BOOK REVIEW: Handbook of Person-Centered Mental Health Care
Nosheen Akhtar, Cheryl Forchuk, Katherine McKay, Sandra Fisman, Abraham Rudnick
Hogrefe Publishing Boston, 2020
Reviewed by Marilyn Baetz, MD
Person-centred care is authentic, compassionate, and built on respect toward individuals with various health problems. It is the foundation of working with people with mental health challenges and beyond. This book expands on the multidimensional construct of care for mental illnesses introduced by Abraham Rudnick and David Roe.1 This treatment approach focuses on the person, is sensitive to their needs, allows them to make choices on their care, and considers their current and past context. The purpose of this book is to provide a comprehensive, hands-on guide on how to provide such care and how it can be implemented by mental health professionals and students. As noted by the authors, the book can also be used as an educational tool for service users, so that they may actively participate in their own care.
Chapter 1 of the book discusses the foundations of this approach and introduces the terminology “service user” and “service provider.” The benefits, challenges, and applications are briefly introduced. Top
Chapter 2, the lengthiest section of the book, is a compilation of knowledge and practical skills needed for working with those with mental health challenges. It discusses a person-centred approach to the clinical encounter with the individual or family, addresses culturally sensitive care, different challenges for adolescents and older adults, as well as the unique aspects of forensic mental health and dual diagnoses. Each scenario is complemented with a case study along with useful cognitive and behavioural worksheets, which are “answered” through the case study. All of these provide further understanding of the process. The worksheets and potential responses can be a very helpful additional resource when one faces challenges in a particular difficult area with a client.
Chapter 3 turns the focus to patient-centred research. The case studies give clear examples of how service users help to initiate and refine the research question and play an imperative role throughout the process. Participatory action research is highlighted as a method that ensures that action and outcome are of real benefit to the service users. As patient-oriented research is a main thrust of the Canadian Institutes of Health Research, these principles are timely and align well with current needs. Top
Chapter 4 is about person-centred education for the service user, family members, health professionals (at all levels), and public at large. The importance of learning to share decision-making, reflecting on the therapeutic alliance, and considering adult education approaches are discussed within the context of optimized care. Although many of the health professions will have their own curricula for teaching person-centred care, the core content remains comparable.
The final chapter is on a person-centred approach to leadership. It uses a case study of the personal development of a physician and an administrator co-leaders, as they bring system change to an outpatient mental health program. The example walks through numerous established leadership concepts, programs/theories, such as reflected best self, strengths based, emotional intelligence, appreciative inquiry, and SWOT (strengths, weaknesses, opportunities, and threats) analysis. These approaches and tools are used to make plans in a consultative, person-centred approach that includes collaboration with teams that incorporates service users at each stage. This chapter covers both theory and practice (the case study) in attempts to pull the many approaches together to make the process easily understandable. Top
The authors have backgrounds in occupational therapy, nursing, psychiatry, and philosophy. Their expertise includes psychosocial rehabilitation, leadership, treating serious and persistent mental illness, programming, and policy. Authorship is more heavily weighted to psychiatry but does provide expertise from a mental health team perspective.
The book is well structured and written in a very easy-to-read style. The content flows well and the case examples are in grayed boxes in handwriting type, making them clearly distinguishable from the theory. There are 33 examples of forms that service users can work on together with the health care worker. The forms are available at the end of the book and for free download from the publisher’s website.2
The authors of Handbook of Person-Centered Mental Health Care took on an ambitious agenda, writing for a wide range of mental health care workers and service users too. A lot of information is packed into this handbook, but, given the number of topics and the breadth of the intended audience, some readers may find it to be only a primer. There is, however, a reference section at the end of each chapter for further study. This book would be a good educational resource for mental health trainees, including psychiatry residents, and a useful resource for practitioners who want to begin to advance their journey in person-centred care.
1.Rudnick A, Roe D (editors). Serious mental illness: person-centered approaches. London: Radcliffe; 2011.
2.Handbook of person-centered mental health care handouts. Boston: Hogrefe; 2020. https://www.hogrefe.com/us/downloads/hpcmhc
Marilyn Baetz, MD, FRCPC, CCPE, is vice-dean of faculty engagement and professor of psychiatry at the College of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan.