Clinical Skills In Psychiatric Treatment

This page intentionally left blank Clinical Skills in Psychiatric Treatment Clinical Skills in Psychiatric Treatment R O B P O O L E A N D R O B E RT H I G G O CAMBRIDGE UNIVERSITY PRESS Cambridge, New York, Melbourne, Madrid, Cape Town, Singapore, São Paulo Cambridge University Press The Edinburgh Building, Cambridge CB2 8RU, UK Published in the United States of America by Cambridge University Press, New York www.cambridge.org Information on this title: www.cambridge.org/9780521705707 © R. Poole and R. Higgo 2008 This publication is in copyright. Subject to statutory exception and to the provision of relevant collective licensing agreements, no reproduction of any part may take place without the written permission of Cambridge University Press. First published in print format 2008 ISBN-13 978-0-511-41009-3 eBook (NetLibrary) ISBN-13 978-0-521-70570-7 paperback Cambridge University Press has no responsibility for the persistence or accuracy of urls for external or third-party internet websites referred to in this publication, and does not guarantee that any content on such websites is, or will remain, accurate or appropriate. Every effort has been made in preparing this publication to provide accurate and up-todate information which is in accord with accepted standards and practice at the the time of pulication. Although the case histories are intended to be realistic, they are fictional. They are not based on the life history or clinical details of any individual patient. Nevertheless, the authors, editors and publishers can make no warranties that the information contained herein is totally free fromerror, not least because clinical standards are constantly changing through research and regulation. The authors, editors and publishers therefore disclaimall liability for direct or consequential damages resulting fromthe use of material contained in this publication. Readers are strongly advised to pay careful attention to information provided by the manufacturer of any drugs or equipment that they plan to use. This book is dedicated to the late Leo Fender, whose supreme mastery of the art of guitar design was unencumbered by an ability to play the instrument. Contents Acknowledgments page ix Author biographies xi Introduction 1 PA R T I – U N D E R LY I N G P R I N C I P L E S 1 Starting points 7 2 A triangle of forces 13 3 Treatment objectives 21 4 Strategic treatment 30 PA R T I I – T H E C O N T E X T A N D L O C AT I O N O F T R E AT M E N T 5 Teams 45 6 Teamwork 56 7 Inpatient treatment in the era of community psychiatry 68 8 Compulsion and locked doors 81 9 Not at home, not in hospital 88 10 Models of care 97