BOOK REVIEW How and Why People Change: Foundations of Psychological Therapy Ian M. Evans, Oxford University Press, 2013, ISBN 9780199917273 Reviewed by Kylie Bailey and Nick Higginbotham, Centre for Clinical Epidemiology & Biostatistics, School of Medicine & Public Health, The University of Newcastle, NSW, Australia The University of Hawai’i clinical studies program in the 1970s was a hotbed for learning theory applications to clin- ical problems, with the likes of Leonard Ullmann, Roland Tharp and Arthur Staats. But newly arrived from Hans Eysenck’s laboratory was a young, captivating and rather charming Englishman who soon became very popular with graduate students, both because of his broader the- oretical reach and his ability to draw theory so effectively into the clinical encounter. It is not surprising, therefore, to see these qualities in abundance in Ian Evan’s new book blended with his rare insights about how people change, gleaned from the ensuing 40 years of teaching, researching and practising the art. This text has 12 chapters that review and explain a range of key theories and interventions that address be- haviour change. He sets the scene by arguing for a unified account of change, and the need for a basic deconstruc- tion of terms and principles used by different treatment methods, so that their fundamentals are revealed. Next, he considers ‘What changes?’ and the metaphors and forms of change that can be measured and evaluated. Change theories are explored across several chapters, including Motivational Interviewing, the Health Behaviour Model, Theory of Planned Behaviour, and Behavioural Condi- tioning (classical conditioning, contingencies, and aver- sion). The text moves on to the many influential com- ponents of change, highlighting clinician variables, client variables (i.e., self-efficacy, intention to change, support to change), the function of the behaviour, and environmental and cultural influences on behaviour change. Evans draws out three primary considerations he believes all clinicians should remember when helping clients: change is difficult; clients can be reluctant or unable to recognise the need for change; and clients do not like to be told that they need to change. To better illustrate Evan’s deeply thoughtful perspective, we’d like to give a bit more detail on three chapters we found especially interesting. The opening chapter, ‘Why we need a theory for change,’ provides a rationale of why therapy needs to focus more on what is to change (viewed as the client’s behaviour) rather than the current preoccupation with treatment per se (viewed as the therapist’s behaviour). This chapter sets the scene for the rest of the book, ar- guing that: (1) behaviour change would benefit from investigations into unrelated disorders to determine if they share an underlying process (p. 4); and (2) ad- dressing the client’s goals and reducing their distress lev- els (i.e., problem solving) may be a more effective ap- proach than viewing disorders as discrete or separate to each other. Evans further states that when assessing client motivation, it is important to identify what the client expects to achieve from therapy (regardless of present- ing problem) so that therapist knows what the client is seeking before change goals are negotiated. Another im- portant component of motivation for client change is the development of a good therapeutic alliance between client and therapist. Throughout this chapter, Evans inte- grates his own clinical experiences about motivation to change across a range of disorders, and in relation to key evidence-based treatments such as behavioural thera- pies, cognitive-behaviour therapy (CBT) and both the sec- ond generation (dialectical behaviour therapy) and third generation (Acceptance and Commitment Therapy) CBT treatments. The chapter ‘Motivation to change’ explores the im- portance of developing an awareness to change in the client, as well as distinguishing between a client’s motiva- tions to change versus motivations to sustain their current behaviour. Enhancing client motivation to change during treatment is then explained through the two motivation frameworks of drive theory and goal theory. From these two frameworks, Evans examines the stages of change model, motivational interviewing, the theory of reasoned action (including the theory of planned behaviour) and JOURNAL OF PACIFIC RIM PSYCHOLOGY, Volume 7, Issue 2 pp. 73–74. c  The Author(s), published by Cambridge University Press on behalf of Australian Academic Press Pty Ltd 2013. doi 10.1017/prp.2013.7 73 https://www.cambridge.org/core/terms. https://doi.org/10.1017/prp.2013.7 Downloaded from https://www.cambridge.org/core. IP address: 54.161.69.107, on 14 Jun 2020 at 02:15:13, subject to the Cambridge Core terms of use, available at