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Letter to the Editor   |    
Review of Interpersonal Reconstructive Therapy
LORNA SMITH BENJAMIN, Ph.D., F.D.H.C.
Am J Psychiatry 2006;163:161-a-162. doi:10.1176/appi.ajp.163.1.161-a

To the Editor: The book review of Interpersonal Reconstructive Therapy: Promoting Change in Nonresponders(1) made the point that both the structural analysis of social behavior and my therapy approach—interpersonal reconstructive therapy—have some substance but are too complex to be understandable or useful. The reviewer is not alone in reaching that conclusion. However, the same sentiment about the structural analysis of social behavior was expressed more positively by Jerry Wiggins (2), who wrote that the structural analysis of social behavior "is the most detailed, clinically rich, ambitious, and conceptually demanding of all contemporary models." Of course, reviewers are free to express any opinions they wish, but if their conclusions are to be fair and if readers are to be able to determine whether they agree or not, readers deserve an accurate representation of the material.

Please consider the following two distortions of fact in the review. The first is the following:

Despite Benjamin’s efforts to use the structural analysis of social behavior for research purposes, it has proven too complicated and cumbersome and never gained widespread application. The few research studies using Benjamin’s coding system focused primarily on interactions in psychotherapy. I too have felt that the structural analysis of social behavior is an intriguing foreign language, but not terribly practical; and I never did learn the language.

There have been many publications based on the structural analysis of social behavior, and the range of topics is broad. A list of known publications is available from the University of Utah (http://www.psych.utah.edu/benjamin/sasb/index .html) by request. One published review of uses of the structural analysis of social behavior involves a series of articles that appeared in the Journal of Consulting and Clinical Psychology in December 1996. Another is a review of articles about the structural analysis of social behavior focused on psychotherapy by Constantino (3). In April 2006, the Annual Review of Clinical Psychology will include a chapter that reviews publications on the use of the structural analysis of social behavior as an assessment instrument.

A second misrepresentation is the following: "Unfortunately, Benjamin oversells her treatment. She claims it has empirical support, but this is limited to a few case studies and testimonials from former students and supervisees."

When the book was published, the limited nature of supporting data was basically as described by Dr. Wetzler (1), and his summary comes from the book. After reporting pilot data, I added, "This list of results—some of which are based on objective, symptom-oriented data gathered before and after treatment, hardly constitutes a formal clinical trial. But the data are a step above the ‘testimonial’ or isolated ‘case report’ methods of validation.…Clearly, formal clinical trials are needed next" (4, p. 343). I have maintained that interpersonal reconstructive therapy is "empirically informed," meaning that its theory and methods draw heavily on published research. These claims do not represent "overselling."

Wetzler S: Bk rev, LS Benjamin: Interpersonal Reconstructive Therapy: Promoting Change in Nonresponders. Am J Psychiatry  2005; 162:639
 
Wiggins JS: Circumplex models of interpersonal behavior in clinical psychology, in Handbook of Research Methods in Clinical Psychology. Edited by Kendall PC, Butcher JN. New York, John Wiley & Sons, 1982, pp 183-221
 
Constantino MJ: Interpersonal process in psychotherapy through the lens of the structural analysis of social behavior. Applied and Preventive Psychol: Current Scientific Perspectives  2000; 9:153–172
 
Benjamin LS: Interpersonal Reconstructive Therapy: Promoting Change in Nonresponders. New York, Guilford, 2003
 
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References

Wetzler S: Bk rev, LS Benjamin: Interpersonal Reconstructive Therapy: Promoting Change in Nonresponders. Am J Psychiatry  2005; 162:639
 
Wiggins JS: Circumplex models of interpersonal behavior in clinical psychology, in Handbook of Research Methods in Clinical Psychology. Edited by Kendall PC, Butcher JN. New York, John Wiley & Sons, 1982, pp 183-221
 
Constantino MJ: Interpersonal process in psychotherapy through the lens of the structural analysis of social behavior. Applied and Preventive Psychol: Current Scientific Perspectives  2000; 9:153–172
 
Benjamin LS: Interpersonal Reconstructive Therapy: Promoting Change in Nonresponders. New York, Guilford, 2003
 
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