alternative to drug therapy
Rehabilitation proponent's revised text stresses supported education for
To many mental health professionals, the title of William Anthony's 1990
college textbook, Psychiatric Rehabilitation, probably seemed like an
oxymoron when it was published.
"It wasn't a widely held notion 10 years ago that people could recover
from serious mental conditions like schizophrenia or bipolar disorder,"
says Anthony, a professor of rehabilitation counseling at Sargent College
of Health and Rehabilitation Sciences and executive director of SAR's
Center for Psychiatric Rehabilitation (CPR). "It was generally believed,
among people in the helping professions as well as members of the public,
that the conditions of such people deteriorated over time."
A proliferation of research during the past decade, however, has shown
that people with mental illnesses once considered chronic and incurable
can improve, and even fully recover, if allowed to reclaim their confidence
through treatment programs that teach basic life and social skills. The
latest treatment methods are outlined in the second edition of Psychiatric
Rehabilitation, published this year by CPR.
One of the new concepts discussed in the book is supported education,
which was developed largely at the center. "In the past, it was thought
that people who dropped out of school because of serious psychiatric disabilities
never could return," says Anthony. "But we've shown that with
the right kinds of support, they can return and be successful, even at
the college level."
Through its own supported education program, CPR provides training in
computers, healthy living practices, and life skills for about 100 people
each year. The goal is to prepare mentally ill adults to pursue course
work at community colleges or to get a job. The Massachusetts Department
of Mental Health has adopted the concept, and with BU's help, has created
similar programs across the state over the past 10 years.
"Another important concept in the book is that of empowerment: that
people with disabilities should be encouraged to make decisions about
their life," says Anthony. "That idea was literally unheard
of a decade ago. Instead, clinicians tended to tell patients what to do
and to try to control and direct their actions. Now we realize the importance
of giving them the opportunity to change their own lives."
Such treatment strategies likely will seem foreign to many psychiatrists,
psychologists, social workers, and nurses, Anthony says, because most
textbooks still do not include research findings about rehabilitation,
focusing rather on the use of drugs to stabilize a patient's behavior.
"The field of mental illness has traditionally been based on the
idea that recovery is not possible, and now we have a new vision,"
says Anthony. "The challenge now is to design more programs that
facilitate recovery rather than impede it."
All proceeds from the sale of Psychiatric Rehabilitation benefit CPR,
which was created in 1975 and was one of the first centers in the world
to research recovery from mental illness. The book was authored by Anthony,
the late Mikal Cohen, who was a SAR associate professor of rehabilitation
counseling and executive director of CPR, Marianne Farkas, a SAR research
associate professor of rehabilitation counseling and director of CPR's
training division and international division, and Cheryl Gagne, a SAR
adjunct instructor of rehabilitation services and senior training associate
For more information about the Center for Psychiatric Rehabilitation,