Abstract
This Manual is another worthy product in the series of practical guides for clinicians involved in early psychosis intervention. The Manual was prepared by the EPPIC group program staff with the assistance of the EPPIC Statewide Services and the Mental Health Branch, Department of Human Services (Victoria). The Manual is a work in progress and is designed in loose sheet format to facilitate section updating. It is divided into eight digestible units that contain a good balance of theoretical and practical information. The impact of psychosis and the relative importance of group intervention for young people who are in transition between parental and marital families, are reviewed from the perspective of adolescent development. Group objectives and processes are described according to stage-of-illness (acute phase; early recovery, representing the first three months of treatment; prolonged recovery, referring to the interval between 3 and 12 months after initiating treatment; and, late recovery, referring to the interval between 12 and 24 months after initiating treatment). Although they may be problematic because of very brief durationofstay, inpatient groups are given particular attention. The manual gives good reasons for conducting inpatient groups, not the least being as a strategy to re-engage younger people in group experiences. The manual is very much an EPPIC production. The upside of this is that the information, based on the years of experience the group has had, is beautifully presented and easily accessible to the reader. It contains a host of sensible and innovative ideas. It also has the stamp of Professor Patrick McGorry which can be seen, for example, in the emphasis given to the distinction between rehabilitative approaches to group work (focusing on specific deficits) and a preventive approach (focusing on recovery through mastery and competence). Irrespective of the validity of this distinction, it may be off-putting to some rehabilitation clinicians. The down side to this EPPIC production is its virtually exclusive focus on the EPPIC group program itself. The five-stream group program of EPPIC may seem a little out of reach to the average group worker who probably is doing well if able to implement even a single group. The difficulties faced by solo clinicians working in routine service delivery settings in simply achieving patient attendance for a group, let alone their engagement in the group processes, could have been given more focus. The perennial problem of trying to match too few young patients with early psychosis who are at the same stage of illness and with relatively similar needs, requires addressing in future updates. Another issue not addressed is what to do when group members share more than their experiences – for instance when substance use becomes a group activity.
An excellent aspect of the Manual is the guidance given to the planning process in establishing a group program. The steps of carefully identifying the needs of the patients in the particular service setting, articulating the group objectives around those needs, and then implementing a feasible program designed to address those objectives are clearly presented. It is encouraging to see a section of the Manual dealing with informal and formal aspects of evaluation. Another useful feature of the Manual are the appendices which include examples of form layouts for describing groups and group activities, evaluation summaries, and for referral information. The worked examples are even more useful. This Manual is essential for every early psychosis program, as are the first two in the series. It also provides valuable information for anyone planning or conducting groups for young people with any type of psychiatric disorder. Overall, the Manual is a very impressive first edition.