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media review
NEDT 00-0651.qxd 09/07/2001 7:55 pm Page 501
Book/media reviews Article
Book/media reviews An A–Z of Counselling Theory and Practice (3rd edition) W. Stewart Nelson Thornes, 2001 ISBN: 0-7487-5710-4, 471 pages Price: £24.50
As the title implies, this is an alphabetically organized reference book for students of counselling. This subject should be of interest to all nurses as so much of our work involves interpersonal communication. As a teacher of both counselling and nursing, I decided to enlist the help of the target readership, namely students themselves, in the reviewing of this book in order to gain a collective view of its usefulness. In addition to my students’ help, I also used this as a reference book for a 4-week period of my teaching in order to assess its usefulness for background reading for teachers and practitioners. My first teaching task was to prepare a session on ‘Solution Focused Brief Therapy’, which did not merit an inclusion in the book (Brief Therapy did but was too brief to be of any real use). The subsequent session was on ‘Communication and Interpersonal Skills for Nurses’. Unfortunately I could find nothing on these skills either. Not a good start. It must be difficult to decide what and what not to include with any type of encyclopaedia, to please ‘all of the people all of the time’ would probably produce a book four times the volume and subsequently unmarketable. I feel duty bound, however, to observe a few anomalies. The book lists 16 types of therapies and approaches that do not include an entry for integrative approach, which is surprising, as colleges around the UK teach this approach. ‘Atonement’, ‘parable’ and ‘forgiveness’ all find a place, but ‘gender’ and ‘sexual orientation’ do not. This I find inexplicable. In spite of being an updated (3rd edition), this book does retain an old fashioned feel. So, with no opportunity to practically test its contents I decided to dip into various sections at
© 2001 Harcourt Publishers Ltd doi:10.1054/nedt.2001.0651, available online at http://www.idealibrary.com on
random. Transference is a topic many novice students struggle with so I decided to evaluate that chapter. The writer gives a brief and succinct explanation of the theory and then gives examples from Freud, Jung and Rogers. It was helpful to ground the concept in both psychodynamic and humanistic theory. A brief vignette to give an example from practice could have enhanced the chapter. I shall give over the rest of this review to the people that really matter: my students. Student A – Communication: This section begins with a confusing and unnecessarily technical definition. Greater clarity is achieved as the chapter progresses; the layout is easy to follow and suggestions about effective communication are useful. Non-verbal communication is dealt with under its own heading but there is no crossreference to this, which leaves the chapter inadequate. Student B – Anorexia Nervosa: The chapter begins with a general introduction to the subject including statistics, which illustrate the association with females. Bullet points under headings including symptoms, causes and prevention present the remainder of the chapter. This is a very bland and matter of fact way of presenting this information, and did not really seem to incorporate any new information. There is very little attention given to therapeutic interventions, which is disappointing. Student C – Aggression – Paranoia: The chapters were beneficial for a short definition and discussion of the difference between professional and lay language. I found that the overgeneralizing nature of the content of the chapters made them of little use. Student D – Forgiveness: Overall this seemed an excellent chapter. I believe it really got to the heart of the meaning. The last sentence about it being ‘an act of will’ could have included something about letting go of the past. Holding on to unforgiveness becomes revenge. Student E – Psychodynamic Counselling: I found the first paragraph hard to grasp until I had read
Nurse Education Today
(2001) 21, 501–504
501
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Book/media reviews
it many times. I got a bit confused again in the 4th and 5th paragraphs which talk about insight and feelings. I found the last paragraph a bit heavy going, but that is probably because I do not know enough about this theory. I have to conclude that, from practical experience, the usefulness of this book is very limited other than as a very basic and cursory textbook. Maybe, however, that is the niche in the market this book can fill. Theodore Stickley Project Development Nurse, Nottinghamshire Healthcare NHS Trust and Teacher/Practitioner University of Nottingham, Nottingham, UK doi:10.1054/nedt.2001.0651, available online at http://www.idealibrary.com on
Integrated Care Pathways: A practical approach to implementation Sue Middleton and Adrian Roberts (Eds) Butterworth Heinemann, Oxford, 2000 ISBN: 0-7506-4087-1, 151 pages Price: £16.99
The health service is felt to be increasingly out of step with what is required by both patients and carers. The primary objective of the NHS is to provide quality health care to patients. It has been suggested that we are increasingly loosing sight of this objective and do not always do the right thing at the right time for patients and carers (Department of Health 1999). The current Labour government has identified a plan for a modernized health service. For this vision to reach fruition requires major reform and investment and for those of us providing that care major change. Developments such as robust systems of Clinical Governance, redesign of patient processes and patient partnerships are seen to be an integral part of the way in which the health services are to ensure quality for the consumer (DOH 2000). The development of pathways of care that contain best practice supported by evidence where it exists is seen as one tool by which to facilitate continuous improvement in the quality of patient care (Johnson 1997, Currie 1998, NHS Executive Trent 1998). However, the development of Integrated Care pathways (ICPs) is not always the right approach and will not be appropriate in
