An Integrated Approach to Family Work for Psychosis: A Manual for Family Workers. By Gina Smith, Karl Gregory & Annie Higgs. Jessica Kingsley Publishers. 2007. 208pp. £18.99 (pb). ISBN 9781843103691

This book is written by experienced clinicians with a genuine passion, enthusiasm and commitment to working with families. It is clear that they have been attempting for years to implement a family approach to care. Their attitude to families is without fault – empathic, humble, respectful of their feelings, experiences, and strengths. It is confirmed by glowing testimonials from family members who have benefited from their help. Their book advocates a non-prescriptive, non-formulaic approach to family work that is individualised and flexible.

The book is divided into two sections: section one deals with the ‘what, why, who, when and where’ of family work; section two covers preparation, assessment, managing meetings with families, and how to promote recovery. Throughout, there is useful guidance on a range of practical issues, such as note-keeping, venues for family meetings and the importance of supervision.

The authors describe a particular model of family work, based primarily on the approach developed by Julian Leff and colleagues. It is very much a mental illness model which regards co-working as essential (p. 84). However, not all psychoeducational family approaches comply with this model, and the strict adherence to it as proposed in the book is at odds with the overall flexibility otherwise advocated here. It would have been helpful if the authors had alerted the reader to different models of family work in psychosis, embracing those that marry systemic and family management models and describing how the various models differ.

The book is probably best used as an adjunct for people in training, rather than as a stand-alone manual. Some quite complex concepts, such as enmeshed or estranged relationships, rigid and diffuse boundaries etc., are discussed briefly, but it would have been helpful to have more detail on the actual content of sessions with families.

Although the book might seem repetitive, with text boxes, summaries and key points in each chapter, overall it is a useful practical manual for those delivering family work.