Reading this somewhat curiously titled, but insightful and engaging book by Diane T. Marsh, PhD, a professor of psychology at the University of Pittsburgh and Melissa J. Marks, EdD, an associate professor of education at the University of Pittsburgh is a pleasurable and educational experience. The title may suggest that the book is focused on communication with family members of patients, likely with emphasis on communication skills. However, it is much more than that. It also discusses providing optimal care for children and adolescents with mental illness by including their home and educational environments in the treatment plans, and involving families instead of ignoring and dismissing their needs and strengths. Grounded in the clinical world and day to day experiences of families, the authors reflect back to clinicians (the primary audience the book is intended for) the confusion, bewilderment, guilt, shame, and anxieties of families in crisis as a result of their loved ones’ mental illness. Having many clinical encounters with such families can desensitize clinicians, but this book provides a timely reminder that for many of the families who come to us, theirs is a singularly life altering experience, and that they are struggling to adapt to the demands of such experiences.
The first section of this book is an engaging introduction consisting of two chapters in which the authors strategically place attention-grabbing quotations from family members of patients to reinforce the impact such illnesses can have on patients and their family members. The second section contains comprehensive information on the resources available in the mental health care system and educational system for children who require assistance, and the legal aspects and processes involved in obtaining such resources. Further parts of this section provide insightful strategies and recommendations for the family to cope with children with mental illness, such as creating a supportive family environment, focusing on the family’s strengths, problem-solving skills, maintaining a balance to meet all the family members’ needs, and having realistic goals and expectations. The third section focuses on specific disorders, dedicating one chapter each to anxiety disorders, depression, bipolar disorder, and schizophrenia. Each chapter begins with a case study, proceeding to information regarding diagnosis, treatment, coping in school and at home, and then returns to the original case and establishes a comprehensive treatment plan that include the home and educational environments. Actual examples of the encounter and dialogue between a healthcare provider and the patient’s family members are used as an effective and engaging method of illustrating the kind of concerns family members have and examples of how to address these concerns. The last section of the book briefly discusses the professional competencies, knowledge, and skills required for professional practice, professional issues such as confidentiality and consent, and reviews the importance of adopting a strength-based approach and model of family-driven care, and resources available for family members. The book ends with a discussion of transitional and long-term planning for children with mental illness, which is an important aspect that is often overlooked by busy practitioners, who end up meeting demands of crisis situations.
It is surprising that disruptive behaviour disorders and developmental disorders with psychiatric co-morbidity, both of which are common in any child and adolescent mental health practice, were not included. Possibly these disorders were not thought of as ‘mental illnesses’ by the authors. The skills involved in addressing these disorders are related to those highlighted and discussed by the authors, but additional perspectives and skills are needed to ‘talk to families’ with those particular clinical syndromes. The chapters related to the education system have some redundancies and perhaps exceeds the depth of knowledge that healthcare practitioners need for providing optimal care. As the book is written by practitioners in the United States, its details are perhaps most applicable to those in the United States and to a lesser extent in Canada, although the principles remain the same. The overall theme of the book and the success of its strategies assume a fairly involved, flexible, and open-minded family. The authors cleverly combine perspectives from psycho-education, basic cognitive-behavioural therapy, basic family therapy, and their clinical experiences to structure a volume which occupies a unique position in the market, a space not filled by handbooks/textbooks and psychotherapy manuals. The clarity of the prose and the narrative structure reflects the wisdom and the depth of understanding of the authors.
We recommend the book for anyone involved in providing professional care for children and adolescents with mental illnesses. It may serve as an ideal supplementary textbook for those in training. It is certainly educational for novice practitioners, but experienced practitioners may also find it as a useful reminder, that in times of turmoil, families find simple and straightforward advice, direction and guidance bolster their psychological resources to navigate the complex and bumpy road ahead. Many patients and their families will likely have much better outcomes and higher treatment satisfaction if practitioners adopt the authors’ approach.