You do not currently have permission to view the full text for this document. Please sign in to an account with an active subscription or contact support.
In the opening words of his foreword Stephen Fleck, Emeritus Professor of Psychiatry at Yale University, considers that this book ‘…may be the most comprehensive treatise on schizophrenia… since [that of] Manfred Bleuler’ [published in 1972].
As the reviewer of the book, I therefore have the challenge of making a judgement as to whether it merits this acclaim and of clarifying whether it is an important enough book for readers of this psychotherapy journal.
The book's greatest value is in its description and illustrations of a particular model of therapy and care for those who are vulnerable to schizophrenia. This has been developed in Finland and is radically different in its conceptualization and practice from that which we usually witness. In Britain, treatment for schizophrenia can be generally characterized as based on a biologically-orientated model. Treatment is centred on ‘compliance’ with long-term ‘anti-psychotic’ medication together with support services for the individual and family of very varying degrees of availability and sophistication. I wish to stress that even proven psychological approaches with very limited goals remain rarely implemented in the UK. I am thinking, for example, of the well-respected and replicated research work of Leff who has convincingly shown that specific interventions significantly reduce relapse rates in families with high levels of ‘expressed emotion’ and/or excessive hours of contact between sufferer and family . This research was actually carried out in Britain and the evidence dates back 20 years. Likewise psychodynamic understandings are now rarely utilized in individual, group or family approaches although cognitive therapy has attracted some attention in very recent years. I shall return to this observation on the lack of implementation of even evidence-based psychological findings at the end of my review.
Therefore when a very different type of treatment philosophy, such as that described in this book that:
has evol