This volume is the first to explore broadly many important theoretical and applied issues concerning the mental health of Appalachians. The authors — anthropologists, psychologists, social workers and others — overturn many assumptions held by earlier writers, who have tended to see Appalachia and its people as being dominated by a culture of poverty.

While the heterogeneity of the region is acknowledged in the diversity of sub-areas and populations discussed, dominant themes emerge concerning Appalachia as a whole. The result of the authors' varied approaches is a cumulative portrait of a strong regional culture with native support systems based on family, community, and religion.

Some of the contributors examine therapeutic approaches, including family therapy, that consider the implications of the cultural context. Others explore the impact of Appalachian culture on the impact of Appalachian culture on the development of mental health problems and coping skills and the resulting potential for conflict between Appalachian clients and non-Appalachian health providers. Still others examine cultural considerations in therapeutic encounters and mental health service delivery. The book is rich in case studies and empirical data. The practical, applied nature of the essays will enhance their value for practitioners seeking ways to improve mental health care in the region.

Susan Emley Keefe

Books