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Working With Patients, by Helen A. DeRosis, is a terse, crisply written, practical guide for the beginning therapist. Using a frame of reference which highlights the phenomenological aspects of Horney theory, Dr. DeRosis discusses issues which commonly confound the “tyro therapist,” such as his assumptions or preconceptions about the patient, the parameters of treatment, the focus on the patient's pathology, the doctor-patient alliance, etc. The author also addresses herself to other specific aspects of clinical practice, such as working with a patient's parents and handling the expression of hostility toward the family. She includes an appealing chapter on the potentially therapeutic value of history taking. Although practical in its intent, the book is more than a “how to” manual, as the suggestions made by Dr. DeRosis flow from the richness of her theoretical framework and her extensive clinical experience.
Throughout Working With Patients, Dr. DeRosis demonstrates a rare sensitivity to the human needs of both patient and therapist, and places particular emphasis on the constructive resources of each. Despite the adversities which affect residents (and other novices) in psychiatry—such as lack of experience, short-term treatment situation, severely troubled patients—one genuinely has something to offer, specifically in the form of interest and acceptance. This helps a patient connect with himself, thus laying a solid foundation for growth. Rather than despairing at unfavorable circumstances, Dr. DeRosis encourages the beginning therapist to increase his or her effectiveness within existing limits; for example, in involving the patient more deeply in what he is saying while giving the history. Beneath this principle of helping the patient connect with himself runs a dialectic thread, continuing throughout the book, which suggests that the potential of a given circumstance can only be realized by a clear recognition and acceptance of the limits of that circumstance.