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Book Forum: Psychotherapies   |    
Treating Adult and Juvenile Offenders With Special Needs
GREGORY B. LEONG, M.D.
Am J Psychiatry 2002;159:508-508. doi:10.1176/appi.ajp.159.3.508
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Tacoma, Wash.

Edited by José B. Ashford, Bruce D. Sales, and William H. Reid. Washington, D.C., American Psychological Association, 2001, 518 pp., $49.95.

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The multidisciplinary editorship of this book, representing social work (Ashford), psychology (Sales), and psychiatry (Reid), has coalesced to produce a rare commodity, a multidisciplinary tome devoted to treatment of those from the criminal justice world. Although only Dr. Reid may be a familiar name to psychiatrists, Drs. Ashford and Sales are prominent in their respective fields. The editorial triumvirate travels beyond the simplistic "mad and bad" paradigm. Instead, the book revolves around the theme of "special needs," defined as "any changeable factors associated with disorders of cognition, thought, mood, personality, development, or behavior that are linked to desired outcomes for offenders at any phase of the justice process." With this theme, the book specifically explores the special needs of offenders with conduct disorder, antisocial personality, psychopathy, substance abuse, mental retardation, educational disabilities, and suicidal potential. The book also devotes separate chapters to three classes of offenders that fall under the special needs rubric, i.e., sex offenders, violent offenders, and insanity acquittees (although insanity acquittees technically are not offenders and often fall in the shadow world between the correctional and mental health systems). Unlike many books on forensic and correctional mental health, this book covers both the adult and juvenile populations of offenders.

As with all multiauthored books, there is chapter-to-chapter variability in writing style. In addition, because each chapter is self-contained, some material is repeated throughout the book. Nonetheless, there are many excellent chapters; the editors have gathered an impressive array of authors. Each chapter provides an in-depth overview of the current knowledge base of the specific topic and numerous references.

The chapters on mental retardation, research on the treatment of adult sex offenders, and release decision making may be particularly enlightening for general psychiatrists because they contain new information and, more important, a different perspective from which to view these difficult clinical challenges. For the forensically inclined, the chapters on treatment rights and release decision making contain up-to-date compilations in these controversial areas. The multidisciplinary focus of the book serves as an important reminder that the biopsychosocial (or, more aptly, biopsychosociocultural) perspective is alive and well. Many of the clinical findings found throughout the book can be modified and have practical application in the everyday practice of psychiatry and other mental health endeavors. Also, there are repeated references among several chapters that not every offender should have or would benefit from treatment or intervention, a point that is often neglected by both those in the mental health fields and the general public.

This book should definitely find a place in the libraries of psychiatrists and other mental health professionals who treat the special needs offender, those who contemplate working with this challenging population, and those who have an interest in learning more about the subject.

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