by Robert Paul Liberman, M.D.; Washington, D.C., American Psychiatric Publishing, 2008, 628 pages, $65
Dr. Jabbarpour is clinical assistant professor at the University of Virginia School of Medicine and chief of staff at Catawba Hospital, Catawba, Virginia.
With historic vision, clinical sensibility, and scientific tenacity, Dr. Robert P. Liberman has been a founding father of psychiatric rehabilitation, developing it to form a cornerstone of treatment for persons with serious mental illness. He is a distinguished professor at the University of California, Los Angeles (UCLA), where he has been a member of the faculty since 1970 and where he has directed since 1977 the UCLA Center for Research on Treatment and Rehabilitation of Psychosis, funded by the National Institute of Mental Health. With Recovery From Disability, Liberman has provided a guiding resource to help clinicians bridge the gap between science and clinical services, thereby helping patients bridge the gap from disabling illness to recovery.
The initial section of the book provides the conceptual and evidence-based foundations for psychiatric rehabilitation, from terminology to discussions on the recovery movement. The main theories are reviewed, ranging from the vulnerability-stress-protective factors model of mental disorders, to social learning theory, to life span developmental psychology. The review provides a framework for the driving principles and practices of psychiatric rehabilitation. The midsection contains the core focuses for psychiatric rehabilitation: illness management, functional assessment, social skills training, family involvement strategies, and vocational rehabilitation. This section is the manual's principal substance, formatted to bring psychiatric rehabilitation home to the clinician and on behalf of the patient.
The last chapters address specific vehicles for the delivery of rehabilitative services and emphasize special service situations. Liberman discusses the applications to case management and personal support specialists and thereafter tackles the further applications to housing, assertive community treatment, and psychosocial clubhouses. Integrated mental health care is underscored. Given the complex needs of persons served in our fragmented systems of care, the author attends to special rehabilitation services for special populations, ranging from those of diverse ethnic and cultural backgrounds to those with severe mental illnesses who are incarcerated in jails and prisons. Rehabilitation for persons with treatment-refractory mental illnesses and co-occurring substance use disorders, as well as for older adults, is discussed. Liberman ends by spotlighting future developments for rehabilitation and recovery, including prevention, cognitive remediation, the use of technology, and the integration of consumers into rehabilitation with peer support specialists and other supports.
Each chapter offers not only direct content but also clinical examples and learning exercises to engage the reader. The author ends each section with summaries and key points that pull together the salient, take-home elements. These teaching techniques help readers incorporate knowledge through multiple formats of learning. The manual also provides a complementary resource that pulls together Liberman and colleagues' multiple modules for psychiatric rehabilitation, as exemplified by medication management, community re-entry, symptom management, and family modules. The manual would have benefited from the use of electronic media—by including a CD-ROM, for example—to provide links to the modules and more elaborative applications.
Liberman provides a large—over 600 pages—yet practical handbook that brings theory into practice for the reader. With this manual, recovery is no longer simply a values-based vision. Recovery From Disability improves our function in psychiatric services by providing pragmatic, evidence-based tools to improve our utility as providers. Clinicians from all disciplines who serve persons with severe mental illnesses will benefit by including this book in their library.