Cancro, R., Fox. N., and Shapiro, L. E., eds. STRATEGIC INTERVENTION IN SCHIZOPHRENIA. CURRENT DEVELOPMENTS IN TREATMENT New York: Behavioral Publications, 1974, 326 pp., $14.95.
The wide variety of approaches to schizophrenia presented in this book reflects the current state of thinking about this disorder. Cancro, Fox, and Shapiro have arranged for editing or expanding of papers that were presented at a symposium sponsored by the Joint Committee on Schizophrenia, New York State District Branches, American Psychiatric Association. Several additional papers were elicited to round out the scope of the volume.
Zubin, in a short foreword, presents the requirements for the effective treatment (planned intervention) of any disorder - with specific concern for schizophrenia, whose essential nature remains elusive. In the absence of sufficient knowledge of the causes and nature of a disorder, determining when and how best to intervene is often a difficult and less than precise decision. In order to learn as much as possible about schizophrenia, Zubin suggests the use of scientific enologie models, which should be pursued to their limits; ecologie, developmental, learning, hereditary, internal environmental, and neurophysiologic models are described. He recognizes that the problems of determining the effectiveness of treatment are great indeed - in part, at least, because of the lack of objective criteria of outcome and because of the subjective prejudices of those who attempt to evaluate.
The articles are placed in three main categories, with the first having to do with various forms of psychotherapy - individual, family, and group. The authors are Will, Harris, Wynne, and Rubinstein. The second group contains writings by Lehmann on somatic and pharmacologic treatment, by Paul on experimental-behavioral approaches, and by Hagaman and Van Witsen on early intervention in childhood schizophrenia. The third section includes articles by Herz and by Gruenberg on the indications for community care and hospitalization, by Becker on the role and modes of rehabilitation, and by Mosher on extramedicai treatment (the "antipsychiatry" approach).
Depending on one's orientation, some of the articles are reassuring, others are disquieting. All are characterized by an essentially optimistic and active attitude towards a potentially crippling disorder, rather than a fatalistic concept of an inalterable disease state. There are no short cuts for the concerned therapist, but only reminders that taking on the challenge of schizophrenia will often require prolonged efforts on the part of everyone.