"NLP: Dinosaur or dolphin?", NLP World 5, No 2 pp 63 - 65 (1998) (Book review)
ESCAPE FROM BABEL - Towards a Unifying Language for Psychotherapy Practice
Scott D Miller, Barry L Duncan and Mark A Hubble - Norton 1997 £22
Review by Mark McKergow
NLP is often described as to do with "modelling excellence". The original question posed by Bateson to Bandler and Grinder is reported to have been to do with the differences between excellent and average performers. Bandler and Grinder went off to model some excellent psychotherapists, and uncovered a rich collection of ideas, models and methods which not only allowed some insights into excellence in therapy, but also offered a meta-model for modelling anything.
Now, some 25 years on, a different effort is being made to understand excellence in psychotherapy. Miller, Duncan and Hubble have examined fifty years of research into the effectiveness of therapy, and attempted to get "behind the models", find out the factors behind change for the clients and establish, outside the frame of any particular model of therapy, what seems important. This is a very significant book. In this review, it will be interesting to see how the findings of these authors compare and contrast with the overall orientations of NLP.
The authors start controversially. They produce their finding that, regardless of the model or orientation of the therapist involved, clients attend an average of only a handful of sessions, and then report some improvements. (The therapists, however, have much more mixed views about success - indeed some therapists define success mainly in terms of the length of time spent in therapy by the client.) Miller, Duncan and Hubble go on to list some things they find make little difference to the client - the model of the therapist, whether the therapist is a "professional" or a "para-professional", and the level of education and training of the therapist.
Miller et al then go on to pose their main question - if this is the case, then how come "model wars" - debates about the efficacy of various therapeutic models - are still so frequent and vehement? Indeed, NLP is mentioned here in connection with an advertisment promising (like advertds for other therapies) "faster, simpler, more effective" treatment. The answer they give is that the model does make a difference - but only indirectly to the client. The model makes the most difference to the therapist! More of this later.
So, what does make a difference? Miller, Duncan and Hubble propose three overall factors - the therapeutic relationship, the client and the chance events in their experience, and hope and expectation of the client.
The Therapeutic Relationship
These authors identify that the way in which the therapist deals with the client has a large impact on the outcome. Clients who effect changes during and after therapy report that therapists take account of their motivation, their state and readiness for change, the view of the world and their own goals. They also respect and validate their client's positions. This is high on the NLP list, of course, in terms of rapport, ecology and so on.
Hope and Expectation
Miller et al rate very highly the generation of hope and expectation of change in the client. Hope can come from a future focus, by taking less time to talk about problems, and by seeking to highlight the client's feeling of personal control. Expectation can come from the fact that the procedure or model being followed should be credible to the client, and indeed the therapist. (This is how the model makes its differences to the outcome, apparently. Indeed, totally eclectic therapists, without a model of some kind, are found to be less effective than those employing a model.) The therapist should also show an interest in the results of attempts made to make changes during therapy. This is in area which is also part of the NLP canon, at least as I read it, but is not always addressed quite so overtly. In particular the effect of expectation (or, in its systemic guise, feedforward) is an interesting and under-worked area in the study of change.
The Client and their chance events
Miller et al are very clear on one particular point - that the client is the most potent source of change, not the therapist. The client doing something different is not at all the same as the therapist doing something different. Miller et al take the view that the difference between an effective and an ineffective therapist is that the effective one will validate all the change that occurs (whether or not they expected, planned or designed it), discover competences and resources that the client displays and change will be more effective if the clients think they have made a contribution to it. Therapists who cutivate long-term dependence in their clients, or erode the clients' self-efficacy, are in general found to be less effective.
The point about the client being the main source of change is interesting - particularly in view of the NLP scene's apparent working assumption that masterful and exquisite therapist skills are necessary, and must therefore be acquired and paid for. Is this an example of NLP getting too interested in an introverted and onanistic paradigm, rather than staying interested in "what works?".
To conclude, this book is an important one for the whole therapeutic community, not just for NLP. Its conclusions support NLP in many ways. There are some interesting divergences, which might be framed in a number of questions:
1. Is the NLP community interested in this report that its own models are no more or less effective than any others. Are we to respond by adjusting our sights, or are we to become as sniffy as the psychoanalysts and crystal healers about such reports? Could we attempt to produce a revised and simpler model, which would be just as effective? Are we going to continue to claim that our field is indeed more effective than others, and are we going to attempt to prove it?
2. What are the relative importance of Miller et al's simple basics of relationship, hope and client, versus the subtleties of Master Practitioners, advanced submodalities, meta-states, language patterns etc? Was Richard Bandler right when he reportedly described these as "just hypnosis"? Has the good Mr Bandler succeeded in hypnotising a generation of trainers?
3. Is the purpose of long, involved and expensive trainings to provide [a] a suitably credible qualification for the recipients and their clients, [b] vital and necessary skills, [c] a good way to while away some weekends, [d] a steady and growing income for the college of cardinals, or "Master Trainers"?
Perhaps someone would like to respond in NLP World to these questions, and the other points raised in this excellent book. "Escape from Babel" could and should be a landmark in the evolution of therapy. What will NLP become - a dinosaur or a dolphin?
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