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k reviews Physiotherapy in Mental Health A practical approach edited by Tina Everett, Maureen Dennis and Eirian Ricketts. Butterworth-Heine- mann, Oxford, 1995 (ISBN 0 7506 1700 4). Illus. 424 pages. f29.50. This book has long been awaited as the inevitable sequel to Mary Hare’s Physiotherapy in Psychiatry, a flag- ship for practice when it was first published in 1986.

Physiotherapy in Mental Health -A practical approach heralds the exciting developments which have since been made, and establishes a sound premise for the future. It succeeds in addressing many of the challenges in this area and provides a valuable resource for all practitioner physiotherapists who inevitably encounter related problems wherever they may work. Students with an interest in mental health will doubtless be inspired by the book‘s detailed and informative style combined with commonsense practical guidance for the applica- tion of interventions.

The variety of contributors is reflected in the diversity of styles, views and approaches represented. Each chapter (except 11 and 12), has a different author or authors and stands happily independent of the rest, providing a comprehensive reference document which can readily be dipped into. While conti- nuity through consistency of style, depth and approach is compro- mised, the book is unanimously united in its unerring commitment to person-centred holism, team- working and the continual challenge t o the mind/body dichotomy. This conveys an unmistakable message clarifying still further the role of physiotherapists in the promotion of positive mental health.

The book has three parts: the first is introductory, providing context for the following chapters and a broad theory base, necessarily covering psychiatric illness, models of mental disorder, communication, team working, community care and guidelines for service evaluation.

Parts 2 and 3 are clinically spec- ific to mental health issues, for example child psychiatry, dementia and challenging behaviour. Other

chapters are also pertinent to physiotherapy more generally, such as those addressing move- ment therapy, touch and handling, nociceptive stress and the general adaptive response, stress manage- ment and relaxation training. Information is augmented, where relevant, by a useful ‘how to’ approach, fulfilling the book’s aim to provide practical guidance. Treat- ment strategies are explored and include complementary therapies, dance, exercise and current advances in the management of agoraphobia and panic attacks where abnormalities in the cere- bellar-vestibular system exist.

The book is largely descriptive, and is enlivened by reference to the

context of the mental health care process and individual case studies. Notable chapters such as those concerned with eating disorders and post-traumatic stress combine profound communication of the tremendous distress felt by sufferers, with an objective, infor- mative approach and a clear rationale for treatment free from dogma and prescription. The message for anyone uncertain of the role of physiotherapy in mental health is resounding and unequiv- ocal. This book will, I am sure, provide inspiration to clinicians and managers alike in furthering the provision of quality care for people suffering mental health problems.

Vanessa Gajewska BA MCSP

Manual of Stroke Rehabilitation by Karl J Sandin and Kristin D Mason. Butterworth Heinernann, Oxford, 1996 (ISBN 0 7506 9489 0). Illus. f 94 pages. f30. This book is written chiefly by the medical director and the ‘staff physiatrist’ a t the Rehabilitation Institute a t Santa Barbara, USA. The book is intended to provide a comprehensive but concise guide to stroke rehabilitation, particularly with reference to the care model used at this facility. The authors state that the book is targeted at a range of staff, from health care professionals, medical and allied health students, medical and therapy practitioners, purchasers, administrators and managers. This seems a very wide target audience.

The book is presented in concise chapters, covering most of the issues around the management of stroke, and there are brief commentaries by the therapist members of the team.

The chapters concerning initial investigations and management may prove to be a useful update for therapists not working in acute units but I found the chapters around the therapies unsatisfying. The authors touch on a range of issues without discussing them in any depth, and make some unsub- stantiated claims. For example, a t one point they state that there is no evidence that any one approach to

physical rehabilitation has been proven to be more effective than any other, but a few lines later they name one approach (PNF) as being the optimal method of treatment. There are no references to support either claim.

I found the therapist commen- taries were clearly presented, but too brief.

Other chapters include models and outcome of stroke rehabilita- tion, which includes sections on team working and discusses the outcome measures in use at Santa Barbara .

The model of care demonstrated refers to the American system of healthcare throughout, with refer- ence to the quantity of therapy provided under the Medicare ‘rules’.

This book touches on most aspects of stroke rehabilitation, but is unable to tackle them in any real depth. The drawback here is that some of the issues discussed appear far simpler than they are in reality.

On the whole, I felt the material was not comprehensive enough to interest therapists working in this field, and I would hesitate to recom- mend it to other clinicians or managerial staff, mainly for the reasons stated above, and also for the heavy bias to the American health system which is go different from our own.

Rhoda Allison GradDipPhys MCSP

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Physiotherapy, March 1997, vol83, no 3