Patient Practitioner Interaction: An Experiential Manual for Developing the Art of Health Care.

This excellent text deals with the process of professional socialization or induction into a professional role. Too often professional education concentrates solely on techniques and procedures. It is assumed that students will somehow know intuitively how to interact with patients, how to motivate patients to participate meaningfully in treatment goals, how to deal with emotion-laden situations, how to provide constructive support to the dying patient and his or her family, and how to interact effectively with othyer professionals. We often expect that students will just naturally experience healthy personal growth as well--that they will know how to preserve their sense of self-worth and identity and avoid professional burnout. As stated by Purtilo in the foreword of this text, ". . . only in recent years has the socialization process been viewed as ambipotent, that is, a process carrying the power to effect either positive or negative results for health professionals and society." It is the author's purpose to help both students and professionals as they grow toward professional maturity.

The book is both a textbook that offers specific didactic information and references and a workbook that offers specific exercises involving personal reflection and simulated experiences. Readers are encouraged to keep a personal journal of their feelings and thoughts as their growth process unfolds; the way in which the material is presented facilitates this interactional process, allowing for deep personal introspection.

The content of the book is organized into two major sections: awareness of self and interaction with others. Included in the first section are the chapters "Basic Awareness of Self," "Family History," and "Values as Determinants of Behavior." Section 2 includes the chapters "The Nature of Effective Helping," "Effective Communication/Problem Identification," "Assertiveness Skills," "The Helping Interview," "Resolving Ethical Dilemmas," "Communicating with the Dying and Their Families," and "Stress Management/Preventing Professional Burnout."

The author covers diverse topics in a comprehensive manner, using well-selected references to supplement her own opinions and to add flavor to the material. The text is informative, yet flows easily with a blend of facts and practical examples. Readers finish the text feeling as though they have learned a lot but still have much to reflect on.

The section on awareness of self is generally very good, and the concepts relating to self-awareness and values clarification are reinforced nicely in subsequent chapters. The chapter on family history deals with number of important but very complex psychological issues. The work of Erikson on the psychosocial theory of development is covered in a fair amount of detail, but other important works are touched on lightly or not mentioned at all. Included is a short section on codependency--a relatively new concept in psychological literature that is very applicable to individuals in helping professions. A list of suggested readings and additional resources to expand on the brief list of references would be helpful in chapters like the one on family history, in which complex topics are covered only superficially.

Particularly helpful are the chapters on assertiveness skills and communicating with the dying and their families. The author drops into the first person in the latter chapter, relating as an example a circumstance that occurred around the time of her father's death. This transaction of perspective is handled subtly and adds to, rather than detracts from, the text. The closing chapter on stress management is a welcome addition and a fitting way to end a book about self-understanding and self-reflection.

A number of minor editorial problems, particularly in the exercise sections, detract from otherwise quality material. These problems include an inconsistent style in citing references throughout the text, missing instructions in an exercise, a survey from separated from the instructions that go with it, and a lack of numbers for exercises in one section that makes it difficult to know where one exercise begins and another ends.

The content of the book is specifically directed toward the physical therapist, but with the exception of the chapter on the helping interview the information is relevant for individuals at all levels of the physical therapy profession. The book's format makes it ideally suited to serve as a textbook for a semester-long course in an entry-level physical therapy education curriculum where the learning process is extended over time, because time is allotted for exercises and for sharing ideas in a group setting. The text could be effectively adapted, however, to serve as the framework for a three-to-four day continuing education course for practicing health professionals, including those in fields other than physical therapy. The book also would be informative for the individual reader, although an individual might ignore the text's experiential aspects and miss a major component of the learning process intended by the author.