Whether you’re fairly new to therapy or you’ve practised for many years, no doubt at times you’ve found yourself stumped with certain clients who leave you feeling perplexed and discouraged with that ‘I just don’t know what to do next’ feeling. George Gafner has been there and that’s precisely why he wrote this book. The reality is that today’s cookie-cutter treatment mentality presupposes that all people with, say, depression, can be treated essentially the same way, which virtually ignores the established fact that a good deal of a person’s mental functioning is governed not by conscious choice but instead by automatic, or unconscious, forces that lie outside voluntary control.

The author believes that all therapeutic approaches should be adapted to the unique needs of the individual client, and that the unconscious needs to be heavily considered in any therapy approach. Centred around two fascinating case studies, Gafner discusses concepts and techniques seldom addressed, including the therapist’s use of voice, subtle vocal shifts, the pause, the strategic interval of silence and seeding as well as the application of hypnotic techniques within standard talk therapy. He makes the case for integrating ego-strengthening in therapy, advocates ego-strengthening as a ‘shovel-ready project’ and incorporates the use of healing metaphors in therapy. As a strong supporter of evidence-based treatments, he believes that in much of real world mental health treatment we can’t simply follow a manual. We must adapt treatment to the unique needs of the individual, and the more skills and tools we can bring to bear, the better for both us and our clients.