'Raman Kapur achieves a great deal in this fascinating book. Drawing from his experiences as a clinical psychologist and manager of a mental health agency he provides valuable insights into the application of Kleinian and post-Kleinian ideas to the delivery of services to adults with a variety of mental health problems. In the course of this narrative, Dr Kapur traverses a range of contexts, thoughtfully illustrated by his own practice examples with individuals, groups and communities. The result is a book that offers a breadth of understanding about the role of the therapist, and manager, in mental health organisations. It will therefore be of great interest to therapists and professionals who seek to question conventional approaches to practice in mental health services.'- Professor Jim Campbell, Chair of Social Work, University College Dublin'In this compelling, clear and honest account we encounter a master clinician's "IQ" (Introspection Quotient, as he terms it) as he reflects on the dynamics of caring for people with severe mental illness. Based on deep experience, combined with a sensitive application of Kleinian concepts - splitting, envy, destructive narcissism - Kapur brings his non-authoritarian authority to real-life difficulties encountered in hospitals, clinics and the community, showing how hope can be maintained, without succumbing to hatred, evasion, or denial. This truly vital and original contribution is essential reading for all who work in mental health - not excluding those responsible for its management.'- Professor Jeremy Holmes, MD, FRCPsych, University of Exeter, UK'This is an original, creative, comprehensive, and research-based approach to treatment and care for the increasing number of patients with severe and chronic mental disorders who are living in residential programs or at home. The proof is in the pudding: Dr Kapur's Threshold program has succeeded for twenty-five years in providing optimal care to individuals and their families who have often foundered in other mental health systems. The author draws from his rich experience to provide detailed descriptions, with case examples, of individual, group, institutional, training, and consultations aspects of carethat is rooted in a psychoanalytic model emphasizing the listening process, unconscious dynamics, and respect for patients' autonomy.'- Victor L. Schermer, MA, psychologist and Life Fellow of the American Group Psychotherapy Association
