Skip to main content Accessibility help
×
Hostname: page-component-8448b6f56d-wq2xx Total loading time: 0 Render date: 2024-04-24T18:19:55.880Z Has data issue: false hasContentIssue false

7 - A Way Forward

Enhancing Training in Psychosocial Interventions for Serious Mental Illness

from Part III - The Future

Published online by Cambridge University Press:  03 March 2022

Meaghan Stacy
Affiliation:
Yale University, Connecticut
Charlie A. Davidson
Affiliation:
Emory University, Atlanta
Get access

Summary

This chapter will highlight one way by which to improve the mental healthcare for people with psychosis: providing enhanced, specialized professional training at the graduate and postdoctoral level. Specialized training is needed for clinical providers of all professions and disciplines, and this chapter will review the recent Substance Abuse and Mental Health Services Administration (SAMHSA) funded Recovery to Practice Initiative, aimed at enhancing knowledge, ability, and practice among interprofessional clinicians working with individuals with serious mental illnesses. The chapter will also provide an overview of cutting-edge efforts to revolutionize psychology training, with a description of the “Serious Mental Illness Psychology” postdoctoral specialty which was recently recognized by the American Psychological Association, as well as current efforts to create a psychology board certification in serious mental illness.

Type
Chapter
Information
Recovering the US Mental Healthcare System
The Past, Present, and Future of Psychosocial Interventions for Psychosis
, pp. 159 - 182
Publisher: Cambridge University Press
Print publication year: 2022