502
Nurse Education Today
(2001) 21, 501–504
every clinical situation. Professionals aiming to develop and use ICPs need to fully understand the essential elements of an ICPs, the perceived benefits, expected outcomes and how to successfully initiate, implement and evaluate the change in practice, if they are to plan for success. In this text, Middleton and Roberts aim to provide that essential practical guide for professionals considering the development, implementation and evaluation of ICPs. The book is divided into three logical and easy to follow sections, in essence: What are pathways; Why use them; and How to develop and introduce them. The first two sections form the basis of an introduction, defining the essential elements of ICPs and giving examples of how pathways can support evidence based practice, ensure cost effective service and meet the Clinical Governance agenda. On the whole this is not new information (Johnson 1997, Currie 1998), but nevertheless is essential to the reader (especially the novice) to put the potential use of ICPs into context within the health service. Often missing from the other available literature is practical advice on techniques for professionals wanting to develop and implement ICPs. Guidance to assist the practitioner to turn the theory into reality in a systematic and practical way is essential for successful implementation, especially for the novice. Pathways do fail for a variety of reasons (Hotchkiss 2000). However, the main challenge for professionals developing ICP is not only the writing of the pathway document itself but the approach employed to facilitate the involvement of all the key stakeholders. Gaining commitment from all involved and reducing the potential for noncompliance is to a great extent minimized by ensuring meaningful participation at every stage (NHS Executive Trent 1998). A large proportion of section three considers how to develop, introduce and evaluate care pathways. Providing useful advice on how to ‘get started’ ranging from selecting patient groups, defining the scope, mapping the current situation, developing the documentation and evaluation. However it does not fully address the issue of how to develop the mapping of the current situation into the optimum pathway. More attention to the role of the facilitator, project management, change management techniques, and process redesign methodologies would all have considerably enhanced this section.
© 2001 Harcourt Publishers Ltd
Book/media reviews Article
Book/media reviews An A–Z of Counselling Theory and Practice (3rd edition) W. Stewart Nelson Thornes, 2001 ISBN: 0-7487-5710-4, 471 pages Price: £24.50
As the title implies, this is an alphabetically organized reference book for students of counselling. This subject should be of interest to all nurses as so much of our work involves interpersonal communication. As a teacher of both counselling and nursing, I decided to enlist the help of the target readership, namely students themselves, in the reviewing of this book in order to gain a collective view of its usefulness. In addition to my students’ help, I also used this as a reference book for a 4-week period of my teaching in order to assess its usefulness for background reading for teachers and practitioners. My first teaching task was to prepare a session on ‘Solution Focused Brief Therapy’, which did not merit an inclusion in the book (Brief Therapy did but was too brief to be of any real use). The subsequent session was on ‘Communication and Interpersonal Skills for Nurses’. Unfortunately I could find nothing on these skills either. Not a good start. It must be difficult to decide what and what not to include with any type of encyclopaedia, to please ‘all of the people all of the time’ would probably produce a book four times the volume and subsequently unmarketable. I feel duty bound, however, to observe a few anomalies. The book lists 16 types of therapies and approaches that do not include an entry for integrative approach, which is surprising, as colleges around the UK teach this approach. ‘Atonement’, ‘parable’ and ‘forgiveness’ all find a place, but ‘gender’ and ‘sexual orientation’ do not. This I find inexplicable. In spite of being an updated (3rd edition), this book does retain an old fashioned feel. So, with no opportunity to practically test its contents I decided to dip into various sections at
© 2001 Harcourt Publishers Ltd doi:10.1054/nedt.2001.0651, available online at http://www.idealibrary.com on
