A glaring deficit in clinical psychology today is the lack of a clear bridge between personology (the study of personality) and the application and administration of clinical technique.  The field is dominated by psychodynamic/humanistic conceptualizations of personality whose assessment instruments have little clear connection to the day-to-day practice of psychotherapy.  Tools used in the clinic are rarely the one's valued in the experimental laboratory and, to my knowledge, the influence of assessment measures on clinical technique is minimal. 

That said, research in the field of therapy has been clear in the importance of the formation of relationship between client and therapist, and the importance of client-therapist matching. Therapy is not a "one-size-fits-all" proposition and the importance of tailoring techniques and approaches to the personality of the client is becoming more and more recognized.  Of course, how to best accomplish this feat is under-researched and not well understood.

The book Personality and Psychotherapy: Treating the Whole Person by Jeffery Singer is a broad attempt to address this problem and offer a framework to help therapy clients based on currently valued techniques of personality assessment.  The work represents a bold and ambitious model deserving of serious consideration and contemplation as it pertains to how to best conceptualize and help clinical clients. 

The model presented in this book is a modification of work by Dan McAdams and Robert Emmons who, in the mid-1990s, proposed a three tiered conceptualization of clients.  Their model, suggested that a client be evaluated in terms of their "traits" (or dimensions of individual differences), "Characteristic adaptations" (how does a client function across different situations and what might they trying to accomplish given different situations) and "narrative meaning making" or how a client finds meaning and importance in their life.  McAdams and Emmons argue that knowledge attained through the survey of these three areas would be important in effectively understanding clients and knowing how to effectively help them.

The book takes the model put forth by Adams and Emmons and adds another element "relational dynamics" or the role and participation of others in the constructions of our life stories, traits and adaptations.  The addition recognizes the importance of the interpersonal in our identity and resultant relational effects on behavior.

The book introduces this model, and suggests a practical way to implement it, including a detailed case example of a subject who is brought through all four stages of data gathering and analysis . Singer's book advocates and centers around the use of the NEO-PI, a staple in currently valued methods in personology and trait psychology.  Detailed descriptions of the NEO-PI are given as an assistance to those who might be unfamiliar with the instrument or the "big-five" theory that underlies the NEO. The illustrative case that is put forth nicely fleshes out his ideas with a practical illustration of client interpretation using the instrument, as well as others that are used in this proposed model.

While the ideas presented in this book is a well-needed plug in the chasm separating theory and practice in personology and clinical psychology, the ideas seem somewhat cumbersome and very difficult to implement.  I believe that the daunting nature of the task is perhaps an illusion brought on by my own clinical unfamiliarity with personality measures other than the standards used in clinical practice (e.g. MMPI-2, PAI, Millon or projective measures).  However, I also am left to wonder about the utility of this multi-faceted model given the often triage-like atmosphere in clinics and private practices.  The model put forth here represents a multi-layered assessment procedure that would seem to be both time and resource consuming.  Clear studies in utility and efficacy would need to be demonstrated before I can imagine this model being given consideration for wide use and implementation.  This book is a bold first step towards this reality, and a fascinating glimpse into how practice can be improved through the work done in the psychology laboratory.  Given psychology's "physics-envy" and perennial striving to be respected as a "science", this is one very important step.

© 2007 Michael Sakuma

Michael J. Sakuma, Ph.D. , Psychology Department, Dowling

Categories: Psychotherapy