106 BookRtllI~W8
The remainder of the papers in the volume include discharge issues for psychiatric
patients, eg concerns about leaving hospital, future plans and resource issues, shortterm
group therapy for fathers incarcerated in maximum security psychiatric hospitals, focusing
on their relationships with their children; and, [mally, an interesting and useful article on
educational and occupational issues concerning chronic psychiatric patients, which uses a
systematic approach to familiarise participants with a number of aspects of employer
organisations.
This book discusses a number of workable approaches to group therapy which could be
implenlented in a variety of Zimbabwean clinical settings.
Reviewed by Angela Davies, Family Counselling Unit, Harare
People Care in Institutions: a Conceptual Schema and Its Application, Yochanan
Womer, Haworth Press, New York, 1991 (237pp, US$19,95 pbk, US$29,95 hbk, ISBN 1
56024 012 1 hbk, 1 56024 082 2 pbk).
(Monograph was published simultaneously as Child and Youth Services, Vol 5, No 1.)
The author uses the word internat as a label for any residential institution "in which persons,
for some period of their lives, do not live in the culturally familiar and normatively preferred
familial arrangement". He includes boarding schools, homes for children and the aged,
hospitals, p:isons, monasteries and others, and makes the point that all internats are agents
for change (whether this is explicitly defined or not).
He presents a schema by which certain dimensions of internat life and function can be
evaluated and planned interventions made to ensure that change is goal-directed and
purposeful rather than random. This analysis is multi-level.
The axes of autocracy/democracy and total/partial internats are then placed in relation
to these axes. They are then placed also in terms of whether they are instrument or container
internats. This axis refers to whether the internat is organised primarily to address the
developmental needs of the internees, in which case interpersonal relationships "constitute
an important and sometimes major factor in the internat's work" (eg a commune) or whether
it is a grouping of people and appliances collected "to perform a task which could just as well
be performed elsewhere except for logistical expediency" (eg a hospital).
The communication feedback loop which connects motivation, participation and
attention is discussed, as is the ecosystemic mapping of the internee, staff and environment
sets. Most of the book, however, is concerned with a problem-solving approach applied to
an analysis of quality of internat life, showing how specific issues related to the internal's
fundamental goals or principles can be addressed in a very practical way, and solutions can
be generated and then evaluated and checked.
I found the approach stimulating. The book does just what the title suggests: it presents
a schema whereby those running residential institutiOns can analyse exactly what is
happening and why, and make corrections to ensure that change is in a positive direction.
I would recommend this as essential reading for all institutional staff, and useful even for
those whose care of people is in a non-residential context.
Reviewed by Margaret Hem1ing, Family Counselling Unit, Harare, Zimbabwe.