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Doody's Review ServiceReviewer: John K. Larson, MD (Rush University Medical Center)
Description: This is a significantly revised second edition of a book, originally published in 1992, that is a collaboration of three authors — a psychiatrist, a nurse, and a psychotherapist — all of whom are actively seeing patients in a predominantly managed care setting. The authors support the position that medical necessity is based on a demonstration of functional impairment and that the mental health professional's role should focus on reducing the severity of that impairment. They provide a pragmatic classification system for assessing impairment, rating its severity, designing a focused treatment plan, and measuring outcome.
Purpose: The purpose is to enable practitioners to communicate more effectively in a managed care environment. However, the book is also provocative and stimulates a higher level of critical thinking in case formulations and in evaluating our effectiveness in our work with patients, regardless of theoretical orientation.
Audience: The book is targeted for all mental health practitioners, especially those who see patients in cost-conscious settings where communication with case managers is necessary. Psychiatrists working in consultation-liaison relationships with other physicians will also benefit from its pragmatic approach and lack of jargon.
Features: The book uses numerous case examples to illustrate major points, including impairment and its relationship to diagnosis, rating of severity, treatment goals, patient objectives, interventions, and measurement of progress and outcome. A description of proprietary software that incorporates the authors' approach to treatment planning is included. The book concludes with an extensive glossary incorporating an impairment lexicon, severity rating scales and qualifiers, a patient objectives list, and an excellent list of supporting references.
Assessment: This book can be enthusiastically recommended to those besieged mental health practitioners looking for a better way to advocate for their patients in managed care settings. Any practitioner will benefit from exposure to the critical thinking and jargon-free language elucidated by the authors.