Helen Kewell

This is a tale of two tragic errors. Or maybe three, because the author doesn't realize the second error.

The first error is a fault of the British health care system, which apparently allows only six counseling sessions for those who need help. Which leads us to the second error. Six sessions is rarely enough to accomplish anything, but if it's all that is allowed, then it is absolutely necessary that the therapist knows how to use a therapeutic system that works fast and a therapist who knows how to use it.

That's perhaps particularly true for the people covered in this work. Helen Kewell set out to work with the very old -- often, people who were so old that they needed assistance of one sort or another with living, and were having trouble adjusting. Rarely, however, did they request help; rather, they were assigned a counselor. For six sessions. With people who were old, often set in their ways, and often in shock from being widowed or moved to a care facility.

So we know what they need: They need Cognitive Behavioral Therapy. That is the most effective, and the fastest, therapeutic system we know.

Most of us know, anyway. Helen Kewell has apparently never heard of it. Despite having only taken up the profession some time in the 2010s, she refers to herself as a humanistic therapist -- "a humanistic counselor with strong existential influence" (p. 116). To be sure, humanistic psychology was a real thing -- more than half a century ago. According to a history of psychology that I have, it was used from about 1950 to 1975. Kewell also refers to Gestalt concepts. Gestalt therapy went out around 1965.

Now a really good counselor can help a willing patient even when using an ineffective treatment modality. But to use an ineffective modality on unwilling patients over a too-short period of time... nah. And we see that here; Kewell came in, started talking with the patients, prodded them sometimes but rarely made suggestions (one of the key aspects of cognitive behavioral therapy is helping people to find an actual method for dealing with a problem, by contrast to the old psychodynamic therapies where the therapist sat on his chair while frowning at the patient, who was forced to do all the work). Having done very little, Kewell perforce left them alone after a few weeks. There were a few cases where Kewell witnesses her patients experience a successful change (I'm not sure she actually helped it along), but mostly the results were pretty meagre.

It's not Kewell's fault that she didn't have enough time, and it's perhaps not her fault that she learned from teachers who should have been embalmed and put on a museum display -- but overall, I found the total irrelevance of most of what happened in this book to be alternately frustrating and disturbing.

There is also at least one instance which seems to clearly violate patient confidentiality. We don't learn "Tom's" full name, but we are told of an extremely unusual job he did during World War II, and of his wife's unusual career, and of his age and approximate date of death. I have no interest in finding out who he was, but I have no doubt that someone who is nosy and persistent could have figured it out.

There is some value in this book, in that it helps us to see that the very old are still people, with very different and individual concerns, which often are not the same as those of us who are younger. But as a guide to how to help and work with them... I truly shudder.… (más)