Handbook of Quality Management in Behavioral Health, George Stricker,Warwick Troy, and Sharon Shueman, 2000, Kluwer±Plenum, New York, 410 pp.

For those of us accustomed to using handbooks of various sorts, many of themdon't ®t in our briefcases, let alone ®t in our hands. Unfortunately, the detailsometimes necessary in creating an excellent handbook can be its nemesis for thosetransporting the book. Refreshingly, the Handbook of Quality Management inBehavioral Health delivers a healthy dose of content while keeping the text lengthwithin 400 pages.

In a prequel to this edition, George Stricker & Alex Rodriquez (1988) published theHandbook of Quality Assurance in Mental Health, at the time conceptualizingmany of the issues surrounding the delivery of quality human service interventions to thepublic. The latest publication, again edited by George Stricker, but with a fresh set ofauthors, was probably ®rst intended to be a mere follow-up to the original 1988publication. However, the recent text is more novel than replicative. In fact, it seems tobe an entirely new work, with only a subtle resemblance to its so-called predecessor.

But what is the quality management movement, and how has it changed what humanservice organizations do? A good example of the quality management movementoutside the ®eld of behavioral health is Ford Motor Company, who used qualitymanagement methods overtly to produce automobiles that meet a variety of consumerdemands for quality and cost (new dashboards, cupholders, airbags, child seats,and many other innovations). What is important here is that consumers were studied,and what they said was put into the creation of a better automobile. Even if you are not aFord lover, you have undoubtedly noticed that your brand of automobile has becomefunctionally better with time, with many of the changes due to the quality movement.

The ®eld of mental health today is very much like the car industry in that asprofessionals we are demanded by our customers (clients) to deliver quality service,not only at the level of one-on-one therapy, but throughout the entire system ofmental health service delivery. Moreover, we are expected to deliver quality servicesto all of the possible stakeholders that interact with us and our organization.Stakeholders could include family members of the client, regulating agencies, otherorganizations we interact with, and the community at large.

What has happened then in the ®eld of mental health is that private corporationquality management methods have become part of daily living in our profession.In the past, the quality assurance movement was primarily focused on qualitywithin the mental health organization, whereas today's quality movement meansassessing quality inside and outside of the organization. For example, an internalquality focus is associated with increasing the quality of doctors, nurses,psychologists, health care workers, and other inside workings of the organization.An external focus would concentrate on customers (patients), families, the

Book reviews 67

Copyright # 2001 John Wiley & Sons, Ltd. Behav. Intervent. 16: 65±76 (2001)

community, stockholders, regulating bodies, and a variety of stakeholders thatoperate in the general environment surrounding the organization. In short, humanservice organizations must look to their external stakeholders in order to producequality services.

The handbook delivers a series of interesting and important new chapters,compared to the 1988 publication, which are in keeping with the rapidly changingtimes of this ®eld. In chapter 4, titled `Information management for clinical deci-sion making', the authors explore such issues as going on-line with the DSM-IV,computerized test administration, on-line analysis of psychophysiological data,record keeping systems, billing systems, electronic treatment plans, and computer-ized decision-making models. Many of these advances have come to the ®eldprimarily during the 1990s, and are currently being used as aids in providing qualitycare and services to the public.

Also timely in its presentation is chapter 10, titled `Quality management practiceissues in behavioral health groups (BHG)'. During the past two decades independentproviders have increasingly come together to form BHGs, but unknown to manyindependent mental health care providers are the complexity of issues that need to beaddressed when running a more complex group based organization. Professionalshave primarily been trained to pay attention to the quality of their clinical practice,but one of these `new' issues to deal with is how to address a more comprehensiveview of quality that accounts for the variety of stakeholders in their environment,especially the accrediting organizations, contracting organizations, and managedcare organizations. Of course, this does not discount paying attention to theconsumer, medical groups, and the public in general, among others. Those of you thatwork in BHGs or study them, will ®nd this chapter informative.

Several others chapters are presented for consumption to targeted audiences, likethe BHGs above. The interested reader will ®nd selected chapters on ensuring qualityin the treatment of chemical dependency (chapter 11), anxiety and traumatic stressdisorders (chapter 12), psychotherapy with children and adolescents (chapter 13), anddepression (chapter 14). Each of these chapters presents a mix of facts supported byscholarly literature, and normative prescriptions of how one `ought to' provide forquality management within areas of human service specialization.

The ®nal section of the handbook is provided for those interested in learning moreabout regulating bodies and other external stakeholders, and their roles in the qualitymanagement movement. Included here are chapters on government initiatives (chapter15), the National Committee for Quality Assurance (chapter 16), licensing andcredentialing (chapter 17), legal and business issues (chapter 18), the role of professionalorganizations (chapter 19), and the role of the consumer (chapter 20). Several of thesechapters appeared in the previous version of the handbook, but they have been organizedtogether in a more logical grouping, and have been updated substantially.

68 Book reviews

Copyright # 2001 John Wiley & Sons, Ltd. Behav. Intervent. 16: 65±76 (2001)

My comments so far here have been primarily, if not completely, positive, but Imust make a few critical comments. First, you will not ®nd a great deal of up-frontconceptual development for the term of quality management and its associatedconstructs. Instead, the reader will become involved in the changing context of thequality movement in the past decade or so (chapter 1). Relatedly, the history of the®eld is truncated a little by focusing only on its more recent history during the pastdecade or so. The reader who wants a fuller description of this ®eld's history may ®ndit lacking. In the previous publication of the handbook there were amplepresentations of both conceptual development and history, and here they appear tohave been removed completely or constructed in a briefer version. A solution to thesecond problem can be found by reading the historical development provided in theearlier version, and combining this reading with chapter 1 in the newer handbook.Unfortunately, I'm not sure there is a solution to the ®rst problem I noted.

I listed these latter issues mainly because they represent an attempt by the authorsto make the handbook more accessible and readable in the practitioner community. Infact, in their preface, the authors note `that this second edition is written in a way thatis less technical, and academically focused than the previous edition' (p. ix). Clearly,they have succeeded in achieving this goal, and this handbook should be wellreceived by the practitioner community. Although I allude to some skepticism aboutthe handbook's practitioner focus. I think the academic reader will ®nd the contentinteresting and informative. Further, the text does contain a varied and fairlycomprehensive set of references and resources for interested readers to explore. Insum, for students and professionals in Behavioral Health, and its related disciplines,this handbook might make for a nice complement to your personal library.

REFERENCE

Stricker G, Rodriquez AR. 1988. Handbook of Quality Assurance in Mental Health. Plenum: New York.

Neil BoydPenn State Harrisburg

Middletown, Pennsylvania, USA

Book reviews 69

Copyright # 2001 John Wiley & Sons, Ltd. Behav. Intervent. 16: 65±76 (2001)