Dr. Amador draws upon his own and others' research findings, his extensive clinical experience, and his own interactions with Henry Amador, a brother with schizophrenia, to create a truly practical, easily readable, and wise guide. It is applicable to many of the people with major depression, and with manic depression (a.k.a. bipolar disorder), who refuse treatment.

About half of people with serious "mental" illness (SMI) eschew treatment, or lapse from it eventually. Their loved ones struggle with the puzzle of why they would not want medication that is often remarkably helpful. Familial battles over non-adherence contribute to the painful chaos wreaked by the symptoms of the illness. The person with the SMI usually resents the constant pressure to take medication against hir wishes. The people who care about hir usually become fearful of the probable return of serious episodes, and in turn, infuriated at hir seeming selfishness, stubbornness, and refusal to face facts.

Amador offers an explanation: The most common reason for lack of adherence is lack of insight: S/he may not realize that s/he is ill. Indeed, various estimates are that nearly 50% of subjects with manic depression simply do not agree with everyone else's perceptions that they have a problem. This lack of recognition is in fact, from his findings, a symptom of the illness, not "being in denial", such that can be worked through.

Furthermore, this is a symptom that may not be relieved when other symptoms improve through treatment. Hir brain disorder may not allow hir to make rational deductions about hirself. Amador theorizes that s/he is `stuck' in a self-image of hirself as the capable person s/he was before mental illness struck. That is why someone who is apparently stabilized and doing well may stop taking hir medication. Like almost anyone, s/he is likely to resist accepting pills or ECT, and their attendant side effects, if they are given for no reason s/he can perceive.

Amador has devised a strategy he calls L.E.A.P., which strives to forge a collaboration between patient, loved ones, and mental health professionals. This is based not on the permanent imposition of the latter two's opinions, but, is based upon the actual experiences, feelings and particularly the goals of the person with an SMI. The steps are 1. Listen, 2. Empathize, 3. Agree, 4. Partnership. He fully describes each of these steps, offering examples of how-to and how-not-to. There are also workbook-style exercises to practice the skills needed for each step.

The success of maintenance therapy ultimately depends on the person with the illness sincerely agreeing to continue it. Amador recognizes this, and is deeply respectful of these individuals' needs and wants. He is also recognizes the impairments caused by these disorders, and is deeply concerned for the long term well being of individuals with SMI, and those who love them. He urges use of every tool available, including involuntary commitment, if necessary. Chapter 10 covers when and how to go about inpatient commitment. An appendix briefly outlines the legal criteria for inpatient and outpatient commitment in every state. He describes an approach that may make it possible to overcome the guilt and resentment that will likely mushroom. The goal is to use commitment as a tool towards greater collaboration towards the person with SMI's long term goals.

A book that combines the latest in research with thoroughly practical suggestions is rare. This volume is one,  and is likely to be an invaluable tool to the family, friends and healthcare providers of people with serious mental illness. Indeed, even those who's loved one's illness is not "serious" may wish to use some of the L.E.A.P. techniques he teaches, which can only increase everyone's understanding, closeness, and treatment adherence.