by Rob Poole and Robert Higgo; Cambridge, England, Cambridge University Press, 2008, 240 pages, $70
Dr. Johnson is clinical director, Cherry Hospital, Goldsboro, North Carolina.
The book Clinical Skills in Psychiatric Treatment is a refreshing read. Rather than being full of statistics and treatment algorithms, it is reflective of decades of frontline clinical experience. It contains the authors' personal opinions on a wide variety of long-standing and accepted treatment interventions. Its primary focus is on working with patients to help them achieve recovery. It acknowledges that recovery is not the same for every patient and that, to achieve recovery, patients need to do a lot of work themselves.
In their foreword, Rob Poole and Robert Higgo state that "Above all, clinicians have to be self-aware and conscious that treatment can do harm as well as good." They later warn the reader that they will be questioning and challenging long-established beliefs and psychiatric practice patterns.
As a psychiatrist who works at a state psychiatric facility in the United States, I had mixed emotions and expectations while reading a book by two psychiatrists in the United Kingdom who admittedly intend the book for mental health professionals in the United Kingdom but who believe its concepts can be generalized to other countries. Add to that the prospect that the book challenges some psychiatric practices—many of which I face by necessity on a daily basis (such as involuntary admissions and compulsory treatment)—and one can probably understand why I faced reading the text with some degree of trepidation.
To my delight, this book, although effectively challenging some of my practice patterns also reinforced some of my own professional beliefs. Some may dismiss the ideas presented in this book as radical, but they would be missing an opportunity to truly consider how to approach each patient in an individualized manner.
The book is well organized. It is arranged in four discrete sections, which cover, in sequence, underlying principles, the context and location of treatment, problems in treatment, and coping. Each section is broken into progressive chapters. Each chapter is divided into segments and then summarized at the end by a listing of its main points in a bulleted format. The book is punctuated by clinical vignettes designed to poignantly exemplify the points raised. Although most of the vignettes are fictional, readers are apt to recall real patients from their own experience with similar circumstances.
The target audience for the book is any mental health professional. Although it raises many specific questions about such issues as compulsory treatment and competency, it also addresses general principles, such as team functioning, therapeutic relationships, treatment planning, and managing change.