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

American Psychiatric Association. (2002). Practice Guideline for the Treatment of Patients with Bipolar Disorder (2nd edition). Washington, DC: American Psychiatric Association Press.Google Scholar
American Psychological Association. (2016). 2015 Survey of Psychology Health Service Providers. Washington, DC: American Psychological Association’s Center for Workforce Studies. Retrieved from: https://www.apa.org/workforce/publications/15-health-service-providers/report.pdfGoogle Scholar
American Psychological Association & Jansen, M. A. (2014). Recovery to Practice Initiative Curriculum: Reframing Psychology for the Emerging Health Care Environment. Washington, DC: American Psychological Association. Retrieved from https://www.apa.org/pi/mfp/psychology/recovery-to-practice/all-curriculums.pdfGoogle Scholar
Baker, J., & Cox, D. R. (2014). The history and importance of specialization in professional psychology. In Johnson, W. B. & Kaslow, N. J. (Eds.), Oxford library of psychology. The Oxford handbook of education and training in professional psychology. Oxford University Press. p. 120132.Google Scholar
Bartels, S. J., DiMilia, P. R., Fortuna, K. L., & Naslund, J. A. (2018). Integrated care for older adults with serious mental illness and medical comorbidity: Evidence-based models and future research directions. Psychiatric Clinics, 41(1), 153164, https://doi.org/10.1016/j.psc.2017.10.012Google Scholar
Beidas, R. S. & Kendall, P. C. (2010). Training therapists in evidence-based practice: A critical review of studies from a systems-contextual perspective. Clinical Psychology: Science and Practice, 17(1), 130. https://doi.org/10.1111/j.1468-2850.2009.01187.xGoogle ScholarPubMed
Bernheim, K. P. (1990). Additional comments to key issues in training in psychology for service to the seriously mentally ill. In Lefley, H. P. (Ed.), Clinical Training in Serious Mental Illness. Washington, DC: National Institute of Mental Health, DHHS Pub No (ADM), p. 901679.Google Scholar
Bighelli, I., Salanti, G., Huhn, M., Schneider-Thoma, J., Krause, M., Reitmeir, C., … Leucht, S. (2018). Psychological interventions to reduce positive symptoms in schizophrenia: Systematic review and network meta-analysis. World Psychiatry, 17(3), 316329. https://doi.org/10.1002/wps.20577Google Scholar
Bordes Edgar, V., Holder, N., Cox, D. R., & Suris, A. (2019). Competence in psychology board certification: Unlike a good wine, it does not get better with age. Training and Education in Professional Psychology, 13(4), 264269. https://doi.org/10.1037/tep0000246CrossRefGoogle Scholar
Buck, B., Romeo, K. H., Olbert, C. M., & Penn, D. L. (2014). Self-reported comfort treating severe mental illnesses among pre-doctoral graduate students in clinical psychology. Journal of Mental Health, 23(6), 297302. https://doi.org/10.3109/09638237.2014.924048CrossRefGoogle ScholarPubMed
Carr, E. R., Bhagwat, R., Miller, R., & Ponce, A. N. (2014). Training in mental health recovery and social justice in the public sector. The Counseling Psychologist, 42(8), 11081135. https://doi.org/10.1177/0011000014555200Google Scholar
Carr, E. R., & Miller, R. (2017). Expanding our reach: Increasing the role of psychologists in public and community mental health. Psychological Services, 14(3), 352360. https://doi.org/10.1037/ser0000094Google Scholar
Chu, J. P., Emmons, L., Wong, J., Goldblum, P., Reiser, R., Barrera, A. Z., & Byrd-Olmstead, J. (2012a). Public psychology: A competency model for professional psychologists in community mental health. Professional Psychology: Research and Practice, 43(1), 3949. https://doi.org/10.1037/a0026319Google Scholar
Chu, J. P., Emmons, L., Wong, J., Goldblum, P., Reiser, R., Barrera, A. Z., & Byrd-Olmstead, J. (2012b). The public psychology doctoral training model: Training clinical psychologists in community mental health competencies and leadership. Training and Education in Professional Psychology, 6(2), 7683. https://doi.org/10.1037/a0028834Google Scholar
Cleary, M., Lees, D., Molloy, L., Escott, P., & Sayers, J. (2017). Recovery-oriented care and leadership in mental health nursing. Issues in Mental Health Nursing, 38(5), 458460. https://doi.org/10.1080/01612840.2017.1314738Google Scholar
Cohen, J. L., Abraham, K. M., Burk, J. P., & Stein, C. H. (2012). Emerging opportunities for psychologists: Joining consumers in the recovery-oriented care movement. Professional Psychology: Research and Practice, 43(1), 2431. https://doi.org/10.1037/a0024394Google Scholar
Corrigan, P. W., Steiner, L., McCracken, S. G., Blaser, B., & Barr, M. (2001). Strategies for disseminating evidence-based practices to staff who treat people with serious mental illness. Psychiatric Services, 52(12), 15981606. https://doi.org/10.1176/appi.ps.52.12.1598Google Scholar
Cox, D. R., & Grus, C. L. (2019). From continuing education to continuing competence. Professional Psychology: Research and Practice, 50(2), 113119. https://doi.org/10.1037/pro0000232CrossRefGoogle Scholar
Davidson, L. (2016). The recovery movement: Implications for mental health care and enabling people to participate fully in life. Health Affairs, 35(6), 10911097. https://doi.org/10.1377/hlthaff.2016.0153CrossRefGoogle ScholarPubMed
del Vecchio, P. (2015). Bringing recovery to practice: Improving provider competencies and promoting positive outcomes. Psychiatric Services, 66(7), 750752. https://doi.org/10.1176/appi.ps.201400310Google Scholar
Frost, B. G., Tirupati, S., Johnston, S., Turrell, M., Lewin, T. J., Sly, K. A., & Conrad, A. M. (2017). An integrated recovery-oriented model (IRM) for mental health services: Evolution and challenges. BMC Psychiatry, 17(1), 22. https://doi.org/10.1186/s12888–016-1164-3CrossRefGoogle ScholarPubMed
Fusar-Poli, P., Papanastasiou, E., Stahl, D., Rocchetti, M., Carpenter, W., Shergill, S., & McGuire, P. (2015). Treatments of negative symptoms in schizophrenia: Meta-analysis of 168 randomized placebo-controlled trials. Schizophrenia Bulletin, 41(4), 892899. https://doi.org/10.1093/schbul/sbu170Google Scholar
