Monday, June 29, 2009
Wednesday, June 24, 2009
Sunday, June 21, 2009
Sunday, June 14, 2009
Wednesday, June 10, 2009
Cordless, C. (Ed.). (2001). Confidentiality in mental health. London. Jessica Kingsley Publishers.
One thing of note when reviewing an edited volume is that each article is not equally good or equally relevant to one’s interests. This book for example had some articles which related more to psychiatry or hospital based care than to the community based work I’m involved in.
An ongoing theme throughout the book is the shift from a psychiatry/hospital oriented model of mental health care to a community based one and it’s implications confidentiality. While in the past, patients may have engaged in individual psychoanalysis with one professional, many clients today are involved with interdisciplinary or interagency teams and their personal information may be shared with all members of the team. Also, in the modern context we place emphasis on supervision, debriefing and consultation with colleagues. While most of us as professionals would not perceive this as a breach of confidentiality, clients might.
Another theme in the book is client expectations of confidentiality, informed consent, and whether clients really know what they are getting into. While a client may be informed that their social worker works as part of a team, do they understand that this may mean common record keeping, or in the case of Assertive Community Treatment, a daily review of their file by the entire team.
Finally, the book discusses the legal aspects of confidentiality and what constitutes a breach. When does the threat of harm to others outweigh a clinician’s responsibility to keep confidentiality? For many, it can be a “damned if you do, damned if you don’t” scenario as they face threat of litigation from both sides.
I actually liked this book. I didn’t read all of the legal chapters, but the chapter about social work was particularly good (or perhaps particularly relevant). The only draw back to the book was that it was British not Canadian and so all laws sighted were British. I’d love to see Canadian authors pull together something similar.
Tuesday, June 9, 2009
Sunday, June 7, 2009
Thursday, June 4, 2009
Monday, June 1, 2009
Dobbert, D. L. (2007). Understanding personality disorders: An introduction. Westport, CT.: Praeger.
The stated intent of Duane L. Dobbert when writing this book was to provide a non-clinical explanation and exploration of personality disorders, and he does. Dobbert approaches the subject from an “us verses them” mentality. In contrast to much psychological literature of the time, Dobbert sees the individuals affected by other people’s disorders as being “victims” and the personal with a personality disorder as being the antagonist. The preface states “if nothing else, this book will help you realize that you are the victim, not the person with the problem”.
Dobbert starts his book with case studies illustrating his position that people are victims of those with personality disorders. The introduction goes through the DSM-IV-TR definition of Personality Disorders and their associated criteria and characteristics. Dobbert’s definitions are clear and his explanations straight forwards. However, Dobbert uses a lot of black and white language and gives a very negative outlook using statements like “they [those with a personality disorder] are not capable of viewing the world from the perspective of another…consequently, it is an egocentric view, albeit inaccurate.” (page 3).
Chapters two through twelve of Dobbert’s book go through the DSM criteria for each of the ten personality disorders (Paranoid, Schizoid, Schizotypal, Antisocial, Borderline, Histrionic, Narcissistic, Avoidant, Dependent, Obsessive Compulsive and Conduct Disorder). For each, he provides at least one case study. He then discusses expected outcomes and therapies. An appendix at the end of the book outlines major theoretic perspectives of personality disorder.
I’ll be honest, and say that I didn’t like the book. For starters, I found Dobbert to be arrogant, and I can’t stand arrogant authors. Secondly, I found it boring. He literally takes the DSM and explains each sentence. However, I can see that this book could be useful for family and friends of someone with a personality disorder. I still wouldn’t recommend it though except as a last resort, because I think it has a very negative perspective. Unfortunately, I haven’t had a great experience with any books I’ve read about personality disorders, so I’m not sure what I would recommend instead (suggestions are always welcome).