Academic journal article American Journal of Psychotherapy

Martha L Crowner: Understanding and Treating Violent Psychiatric Patients

Academic journal article American Journal of Psychotherapy

Martha L Crowner: Understanding and Treating Violent Psychiatric Patients

Article excerpt

MARTHA L. CROWNER, ED.: Understanding and Treating Violent Psychiatric Patients. Washington, DC: American Psychiatric Press, 2000, 192 pp., $34.95, ISBN: 0-88048-752-6.

This book, from the Progress in Psychiatry series of the American Psychiatric Press, offers an interesting and varied set of views regarding the treatment of psychiatric patients who are violent. It does not pretend to be a comprehensive treatise on the topic; rather it is an update on some salient issues of potential interest. It will be especially useful to those engaged in the long-term treatment of violence in institutional settings. It is particularly strong in providing information about behavioral approaches, although the chapters vary in theoretical approach. Overall, it has more to do with technique than insight, behavior rather than cause. The word "understanding" in the title may be taken as something of a technical term; certainly, each ounce of understanding is appreciated in the face of violence on the psychiatric ward.

Chapter I deals with the assessment and pharmacological treatment of violent adult inpatients. The assessment aspect of the chapter is helpful for those working in applicable settings. The medication review is interesting, but does not venture enough into newer agents and unproven (but possibly effective) options. There is a relative paucity of studies on the psychopharmacology of violence, and practitioners often have to venture beyond the hard data.

Chapter II ably discusses the assessment of violence in children and adolescents, although I would have liked to have seen more about the sociological and media roles in precipitating violence in children. Chapter III focuses on acute management of inpatient violence follows, emphasizing behavioral approaches. Chapter IV continues the coverage of behavioral techniques. Chapter V concentrates on a social learning approach to hospital treatment of violent patients (including a comprehensive token economy). As something of a set, these three chapters are well-researched and provide considerable depth on the theory and techniques of these methods. …

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