impossible to know how much of the
modi®cations of CBT have arisen from a
knowledge of more recent literature and
how much has arisen from clinical prac-
tice. The fact that the book contains no
references will, I am sure, appeal to
readers who are phobic of such objects,
but may ultimately be seen as a weakness
by those of us who occasionally like to
follow-up interesting references. Neverthe-
less, this complaint is only a minor one for
what is otherwise an excellent readable
introduction to CBT for schizophrenia.
Mick Power
BSc DPhil MSc
Professor of Clinical Psychology
University of Edinburgh & Royal
Edinburgh Hospital
Edinburgh
Scotland
Managing High Security Psychiatric Care
edited by C. Kaye and A. Franey. Jessica
Kingsley Publishers, London, 1998, 304
pages, £19á95 (paperback), ISBN 1 853
02581 X.
Published material on the special hospi-
tals is important for two main reasons.
Firstly, their closure is currently being
debated and the end of an era is in sight,
and, secondly, they are complex cultural
artifacts representing the good and bad of
society in all its symbolic forms. This book
is one version of some of the events
leading to the brink of extinction of our
special hospitals.
Part 1 sets the scene with an unusual,
but interesting, structure of chapters. In
preparing the reader, the authors give a
brief outline of the major themes that, in
their view, contributed to the problem of
the special hospitals. From this they
adduced that they, as managers, were the
most appropriate people to change them.
In part 2 the six chapters outline what
those authors consider was bequeathed to
them through the generations of manage-
rial structures, political whims, and
professional stagnation. Their inheritance
was perceived as a cluster of dead-ends
and cul-de-sacs with only the dim light of
change at the end of a very long, dark and
dreary tunnel. There is a sense of claiming
a high managerial morality in this section
as they report a steeling in readiness for
the battle ahead.
Three chapters form part 3 of the book
which is concerned with focusing on the
patient. Although the reporting of this
topic is sadly short in this section, and
there is little new in the limited material,
one chapter is singled out for special
mention. This is chapter 12 on Patients
as Intimate Partners which is a superb
coverage of a dif®cult and sensitive issue
offering clear guidance, at a human and
practical level, for policy development.
Some strategic approaches to managing
change are outlined in part 4 and largely
deal with individual strategies encapsu-
lated in a wider organizational framework.
Of particular note are the re¯ections of the
chaplain in chapter 13. The interface
between the all too human condition and
the highest ideals of humanity are handled
in a convincing and honest way.
The ®nal section of the book deals with
the external mechanisms of scrutiny of the
special hospitals by professional bodies
and through public interest. This often
uncomfortable interface between secret
places and media attention provides an
interesting perspective, formulated from
these authors, as they attempt to balance
information, infamy and ignorance. As an
endangered species the special hospitals
teeter on the brink of extinction and this
book provides good documentary evidence
of some of the reasons for their possible
demise, and also gives us a snapshot of a
6-year reign to change them. If there is any
weakness to the book it is the sense of the
managerial claim for the high moral
ground which is a little over-the-top in
places. Having said that, however, we have
heard a great deal about the specials from
other sources, so why not let the managers
have their day.
Tom Mason
RMN RNMH, RGN BSc(Hons) PhD
Senior Lecturer in Forensic Mental Health
Liverpool University
Liverpool
England
An Introduction to Counselling 2nd
edition by John McLeod. Open University
Press, Buckingham, 1998, 464 pages,
£16á99, ISBN 0 335 19709 4.
The proliferation of counselling courses in
recent years has been mirrored by an
explosion in the number of counselling
texts. As one might expect, the quality is
sometimes less impressive that the quan-
tity. McLeod's Introduction to Counsel-
ling, however, will be read and
appreciated after most of the current crop
of simplistic counselling texts are
forgotten. Indeed, on the evidence of this
revised and expanded second edition, it is
set fair to become a classic in the ®eld. The
book covers all the major theoretical
approaches in a clear and readable style
and new chapters of systemic, feminist,
narrative and multicultural viewpoints
enrich a text which was already both
informative and challenging. Of particular
relevance to clinical practice is the new
chapter on the use and abuse of power in
the therapeutic relationship, an issue
which some textbooks avoid. Where it
remains unexamined and unresolved is a
major cause of breakdown in the relation-
ship between counsellor and client. The
text is enlivened throughout by the use of
case studies and vignettes to illustrate
theoretical issues, and one has a strong
sense that the author writes not only out of
a thorough acquaintance with the litera-
ture but also from his own clinical experi-
ence, which has both breadth and depth.
In the end this is what makes the book the
invaluable aid to practice that it is. This
text should be required reading for both
practitioners and students.
Brendan McMahon
BA MSc SRN RMN
Clinical Nurse Specialist in Dynamic
Psychotherapy
Psychotherapy Department
South Derbyshire Mental Health Trust
Derby
England
Promoting Positive Practice in Nursing
Older People: Perspectives on Quality of
Life edited by Sharon Pickering & Jeanette
S Thomson. BaillieÁre Tindall & Royal
College of Nursing, London, 1998, 322
pages, £19á95 ISBN 0 702 02080 X.
The words promotion and positive should
not be used merely as vehicles for
publishing another book on caring for older
people and it is my impression that the
niche for this particular book may already
have been ®lled. The book is divided into
four sections and the ®rst section which
includes two chapters by the editors, is the
Media reviews
Ó 2000 Blackwell Science Ltd, Journal of Advanced Nursing, 31(1), 242±248 247
