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