on ways to "cut to the chase" in psychotherapy. Cutting to the chase is not a new idea for Lazarus for, as he writes, "The multimodal approach has always been relatively brief, but in the present era of managed health care, the need for even greater brevity has become a necessity" (1997, p. 124). Although much of the material assembled in this book has appeared previously in numerous articles, book chapters, and in The Practice of Multimodal Therapy: Systematic. Comprehensive and Effective Psychotherapy (1981, reprinted in 1989), this is Lazarus' s first attempt to provide an updated, book-length overview of his approach since the publication of the 1981 volume. In addition to an overview of the multimodal approach, including a discussion of newer techniques and ideas not included in the 1981 book (e.g., bridging and tracking), this book also includes a number of new case studies. Also included are appendices containing an updated version of Lazarus' useful clinical selfreport tool, the Multimodal Life History Inventory, as well as the Structural Profile Inventory, the Expanded Structural Profile, the Marital Satisfaction Questionnaire (Revised), and a copy of a Lazarus article on eclecticism and psychotherapy integration (Lazarus, 1995). Lazarus is perhaps best known for his approach to problem assessment in psychotherapy. He has argued that the conventional cognitive-behavioral approach to assessment, which focuses on affects, behaviors, and cognitions (the "ABC" model) should be broadened to include attention to bodily sensations, imagery, interpersonal relationships, and the biological dimension. The catchy acronym, BASIC-ID (for Behaviors, Affects, Sensations, Imagery, Cognition, Interpersonal, and the biological dimension or "Drugs"), summarizes Lazarus's assessment model. The BASIC-ID assessment framework is widely known and is presented in many popular counseling and psychotherapy textbooks (e.g., Cormier & Cormier, 1991). By increasing our attention to such crucial factors as the interpersonal and biological dimensions of human functioning, Lazarus has done cognitive-behavioral therapy a great service. Lazarus (chapter 1) provides an introduction to and a succinct rationale for the BASIC-ID assessment model. This chapter also includes a list of eight issues that should be addressed if therapy is to be both short term and comprehensive (p. 9) and has a useful list of 12 questions that should be addressed in the initial interview (p. 10). Chapters 2 through 5 discuss the theoretical basis and history of Lazarus's multimodal approach. A case study in chapter 3 illustrates the application of the BASIC-ID in a multimodal problem assessment process. A very brief theoretical basis for the multimodal approach is provided, and other topics, such as technical eclecticism, are discussed. Two short chapters, 5 and 6, are devoted to the finer points of multimodal problem assessment. In chapter 5, Lazarus describes two multimodal techniques, bridging and tracking, which awe during assessment as well as treatment. Bridging refers to the process of gently guiding the client from a discussion in a comfortable modality (for example, the cognitive modality) to a modality in which the client feels less comfortable (for example, the affective modality). Tracking refers to the assessment of the client's tendency to go through a predictable sequence of modalities in problematic situations. Lazarus states that most clients appear to have a typical "firing order" so that, for example, in one client with panic attacks, a typical attack might begin in the imagery modality (e. …