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Martindale, B.V. (1999). Schizophrenia: Its Origins and Need-Adapted Treatment by Yrjo O Alanen. Published by Karnac Books, London, 1997; 312 pages; £24.95 paperback. Brit. J. Psychother., 16(2):232-235.

(1999). British Journal of Psychotherapy, 16(2):232-235

Schizophrenia: Its Origins and Need-Adapted Treatment by Yrjo O Alanen. Published by Karnac Books, London, 1997; 312 pages; £24.95 paperback

Review by:
Brian V. Martindale

In the opening words of his foreword Stephen Fleck, Emeritus Professor of Psychiatry at Yale University, considers that this book ‘…may be the most comprehensive treatise on schizophrenia… since [that of] Manfred Bleuler’ [published in 1972].

As the reviewer of the book, I therefore have the challenge of making a judgement as to whether it merits this acclaim and of clarifying whether it is an important enough book for readers of this psychotherapy journal.

The book's greatest value is in its description and illustrations of a particular model of therapy and care for those who are vulnerable to schizophrenia. This has been developed in Finland and is radically different in its conceptualization and practice from that which we usually witness. In Britain, treatment for schizophrenia can be generally characterized as based on a biologically-orientated model. Treatment is centred on ‘compliance’ with long-term ‘anti-psychotic’ medication together with support services for the individual and family of very varying degrees of availability and sophistication. I wish to stress that even proven psychological approaches with very limited goals remain rarely implemented in the UK. I am thinking, for example, of the well-respected and replicated research work of Leff who has convincingly shown that specific interventions significantly reduce relapse rates in families with high levels of ‘expressed emotion’ and/or excessive hours of contact between sufferer and family (Leff et al.

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