ELLEN LEIBENLUFT, M.D., ALLAN TASMAN, M.D., AND STEPHEN A. GREEN, M.D., EDS: Less Time To Do More: Psychotherapy on the Short-Term Inpatient Unit. American Psychiatric Press, Washington, DC, 1993, 306 pp., $42.50.
This fine book brings the reader excellent information on psychotherapy in acute-care settings. It is easily readable and enhanced by case histories in every chapter. The inherent unevenness of edited works is largely avoided. There may be no other organized guide to psychotherapy with inpatients whose stays are limited by either the questionable wisdom of "get' em out" management policies or the patient's own intolerance for hospital care. This book goes a long way toward filling that void, and toward increasing the skills of psychiatrists, other therapists, and ward counselors.
Although the editors define "psychotherapy" as almost any therapeutic contact, I prefer to draw a distinction between (even wholly supportive) psychotherapy and the people and programs that make up inpatient and outpatient therapeutic support. Many of the authors assume, for example, that inpatients have, or will have, competent outpatient therapists. In my experience, particularly with severely mentally ill persons in the public sector, that assumption is unwarranted. Nearly all patients will be offered some follow-up at discharge, often a case manager or community worker; but access to individual attention, programs, and counselors/therapists varies greatly. …