random. Transference is a topic many novice students struggle with so I decided to evaluate that chapter. The writer gives a brief and succinct explanation of the theory and then gives examples from Freud, Jung and Rogers. It was helpful to ground the concept in both psychodynamic and humanistic theory. A brief vignette to give an example from practice could have enhanced the chapter. I shall give over the rest of this review to the people that really matter: my students. Student A – Communication: This section begins with a confusing and unnecessarily technical definition. Greater clarity is achieved as the chapter progresses; the layout is easy to follow and suggestions about effective communication are useful. Non-verbal communication is dealt with under its own heading but there is no crossreference to this, which leaves the chapter inadequate. Student B – Anorexia Nervosa: The chapter begins with a general introduction to the subject including statistics, which illustrate the association with females. Bullet points under headings including symptoms, causes and prevention present the remainder of the chapter. This is a very bland and matter of fact way of presenting this information, and did not really seem to incorporate any new information. There is very little attention given to therapeutic interventions, which is disappointing. Student C – Aggression – Paranoia: The chapters were beneficial for a short definition and discussion of the difference between professional and lay language. I found that the overgeneralizing nature of the content of the chapters made them of little use. Student D – Forgiveness: Overall this seemed an excellent chapter. I believe it really got to the heart of the meaning. The last sentence about it being ‘an act of will’ could have included something about letting go of the past. Holding on to unforgiveness becomes revenge. Student E – Psychodynamic Counselling: I found the first paragraph hard to grasp until I had read
Nurse Education Today
(2001) 21, 501–504
501
NEDT 00-0651.qxd 09/07/2001 7:55 pm Page 502
Book/media reviews
it many times. I got a bit confused again in the 4th and 5th paragraphs which talk about insight and feelings. I found the last paragraph a bit heavy going, but that is probably because I do not know enough about this theory. I have to conclude that, from practical experience, the usefulness of this book is very limited other than as a very basic and cursory textbook. Maybe, however, that is the niche in the market this book can fill. Theodore Stickley Project Development Nurse, Nottinghamshire Healthcare NHS Trust and Teacher/Practitioner University of Nottingham, Nottingham, UK doi:10.1054/nedt.2001.0651, available online at http://www.idealibrary.com on
Integrated Care Pathways: A practical approach to implementation Sue Middleton and Adrian Roberts (Eds) Butterworth Heinemann, Oxford, 2000 ISBN: 0-7506-4087-1, 151 pages Price: £16.99
The health service is felt to be increasingly out of step with what is required by both patients and carers. The primary objective of the NHS is to provide quality health care to patients. It has been suggested that we are increasingly loosing sight of this objective and do not always do the right thing at the right time for patients and carers (Department of Health 1999). The current Labour government has identified a plan for a modernized health service. For this vision to reach fruition requires major reform and investment and for those of us providing that care major change. Developments such as robust systems of Clinical Governance, redesign of patient processes and patient partnerships are seen to be an integral part of the way in which the health services are to ensure quality for the consumer (DOH 2000). The development of pathways of care that contain best practice supported by evidence where it exists is seen as one tool by which to facilitate continuous improvement in the quality of patient care (Johnson 1997, Currie 1998, NHS Executive Trent 1998). However, the development of Integrated Care pathways (ICPs) is not always the right approach and will not be appropriate in
502
Nurse Education Today
(2001) 21, 501–504
every clinical situation. Professionals aiming to develop and use ICPs need to fully understand the essential elements of an ICPs, the perceived benefits, expected outcomes and how to successfully initiate, implement and evaluate the change in practice, if they are to plan for success. In this text, Middleton and Roberts aim to provide that essential practical guide for professionals considering the development, implementation and evaluation of ICPs. The book is divided into three logical and easy to follow sections, in essence: What are pathways; Why use them; and How to develop and introduce them. The first two sections form the basis of an introduction, defining the essential elements of ICPs and giving examples of how pathways can support evidence based practice, ensure cost effective service and meet the Clinical Governance agenda. On the whole this is not new information (Johnson 1997, Currie 1998), but nevertheless is essential to the reader (especially the novice) to put the potential use of ICPs into context within the health service. Often missing from the other available literature is practical advice on techniques for professionals wanting to develop and implement ICPs. Guidance to assist the practitioner to turn the theory into reality in a systematic and practical way is essential for successful implementation, especially for the novice. Pathways do fail for a variety of reasons (Hotchkiss 2000). However, the main challenge for professionals developing ICP is not only the writing of the pathway document itself but the approach employed to facilitate the involvement of all the key stakeholders. Gaining commitment from all involved and reducing the potential for noncompliance is to a great extent minimized by ensuring meaningful participation at every stage (NHS Executive Trent 1998). A large proportion of section three considers how to develop, introduce and evaluate care pathways. Providing useful advice on how to ‘get started’ ranging from selecting patient groups, defining the scope, mapping the current situation, developing the documentation and evaluation. However it does not fully address the issue of how to develop the mapping of the current situation into the optimum pathway. More attention to the role of the facilitator, project management, change management techniques, and process redesign methodologies would all have considerably enhanced this section.
© 2001 Harcourt Publishers Ltd