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Book Forum: Therapies for Psychosis   |    
Personal Therapy for Schizophrenia and Related Disorders: A Guide to Individualized Treatment
Am J Psychiatry 2004;161:1317-a-1317. doi:10.1176/appi.ajp.161.7.1317-a
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Toronto, Ont., Canada

By Gerard E. Hogarty. New York, Guilford Publications, 2002, 338 pp., $39.00.

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Gerard Hogarty, a social worker and research scientist, is Professor of Psychiatry at Western Psychiatric Institute and Clinic, University of Pittsburgh. It was his research in the early 1970s that proved the efficacy of drug treatment in preventing rehospitalization for schizophrenia, and the same research clearly showed the scientific world that drugs alone were not enough. Hogarty’s research agenda has been straightforward ever since: to clarify the elements of social therapy that add to the efficacy of drugs and to integrate the two approaches into a seamless whole. He has carefully scoured the literature on patients’ personal experience with this illness, on subjective and objective signs of prodrome and recovery, on what helps at different stages of illness, and on theories of why it works. He has kept the elements of supportive therapy that empirical research supports and has added a blend of medication management, psychoeducation, alliance building, cognitive strategies, and social skills training. He has tested each element, weeded out the superfluous, and kept the whole flexible and attuned to the individuality of people who may share a diagnosis but differ in many other ways. He has used his clinical skills to pace his interventions pragmatically, keeping an eye out for what individuals can bear at acute, middle, and semirecovered stages of the progression of their illness. He understands that therapy itself can unwittingly make a person ill. And he has packaged all this wisdom into a wonderfully readable book, a practitioner’s guide to the gradually staged and proven-to-be-effective therapy of schizophrenia.

Among the how-to, he has slipped in, almost imperceptibly, theory, mechanisms, even statistics. Students knowing only what’s in this short book would effectively know most of what they need to know about schizophrenia, its theoretical causation, its epidemiology, its evolution, its complex management, its unanswered questions, and its prognosis. The outlook is practical and always hopeful. Achieving stability is possible, asserts Hogarty, but it’s hard work. It needs to draw on a powerful alliance and to persist. It’s a life-long effort. But it works!

Thank you for a great book, Gerard Hogarty.




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