With such a diverse range of contributing authors, this well-edited opening volume offers something of value for clinicians, managers and policy makers, and potentially for patients and carers too. The chapters are all relatively brief and accessible, and some have diagrams and illustrations, so reading the entire book is neither challenging nor repetitious.
The book prompts the reader to question the position most mainstream services have arrived at, in which service design inhibits rather than supports best practice when working with whole families. Increasing specialisation in teams, risk-averse and target-focused service cultures, and fragmented commissioning arrangements all contrive to make it harder to routinely ‘think family’. Thankfully, with its emphasis on ‘learning from success’, this book does not just lay out the imperative to overcome these barriers, it also equips us with ideas and tools to do so.
The opening section goes to the heart of the matter, with personal accounts from young carers, mothers with lived experience, a trainer and an adult psychiatrist. These accounts challenge common assumptions by highlighting the significance of unique outcomes and learning from each other. In chapter 4, for example, Dr Joanna Fox reflects on her experience of pregnancy and the early years of motherhood in the context of a psychosis diagnosis. She describes the problems that arose from professionals' preoccupation with diagnosis, risk and medication. This position compromised the real choices that should have been available to her and her baby based on recognition of her considerable strengths.
These opening stories document with clarity simple underlying principles which set into context the more academic sections of the book: covering policy, tools, conceptual models and delivery. The final chapters summarise real practice examples of collaboration and integration – essential components of a successful whole-family approach.
The book balances tensions throughout: intense need and opportunity, problems and resources, personal and professional. A chapter focusing on the needs of fathers is a welcome addition to a field often preoccupied with the concerns of mothers. The particular types of stigma faced by fathers are highlighted, with implications for their help-seeking behaviour. The authors consider ways in which professional attitudes can compound rather than ameliorate stigma and advocate moves towards more father-inclusive practices, with the help of a series of questions designed to promote reflection on current practice.
The closing sections, offering a brief ‘research digest’ and summary of relevant online resources, are of immediate practical help. As the first volume in a series of annuals, this is a comprehensive and well-presented opening text. In the next volume I would like to see something on the specific needs of adolescents, the under-fives more often being the focus of our gaze. Also missing was a clinician's account of wrestling with complex ethical and clinical dilemmas in the context of inadequate or unhelpful service structures. This may do more to connect with practitioners who are not in a position to influence service design but would like to feel hopeful about their daily practice.
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