Second-order Change in Psychotherapy: The Golden Thread That Unifies Effective Treatments

After more than 40 years of research, a substantial body of evidence has shown psychotherapy to be helpful in ameliorating psychological suffering. This is seldom questioned in professional circles, yet intense debate persists over how, when, and why therapy works. Those claiming to know the answers fall into two main camps, one arguing that some empirically supported treatments are therapeutic for specific problems, while others are less effective. The other camp posits that all approaches work equally well, as long as a strong therapist–client relationship and other common curative factors are present. Can both doctrines be correct? Second-Order Change in Psychotherapy: The Golden Thread That Unifies Effective Treatments asserts that they can, but what is needed is a unifying framework of change that underlies both positions. Drs. Fraser and Solovey identify that framework as second-order change in psychotherapy, or the “golden thread” that runs through the labyrinth of all effective therapies. To better elucidate this, first-order change refers to solutions that do not change the problem but that create stability, while second-order change transforms the first-order solutions, resulting in a resolution of the problem. In this fascinating and rich book written for researchers, practical theorists, and policy makers, the authors show how second-order change is at the core of all effective treatments and demonstrate how to creatively employ specific, targeted approaches in an interpersonal context of shared respect, empathy, and compassion.

J. Scott Fraser is a professor at Wright State University in Dayton, OH; Andrew Solovey is Associate Director of Clinical Services at Scioto Paint Valley Mental Health Center in Chillicothe, OH.