Book Review
Mental Retardation 
Guidebook on Helping Persons with Mental Retardation Mourn Jeffrey Kauffman, John D Morgan, editor. Amityville (NY): Baywood Publishing Company Inc; 2005. 127 p. US$34.95.
Reviewer
rating*: Good
Review by: Bruce D McCreary, MD FRCPC
Kingston, Ontario
Part of the Death, Value and Meaning series, this guidebook sets out to characterize grief in persons with mental retardation and to provide professionals and agencies serving this population with guidance on how to help their clients mourn.
The author, a Philadelphia clinical social worker, says he became aware of the need for work on this topic in 1988. His contribution is based on clinical practice since then. He illustrates his concepts and suggestions with numerous case vignettes from his practice. At the end of the text, he lists several pages of references. Readers looking for a systematic and comprehensive literature review should look elsewhere.
There are 6 chapters. The first includes a general introduction. It defines grief as the “psychological reaction to an experience of loss” and mourning as a healing process that aims to repair the injury of grief. Noting that the importance of grief in persons with mental retardation is often ignored, the author warns us, “When a loss is not evident, that is when there is no link recognized between the loss event and the grief behaviour, the behaviour is seen to be a behavioural or mental health problem” (p 7).
Chapter 2 provides guidelines for supporting and facilitating the mourning process. This chapter is practical, comprehensive, and well illustrated with case material. It includes not only what to do when a death happens, but also how to prepare for the anticipated death of a primary family caregiver. Kauffman’s opinion on the question, “Does a person with mental retardation understand death?” is clearly set out: “All the grieving persons with moderate and mild retardation with whom I have worked grasp, in their lived experience of loss, the concept of irreversibility, and the firmness of this grasp does not appear to be less than that of other humans” (p 17).
Chapters 3 and 4 focus on some special issues that arise in assisting those with mental retardation. Included are the high prevalence of behavioural disruptions, somatization, chronic anxiety, and compulsivity in patients who have experienced a significant loss. These are topics that may be particularly relevant for psychiatrists who are asked to consult when such problems occur. Indeed, the most important message for psychiatrists is to recognize the possible link between these problems and a death that may have occurred months, or even years, earlier.
Psychiatrists will be less interested in Chapter 5, which is concerned with assisting agencies serving persons with mental retardation create supportive programs for clients experiencing loss. Chapter 6, the shortest in the book, allows the author to remind himself, and us, that despite their intellectual impairments, distressed persons with mental retardation can be intuitively empathetic in group treatment focused on issues of loss and grief.
Jeffrey Kauffman has successfully described what we need to know about helping persons with mental retardation mourn. Although his approach is put forth in a psychodynamic framework, much of the book is essentially practical and will be useful to front-line agency staff as well as to mental health professionals. The text is attractive in layout and free of production errors.
The price is reasonable.
*Reviewer
Rating Scale/ Échelle d’évaluation du réviseur
Excellent / Excellent
Very Good / Très bon
Good / Bon
Fair / Passable
Not recommended / Pas recommandé
|
