The Chronic Psychiatric Patient in the Community: : Principles of Treatment

The purpose of this book is to present an integrated approach to the treatment of the chronic psychiatric patient living in the com­ munity. This requires that topics as diverse as pharmacokinetics, psychotherapy and community organization be appropriately coor­ dinated. Such an approach is partly complicated by the wide range of differences among patients, in terms of social skills, intellectual capacity and psychiatric diagnosis. In addition, unclear, insular or overlapping roles of various mental health disciplines further con­ found integrated treatment efforts. Given such complexity, any single clinician's point of view is sub­ ject to the distortion inherent in specialization. Too often a volume in the field of mental health focuses either on only one aspect or presents only one clinician's unique perspective of a task that is, in fact, multifaceted. We have tried to avoid this pitfall by having representatives from many of the concerned professions present a variety of treatment approaches and associated issues in one text. Further, the editors have attempted to illuminate the relevant clinical and/or administrative interrelationship between the subjects of each section through a succinct introductory commentary. The book is divided into five sections. The first section represents an attempt to address some of the interactive sociological, psycho­ logical and pharmacological background issues common to all at­ tempts at treatment of this population. Front Matter....Pages i-xiv Front Matter....Pages 1-3 Concepts and Issues in Deinstitutionalization....Pages 5-28 Preserving Chronic Patients’ Assets for Self Care....Pages 29-47 Social Networks and the Long Term Patient....Pages 49-82 Problems in Providing Effective Care for the Chronic Psychiatric Patient....Pages 83-129 Front Matter....Pages 131-136 The Individual Psychotherapies and their Relationship to the Therapeutic Community....Pages 137-158 The Management of the Family of the Chronic Psychiatric Patient....Pages 159-179 The Role of Crisis Intervention in the Management of the Chronic Psychiatric Patient....Pages 181-204 The Vocational Preparation of the Chronic Psychiatric Patient in the Community....Pages 205-239 The Place of the Partial Hospital in the Treatment of Chronic Psychiatric Patients....Pages 241-264 Psychosocial Rehabilitation Centers: Old Wine in a New Bottle....Pages 265-280 Residential Care for the Chronically Mentally ill....Pages 281-308 Front Matter....Pages 309-311 Clinical Experiences and Principles in Selection of Medication....Pages 313-320 Clinical Pharmacology and Side Effects of Antipsychotic and Mood-Stabilizing Drugs used in the Treatment of Psychiatric Patients with Chronic or Recurrent Disorders....Pages 321-381 The Clinical Management of Noncompliance....Pages 383-395 Front Matter....Pages 397-399 Serving Long-Term Patients in the Cities....Pages 401-416 Rural Care: Providing Care for the Chronic Patient Under Conditions of Dispersed Resources....Pages 417-430 The Community as the Treatment Arena in Caring for the Chronic Psychiatric Patient....Pages 431-452 Front Matter....Pages 453-455 Benefit-Cost Analysis and the Care of the Chronic Psychiatric Patient in the Community....Pages 457-474 Advocacy in the Community....Pages 475-495 Judicial Decisions and the Chronic Psychiatric Patient....Pages 497-524 Front Matter....Pages 525-525 Essential Principles in the Delivery of Adequate Clinical Care to the Chronic Psychiatric Patient in the Community....Pages 527-540 Community Survival of the Chronic Psychiatric Patient: Research Priorities....Pages 541-561 Back Matter....Pages 563-570