This is the book to read if one is serious about helping persons recover from the disabling effects of chronic mental illnesses. It is written for clinicians, patients and family members, and it serves as a manual of evidence-based best practices related to psychiatric rehabilitation. The author has spent the past 40 years of his professional life conducting research and treating persons who have psychiatric and developmental disabilities, and we are all the beneficiaries of his knowledge and wisdom. The focus on recovery is uplifting, and it is defined as a process that includes symptom remission, engagement in instrumental role activity, ability to manage one's own day-to-day needs, satisfying peer and family relationships and ability to engage in normal recreational activities. Recovery conceptualized in this way, as a continuum, is a useful and realistic idea, since it is not an end state but an ongoing process that includes progress and relapse.
The author's approach to recovery is collaborative; what he envisions is a shared partnership between patients, families and practitioners. But at the same time, he highlights the importance of a practitioner who is always there and does not give in to pessimism about the possibilities for recovery, no matter where the patient is. In this regard Dr Liberman acknowledges the very difficult task at hand and the chronic commitment one must make to this endeavor. This is not easy work. Throughout the book the author tries to avoid using terms such as provider and consumer, which he notes are terms that denote a business relationship. Instead, the term patient is used. While some will be offended by this terminology, I find it refreshing and accurate. Working in the area of recovery and rehabilitation is not a commercial enterprise but a caring professional endeavor.
This book is a manual of evidence-based ‘best practices’ for psychiatric rehabilitation (‘best practices’ refers to behavioral therapies and psychosocial rehabilitation combined with pharmacotherapy). As such, it can be used repeatedly as a guide, and as a reference book for each step of the rehabilitative process. Psychiatric rehabilitation is based on seven principles, starting with the belief that recovery from psychiatric disorders is possible for many persons, if they are provided with best practices. Additionally, treatment needs to be individualized (to include attention to cultural and ethnic uniqueness), pharmacological and psychosocial services must be integrated, patients and families need to be actively involved in the treatment process, services must be integrated and coordinated, and it is crucial to build on patients' strengths, interests and capabilities. The book makes the important point that rehabilitation is not a quick fix but a process that takes place over time, with small steps, and requires patience and resilience by all participants. It is conceptualized using a bio-psycho-social-spiritual framework, which caters to the whole person.
Recovery from Disability provides a wealth of information that applies the principles of psychiatric rehabilitation to ‘real life’ settings and people. There are ten well-written chapters that focus on topics such as Illness Management, Functional Assessment, Social Skills Training, and Vocational Rehabilitation. Of special note is the chapter on Special Services for Special People, which focuses on those patients who present unique challenges, i.e. dually diagnosed patients, those with treatment-refractory illness, mentally ill offenders, patients with aggressive behavior, and older adults. These are populations who are often more stigmatized than other persons with mental illness, and it is important that they be singled out for special attention. Clinical examples are interspersed throughout, which demonstrate direct applicability of the material being presented. The voluminous material is made more manageable by an array of tables and figures, using graphs, charts, and diagrams to provide summary statements, highlight important points and emphasize the major content of each chapter. Though a challenging read, this book provides invaluable knowledge and detailed assistance to help those with mental illnesses recover from their disability.