105 of 105 people found the following review helpful:
5.0 out of 5 stars
Wonderful Book, August 25, 2006
This review is from: Diagnosis Made Easier: Principles and Techniques for Mental Health Clinicians (Hardcover)
1. What makes James Morrison's books special to me
James Morrison has a wonderful quality: He is precise without losing his warmth. From graduate school (I have an M.A. in Psychology), I know the following dilemma: Nobody wanted to make a diagnosis of a patient (and wanted even less to be diagnosed!), because it felt like "putting people in boxes" or "being judgmental"; people were afraid the diagnostic process would be mechanical and heartless, the more so, the more precise one tried to be. Indeed, estrangement between clinician and patient/client is a danger of the diagnostic process. On the other hand, I also saw the opposite: the attempt of being close to a client, to establish warmth and rapport, can blur the clarity with which the client's problems are perceived and described. When diagnosing, it is difficult to have both, precise diagnosing and establishing optimal rapport.
The best way to learn how to unify precision and rapport is to have a mentor who can do this. James Morrison's books on diagnosis are, in my opinion, such a mentor. In every description and discussion of a patient you feel the warmth toward the described patient; at the same time you can clearly see how and why Morrison diagnoses a patient in a certain way. (At times, by the way, he also describes cases when a diagnosis cannot be made.) And he does not only like the patients, he also likes you, the reader, which you will soon feel when you start reading.
In addition, James Morrison writes very well. Reading him is a joy. The descriptions of his patients are personally (not just clinically) interesting: at times you can read it like a novel. He shows humor that is *never* denigrating. And it is, in a way, a very easy read. It is not an easy read because it is fluffy, needs pages to explain a point, or glosses over complicated topics, but because it is structured so well that one thing naturally leads to the next. Dolly Parton supposedly said of herself, "It's quite expensive to look so cheap"; with regard to James Morrison's books I would to say, "I must have been quite difficult writing a book that is so easy to read."
2. Content
The book has three parts:
I. The Basics of Diagnosis, describes the diagnostic method: How to get from the signs and symptoms of a patient to the differential diagnosis (i.e., a list of possible diagnoses), how to put these into a hierarchy (the "Hierarchy of Safety") and how to pick one (or several) as your working diagnosis. He discusses how to deal with conflicting information, missing information, uncertainty, and possible comorbid diagnoses in this process. Morrison stresses how important it is to "cast a wide net", i.e., consider a wide range of diagnoses in the beginning to avoid narrowing oneself down too fast with the danger of possibly missing the correct choice.
II. The Building Blocks of Diagnosis, covers (a) what information we might want to get, beyond and apart from just a symptom list, to understand the whole patient as a human being, (b) the connection between physical and mental illness, covering especially the case that a physical or substance problem causes the patient's mental symptoms, and (c) the role of the Mental Status Examination in a short summary.
III. Applying the Diagnostic Techniques, discusses in depth diagnostic problem fields (such as Mood Disorders, Anxiety Disorders, Psychoses, Cognitive Disorders, Substance Use Disorders, and Personality Disorders), each in a seperate chapter. (I am not through reading this part of his book.)
3. Relationship to Morrison's other books
Part I, in which the diagnostic method is explained, was covered in a shorter version in his "The First Interview" (Ch. 18). I am very thankful to be able to read this material in an elaborated version, enriched with more discussion and case studies. Part II covers material that Morrison already covered in much greater detail in his "The First Interview" and in "When Psychological Problems Mask Medical Disorders" (both of which I highly recommend). But Morrison did not just copy-paste this part from his older books, but wrote these chapters anew. Thus, I did not find it boring to read them; rather, they presented a helpful summary of what I already knew. Part III (which I have just started) seems to cover material that Morrison already wrote about in his "DSM-IV Made Easy". But he arranged it very differently. Currently, I have the impression that it goes beyond his "DSM-IV Made Easy" insofar as it discusses details and subtleties not thus discussed in his earlier book. E.g., he gives very nice "decision trees". It may be that it is helpful to have a basic knowledge of mental health diagnosis if one wants to get the most out of this part, as it discusses details that a beginner may not be able to appreciate. Whatever, I always feel it is helpful to read cases and case discussions, as these discussions somehow sink into my unconscious and, in the long run, help me make better decisions for my patients.
4. For whom
I think this is a good book for any student of mental health diagnosis, be it as a clinical psychologist, psychiatrist, psychotherapist, social worker, psychiatric nurse, or psychiatry intern. As a refresher, and if you think you have some bad diagnostic habits that you might want to challenge, I think it would also be interesting for more experienced diagnosticians. (I do not think that lay people would be really interested in this book, although I do think an intelligent lay person with a batchelor in any field would probably understand it.) Should you read this book if you have read his other books? Well, I think it can hone your skills, deepen your knowledge, refresh things you might have forgotten--and it won't be boring.
I wrote this to give something back in return for all the help I received, personally and professionally. I hope this was helpful to you, the reader.
Help other customers find the most helpful reviews
Was this review helpful to you? Yes
No
