Abstract
Pat McGorry and John Gleeson have done much to promote specific service provision for people presenting in early psychosis. This book provides a pleasing ‘road map’ on what, how and when specific psychological interventions can be made at the same time acknowledging the importance of broader psychological engagement with the patient at all stages of therapy.
This book is especially important as it describes psychological interventions that are applicable for the majority of patients seen in public psychiatry, an area of psychiatry that the majority of psychiatric training occurs in, and which therefore has to incorporate training in a broad range of psychological interventions in everyday clinical work for trainees. This is a multi-author, multinational book, although it also draws heavily on local expertise.
The chapters all adhere to a similar structure with a literature review focusing on evidence based practice, a description of the techniques involved, and is illustrated with clinical cases where possible. This makes the book highly engaging and of immediate use to anyone working with patients suffering from psychotic illness.
A range of therapies are included with a focus on cognitive, behavioural, but also family, psychodynamic, and group therapies. A number of specific areas are addressed such as substance abuse, suicide prevention and the interplay between psychosis and affective dysfunction. All aspects of the psychotic experience appear to be addressed thoroughly ranging from the prodrome through to chronic illness and the management of negative symptoms.
The chapter on making sense of psychotic experience is another reminder of how very important it is for us to listen to what patients have to say and to incorporate their feedback into our practice.
The chapter on dynamic psychotherapy gives a short and balanced review of psychodynamic approaches to psychosis over the last 50 years emphasizing the importance of developing a therapeutic relationship and having a dynamic understanding of the context in which the person has developed their illness. The emphasis is on integrating the psychodynamic understanding within a broader psychological approach. This common sense integrative approach is reflected throughout the book. I would have wished for perhaps some more specific case examples of the psychodynamic approach to psychosis as this is an area that can become shrouded in mystique.
Overall, I found this book an excellent and informative read that all clinicians working within the public system, medical or-non-medical, would find useful to frame their work with patients with psychosis. I would certainly commend it to trainees in psychiatry who wish to develop their understanding of the psychological work that they are doing as well as to consultants working in the field.