Book Review
Emergency Psychiatry
Crisis Intervention and Counseling by Telephone. 2nd edition. David Lester, editor. Springfield (IL): Charles C Thomas; 2002. 306 p. US$62.95
Reviewer
rating*: Good
Review by: George Voineskos, MD
Toronto, Ontario
The first edition of this book, published in 1973, was edited by David Lester and Gene Brockopp. The creation of the text was inspired by the editors’ experience setting up, operating, and evaluating the suicide prevention and crisis intervention service in Buffalo, New York. The influence of experiences from the Buffalo service has continued into the second edition, with 13 of the 18 contributing authors being associated with the service when the first edition was written. The purpose of this book, as outlined in the preface by the editor, is to stimulate further interest in the telephone as a mode of treatment and to assist those setting up and operating telephone crisis and counselling services—especially those training and supervising front-line workers.
The second edition of the book consists of 26 chapters organized into 6 parts. In the first section, 4 chapters pertain to an overview of telephone use in counselling, a survey of 3 telephone counselling services, and a description of an emergency youth telephone service. Part 2 consists of 8 chapters dealing primarily with therapeutic techniques employed in telephone crisis intervention and in counselling suicidal and other people. Part 3 has 6 chapters, each chapter discussing one of the following problem callers: the obscene caller, the chronic caller, the covert cry for help, the silent caller, the nuisance, and the “one- counselor” caller. Part 4 contains 3 chapters, each detailing a different mode of communication (that is, telephone, e-mail, or letter) for crisis intervention and counselling of the suicidal person. In Part 5, 2 chapters discuss the comparative merits of using professional and nonprofessional workers in telephone crisis intervention. A third chapter outlines criteria for selecting and firing volunteer crisis counsellors, and the fourth chapter describes training requirements. Part 6 is devoted to the evaluation of telephone suicide-prevention and crisis-intervention services.
About one-third of the chapters have been replaced or drastically changed in the second edition. Other chapters have been revised and updated as necessary. Some of the chapters are very good. The problem callers discussed in Part 3 are realistic and will be useful both to persons operating telephone crisis lines and to psychiatric emergency room (ER) staff who receive telephone calls from people in distress. Several cases are reported and are well described. The advice on management is clear and practical. The therapeutic techniques covered in Part 2 are based on diverse theoretical approaches, such as cognitive therapy, transactional analysis, or gestalt therapy. However, while these techniques could provide a suitable framework for face-to-face crisis intervention and counselling, their application over the phone would be difficult. In contrast, the generic framework for responding to callers as described in Chapter 6 is excellent. This framework is derived from the pioneering approach of the Los Angeles Suicide Prevention Centre and will be applicable to a large variety of callers.
Overall, the chapters of the book are uneven, both in length and utility. The section that overviews telephone counselling digresses into various unrelated hotlines and even into telephone use in psychoanalysis. Some chapters are 4 times longer than their neighbouring chapters, with considerable duplication between sections. Although the editor explains in the preface that “this overlap has not been eliminated so that each chapter can stand alone as a complete essay,” the book would have been strengthened had the duplication been addressed. Written primarily from an experiential viewpoint, the text is coherent and almost free of production errors. The references enhance the text, and the subject index is useful. The book fulfills one of the stated purposes: to assist those who operate telephone crisis and counselling services—both nonprofessional front-line workers and their supervisors. It will also be helpful to psychiatric ER staff, who receive telephone calls from the public. However, the book fails to stimulate interest in the telephone as a mode of treatment. The editor’s inclusion of the Internet as a mode of crisis intervention is commendable. It would be interesting to consider the future of the Internet for crisis work when current youth (who make enormous use of the Internet for instant communication) grow into adulthood. The price of the book is reasonable.
*Reviewer
Rating Scale/ Échelle d’évaluation du réviseur
Excellent / Excellent
Very Good / Très bon
Good / Bon
Fair / Passable
Not recommended / Pas recommandé
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