Foreword

This beautiful and immensely useful book is a great gift. It should stand as the best starting clinical text for all mental health professionals, because the ultimate success of our clinical interventions is determined directly by the information we must sensitively garner from the interview. Einstein remarked that in early sciences, examples serve better than concepts; indeed, they form the earliest concepts. Shea introduces the beginning clinician to the work by means of concrete situations and particular examples of actual clinical dialogue. There could be no sounder starting point. Later, I predict, beginning clinicians, and many experienced ones, too, will return to this book the way people return to the books that they find deepest and most evocative, reading a few pages at a time, to be savored and enjoyed, so its wisdom enters their bones.

The book starts where all interviewers start, in the dark, knowing that they must gently feel their way. This is a necessity not only because valid psychological data are extremely difficult to secure but also because our first job is to establish an effective relationship to carry on the work. In other words, Shea takes the interview with deep seriousness, which is the same as taking the relationship seriously and the importance of uncovering valid findings.

On the other hand, in a particularly refreshing light, Shea does not take himself too seriously. He draws our attention to his own mistakes, reflecting on them with a gentle humor, demonstrating directly what can be learned from them. No better model for learning could be demonstrated for the beginning, and often frightened student, allowing the student immediately to feel more at home both with himself or herself and with the author. Moreover, Shea knows that an interview and a relationship can be at cross purposes, so he doesn't want patients to feel that they are "being interviewed," but rather that they are "talking with someone." He states his goal early, "to gather the necessary clinical information efficiently while powerfully engaging the patient."

The focus is on assessment, not ongoing psychotherapy, but there is much here for all psychotherapists. For instance, throughout the book Shea emphasizes the point that a well-crafted initial interview, although it is not psychotherapy, is always therapeutic. He proceeds to demonstrate with practical illustrations, including an entire transcript of one of his own interviews, exactly how to accomplish this complex task.

With "facilics," his innovative set of principles for studying and understanding the methods by which clinicians structure interviews and manage their time, he provides a wonderfully practical method for gracefully navigating the tight time constraints of modern clinical practice. He manages to artfully wed the process of data gathering with compassionate listening. He furthers this integrative task by highlighting the many practical interviewing techniques that other authors have developed from a myriad of disciplines, including analytic, interpersonal, selfpsychological, cognitive-behavioral, and existential schools of thought. In short, this is a sophisticated, deeply informed work, the hands-on emphasis of which does not belie a profound understanding.

Too often clinical discussions have a pretentious, high theoretical cast, wheth-er of putative brain processes or unconscious ones. In our mission to help others, unlike theoretical physicists, it is not our main goal to penetrate the secrets of nature and society. Rather, in clinical care, we are more like engineers whose task is to construct the practical bridges and strong foundations that foster the healing process. We need to get from A to B, from meeting to connecting, from guessing to surmising, from sensing to feeling deeply. Shea breaks down the steps, makes the distinctions, and lets us build our own working methods from the various examples he provides. We are to practice techniques and create new ones, until a wide range of possible actions becomes second nature to us all.

This is where clinical work must begin. We could not be in better hands.

Leston Havens, M.D

Return to Book Two Index