Brief Dynamic Interpersonal Therapy:  A Clinician's Guide, by Alessandra Lemma, Mary Target, and Peter Fonagy, Oxford, UK:  Oxford University Press, 2011,  256 pages (paper-bound), $39.95. ISBN 978-0-19-960245-2

The use of treatment manuals was expected to incite a “small revolution” in psychotherapy training and research (Luborsky & De Rubeis, 1984). Over 30 years of use has shown that expectations about their impact were overblown (Strupp & Anderson, 1997; Rønnestad & Ladany, 2006). The delivery of manualized treatments was going to be highly standardized, like medications in a drug trial. Indeed, treatment manuals were first created for use in randomized controlled trials for psychotherapies. But we have learned that psychotherapy training is a tricky business, involving a complex interplay of many factors (e.g., Rønnestad & Ladany, 2006). The specific guidelines and illustrative transcripts provided by treatment manuals are an improvement over the highly abstract discussions and overly condensed clinical illustrations characteristic of older psychotherapy texts. Manuals have played an important role in psychotherapy training by improving the quality of declarative knowledge acquired by trainees. Other components of training, however, determine how successfully declarative knowledge is transformed into the type of procedural knowledge required to competently conduct therapy.

Treatment manuals vary in the specificity of their guidelines and technical prescriptions across orientations (e.g., cognitive/behavioral manuals generally having more specific technical prescriptions than psychodynamic manuals) as well as within orientations. The early psychodynamic manuals were considered applicable to a wide range of problems and disorders and offered more general guidelines than prescriptions (e.g., Luborsky, 1984; Strupp & Binder, 1984). Requirements for federal funding of treatment research have resulted in the latest psychodynamic manuals being written for specific DSM-defined disorders (e.g., Milrod, Leon, Busch, Rudden, Schwalberg, Clarkin, et al., 2007). Ironically, although treatment manuals have become more DSM disorder-focused with techniques that target specific problems