Solution Focused Practice for Approved Mental Health Professionals: Skills for promoting autonomy and choice by Nick Perry
Routledge, 2027, 172pp, ISBN 9781041150008, £36.99 pbk (Kindle edition available)
At first glance, this book is aimed at Approved Mental Health Professionals (AMHPs) in the United Kingdom (and those in training). In fact, it has much wider relevance for anyone wishing to use solution focused (SF) practice in situations where a client is surrounded by legal and medical processes that may constrain their actions. Anyone working with mandated, involuntary or reluctant clients — and the wider authorities and stakeholders around them — should make a beeline for this practical and detailed text.
An AMHP has a statutory role under the UK Mental Health Act 1983 (as amended in 2007). It replaced the former Approved Social Worker position and can be undertaken by professionals from various fields (not just social workers), who are required to make legally binding decisions about whether a person should be detained (“sectioned”) for assessment or treatment. This often involves someone in crisis, where behaviour may be unpredictable, who may be known to social and medical services. The Mental Health Act 2025 introduces significant changes to the legal framework governing detention, treatment and care, raising the bar for detention and opening more possibilities for alternative ways forward. Perry’s book responds directly to these changes.
If this language is familiar, the book is certainly for you. If it looks like legal gobbledygook, keep reading; there is a huge amount of wisdom here for anyone dealing with high uncertainty and high potential risk.
Perry’s previous collection (Solution Focused Practice and Mental Health Crisis, Routledge, 2025) offered short chapters on using SF ideas in crisis situations. This new volume focuses specifically on SF within the AMHP role, with its inevitable involvement of medical professionals and others. After a scene-setting prologue, the opening chapter presents a simple, highly usable framework for applying SF in this context. Perry’s clarity is admirable: no prior SF knowledge is required, and key questions are bolded for easy reference. This helpful format continues throughout. He also introduces the important concept of “twin-tracking” (from Evan George): attending simultaneously to both the medical/legal process and the therapeutic process, acknowledging that one may be more visible at any moment, but both are always running.
The middle section comprises three chapters linking the AMHP role directly to SF work. Colleen Simon’s chapter explores how SF practice can support anti-racist practice, requiring awareness of biases, assumptions and privileges. This is an important contribution; as Guy Shennan notes in his excellent Foreword, such material is rarely found in SF books. Simon concludes that SF can be “an ally to anti-racist practice, as it is not over-occupied with diagnostic labels and honours the co-production element of the framework, allowing people’s voices to be heard.” She also makes the first of several connections with Open Dialogue (Putman & Martindale, 2021), a dialogic approach that similarly values the client’s words and experience over professional terminology. These links deserve further exploration.
In their chapter A Suitable Manner, Ama Dhami and John Mitchell examine how the Mental Health Act opens opportunities for humane and potentially therapeutic conversations. The Act requires the AMHP to “consider the patient’s case” in a suitable manner but says little about what that might entail. While assessment is expected, tensions and possibilities arise around other values and modes of engagement. Dhami and Mitchell also consider anti-discriminatory practice and working with interpreters; their 14 pages contain much to build upon.
Kelly Alexander’s chapter explores how SF practice helps AMHPs demonstrate professional competence. She examines the new statutory principles and shows how SF aligns strongly with treating the person as an individual, offering choice and autonomy, limiting freedom no more than necessary and providing therapeutic benefit. This chapter offers a valuable high-level view of how SF practice is not only acceptable but often positively desirable.
The final — and largest — section is the book’s real heart. Perry offers dozens of anonymised examples from his AMHP work, showing SF in action amid turmoil, pain and uncertainty. The SF used is simple: best hopes, “what difference would that make?”, other perspectives, tiny signs, perhaps a scale. The learning lies in how Perry finds ways to get these questions heard, attends closely to the answers and uses them to engage both clients and fellow professionals. Alongside the dialogue, he shows how the exchange was written up and reported in ways that honour the client while meeting professional expectations.
One example gives the flavour. Annie, 63, arrives at hospital in a distressed and suicidal state, having self-harmed en route. Her sister Megan is present. Asked about her best hopes, Annie has little confidence that anything can emerge yet begins talking about “getting all this resolved” and “stopping having the thoughts”. She wants to sleep better and not be distressed by the images she has been seeing. It would be useful to deal with these things.
The conversation moves through past instances of coping and a “tomorrow” question. Among caring for her animals, not hearing voices, washing and dressing well, Annie says she would like to look in the mirror in the morning and say, “I love you Annie”. She becomes distressed, and Megan helps her with breathing exercises. Annie talks about walking her dog and how her friend Helen would notice she was getting better. Discussing the case with colleagues, the practitioner decides against arranging a medical examination (a possible precursor to detention) and instead arranges a respite bed and nighttime medication. A social care assessment is also mooted. Annie and the A&E matron agree to the plan.
This is a summary of a detailed two-page description. Many such examples follow: in police custody, on a paediatric ward, in intensive care, with relatives, in chronically high-risk circumstances. Often detention can be avoided. On other occasions, Perry notes that if detention can be framed as a step towards a preferred future, the process is likely to go more smoothly for everyone.
This outstanding book is a landmark publication — both for mental health professionals in the UK and for anyone seeking to use SF in high-stakes, high-tension settings. The rest of us can be grateful for Nick Perry’s insight and courage and take heart from the many ways solution focused language can gently illuminate even the darkest corners of human experience.