Hospital Psychiatry Meets Cognitive Therapy: A New Beginning Cognitive Therapy With Inpatients Jesse H. Wright, Michael E. Thase, Aaron T. Beck, and John W. Ludgate (Eds.). New York: Guilford Press, 1993. 445 pp., $38.95 (Hardcover) This volume reflects ongoing clinical research and practice that suggests the potential for a truly "new beginning" for hospital psychiatry! Chapters were written by an outstanding group of cognitive therapists and researchers, many of whom were trained at the Philadelphia Center for Cognitive Therapy. Overall, the book was quite exciting to read. The articulated cognitive strategies for inpatient treatment clearly represent a significant refinement over what was available just a few years ago. This book is divided into five parts. Part I, "General Principles of Inpatient Cognitive Therapy," includes three chapters. In chapter 1, Michael Thase and Aaron Beck provide a concise overview of cognitive therapy, including historical background, the cognitive theory of psychopathology, principles of cognitive therapy, structure of therapy techniques, modification of core cognitive content and processing, and a review of the empirical status of cognitive therapy. Chapter 2, "Hospital Psychiatry Transition," by Jesse Wright and Mary Helen Davis, identifies how the current evolution of hospital psychiatry towards focused, short-term treatments relates to the incorporation of cognitive therapy principles. The introduction of the concept "cognitive milieu" articulates the manner in which cognitive theory contributes to and complements the traditional approaches. Chapter 3, "The Cognitive Milieu: Structure and Process," by Jesse Wright, Michael Thase, John Ludgate, and Aaron Beck, further elaborates the nature of a therapeutic cognitive environment and how to create such. It delineates how the diverse disciplines and traditional therapeutic activities can be enhanced and better integrated by cognitive therapy principles. For example, Activities Therapists can evoke automatic thoughts (prior to and following activities) regarding how well patients expect to perform, and whether patients think they will enjoy or benefit from the activity, thus enhancing motivation to participate. Part II is entitled "Treatment Modalities," and includes Chapter 4, "Individual Cognitive Therapy With Inpatients," by John Ludgate, Jesse Wright, Wayne Bowers, and Glenda Camp; Chapter 5, "Group Cognitive Therapy With Inpatients," by Arthur Freeman, Randolph Schrodt, Mark Gilson, and John Ludgate; and Chapter 6, "Inpatient Family Therapy," which is divided into two parts-part A on "General Priniciples," by Ivan Miller. Gabor Keitner, Nathan Epstein, Duane Bishop, and Christine Ryan, and Part B, "Family Cognitive Therapy With Inpatients," by Jesse Wright and Aaron Beck. This section of the book provides specific examples of how the standard outpatient formulation of cognitive therapy is modified for inpatient treatment modalities. For example, Chapter 6, "Inpatient Family Therapy," stresses differences between individual and family cognitive therapy: In conducting family cognitive therapy, the therapist is relatively more "passive" in allowing the family systems process to manifest itself, rather than structuring the interactions as individual treatment. Part III includes three chapters on "The Biomedical Interface," including Chapter 7, "Cognitive and Biological Therapies: A Combined Approach," by Jesse Wright, Michael Thase, and Tom Sensky; Chapter 8, "Cognitive Therapy With Medical Patients," by Tom Sensky and Jesse Wright; and Chapter 9, "The Role of the Nurse in the Cognitive Milieu," by Kathleen Bowler, Lisa Moonis, and Michael Thase. Chapter 7 presents a sophisticated perspective for combining pharmacotherapy and psychotherapy. This chapter goes beyond most systems theories by providing a framework to depict the roles played by cognitive, biological, emotional, behavioral, and "environmental" influences on psychiatric disorders. …