Gill, K., & Murphy, A. (2013). Psychiatric/psychosocial rehabilitation (PSR) education: Academic and professional. Current Psychiatry Reviews, 9(3), 260269. https://doi.org/10.2174/1573400511309030008Google Scholar
Gitlin, M. J., & Miklowitz, D. J. (2017). The difficult lives of individuals with bipolar disorder: A review of functional outcomes and their implications for treatment. Journal of Affective Disorders, 209, 147154. https://doi.org/10.1016/j.jad.2016.11.021Google Scholar
Häfner, H. (2004). Schizophrenia: Still Kraepelin’s dementia praecox? Epidemiologia e Psichiatria Sociale, 13(2), 99112. https://doi.org/10.1017/s1121189x00003328Google Scholar
Happell, B., Byrne, L., & Platania-Phung, C. (2015). The Recovery Knowledge Inventory for measurement of nursing student views on recovery-oriented mental health services. Issues in Mental Health Nursing, 36(10), 799808. https://doi.org/10.3109/01612840.2015.1049310Google Scholar
Harding, C. M., Brooks, G. W., Ashikaga, T., Strauss, J. S., & Breier, A. (1987a). The Vermont longitudinal study of persons with severe mental illness, I: Methodology, study, sample, and overall status 32 years later. American Journal of Psychiatry, 144(6), 718726. https://doi.org/10.1176/ajp.144.6.718Google ScholarPubMed
Harding, C. M., Brooks, G. W., Ashikaga, T., Strauss, J. S., & Breier, A. (1987b). The Vermont longitudinal study of persons with severe mental illness, II: Long-term outcome of subjects who retrospectively met DSM-III criteria for schizophrenia. American Journal of Psychiatry, 144(6), 727735. https://doi.org/10.1176/ajp.144.6.727Google Scholar
Harding, C. M., Zubin, J., & Strauss, J. S. (1987). Chronicity in schizophrenia: Fact, partial fact, or artifact? Psychiatric Services, 38(5), 477486. https://doi.org/10.1176/ps.38.5.477Google Scholar
Hargrove, D. S. (1990). Key issues in training in psychology for service to the seriously mentally ill. In Lefley, H. P. (Ed.). Clinical training in serious mental illness. Washington, DC: National Institute of Mental Health, DHHS Pub No (ADM), p. 901679.Google Scholar
Horvitz-Lennon, M., Donohue, J. M., Domino, M. E., & Normand, S. L. T. (2009). Improving quality and diffusing best practices: The case of schizophrenia. Health Affairs, 28(3), 701712. https://doi.org/10.1377/hlthaff.28.3.701CrossRefGoogle ScholarPubMed
Horvitz-Lennon, M., Volya, R., Donohue, J. M., Lave, J. R., Stein, B. D., & Normand, S. L. (2014). Disparities in quality of care among publicly insured adults with schizophrenia in four large US states, 2002–2008. Health Services Research, 49(4): 11211144. https://doi.org/10.1111/1475-6773.12162Google Scholar
Hunt, M. G., & Resnick, S. G. (2015). Two birds, one stone: Unintended consequences and a potential solution for problems with recovery in mental health. Psychiatric Services, 66(11), 12351237. https://doi.org/10.1176/appi.ps.201400518Google Scholar
Jansen, M. A. (2018). Psychosocial services for individuals with serious mental illness/severe emotional disturbance: Clinical practice guideline toolkit. Psychiatry, 81(1), 321. https://doi.org/10.1080/00332747.2018.1440116Google Scholar
Jawad, I., Watson, S., Haddad, P. M., Talbot, P. S., & McAllister-Williams, R. H. (2018). Medication nonadherence in bipolar disorder: A narrative review. Therapeutic Advances in Psychopharmacology, 8(12), 349363.Google Scholar
Johnson, D. L. (1990). Response to key issues in training in psychology for service to the seriously mentally ill. In Lefley, H. P. (Ed.). Clinical training in serious mental illness. Washington, DC: National Institute of Mental Health, DHHS Pub No (ADM), p. 901679.Google Scholar
Judd, L. L., Akiskal, H. S., Schettler, P. J., Endicott, J., Maser, J., Solomon, D. A., … Keller, M. B. (2002). The long-term natural history of the weekly symptomatic status of bipolar I disorder. Archives of General Psychiatry, 59(6), 530537. https://doi.org/10.1001/archpsyc.59.6.530Google Scholar
Kaslow, N. J., Graves, C. C., & Smith, C. O. (2012). Specialization in psychology and health care reform. Journal of Clinical Psychology in Medical Settings, 19(1), 1221. https://doi.org/10.1007/s10880–011-9273-0CrossRefGoogle ScholarPubMed
Kimhy, D., Tarrier, N., Essock, S., Malaspina, D., Cabannis, D., & Beck, A. T. (2013). Cognitive behavioral therapy for psychosis – Training practices and dissemination in the United States. Psychosis, 5(3), 296305. https://doi.org/10.1080/17522439.2012.704932Google Scholar
Kreyenbuhl, J., Buchanan, R. W., Dickerson, F. B., & Dixon, L. B. (2010). The schizophrenia patient outcomes research team (PORT): Updated treatment recommendations 2009. Schizophrenia Bulletin, 36(1), 94103. https://doi.org/10.1093/schbul/sbp130Google Scholar
Kurtz, M. M., & Mueser, K. T. (2008). A meta-analysis of controlled research on social skills training for schizophrenia. Journal of Consulting and Clinical Psychology, 76(3), 491504. https://doi.org/10.1037/0022-006x.76.3.491Google Scholar
Kymalainen, J. A., Henze, K. T., DeLuca, M., Mitton, T. A., Walton, H. M., Duffy, P., … & Pinsky, J. (2010). Are we there yet? The four-year impact of a VA fellowship program on the recovery orientation of rehabilitation programs. Psychiatric Rehabilitation Journal, 33(4), 320327. https://doi.org/10.2975/33.4.2010.320.327Google Scholar
Leonhardt, B. L., Huling, K., Hamm, J. A., Roe, D., Hasson-Ohayon, I., McLeod, H. J., & Lysaker, P. H. (2017). Recovery and serious mental illness: A review of current clinical and research paradigms and future directions. Expert Review of Neurotherapeutics, 17(11), 11171130. https://doi.org/10.1080/14737175.2017.1378099Google Scholar
Mabe, A., Ahmed, A. O., Duncan, G. N., Fenley, G., & Buckley, P. F. (2014). Project GREAT: Immersing physicians and doctorally-trained psychologists in recovery-oriented care. Professional Psychology: Research and Practice, 45(5), 347356. https://doi.org/10.1037/a0037705CrossRefGoogle Scholar
McFarlane, W. R. (2016). Family interventions for schizophrenia and the psychoses: A review. Family Process, 55(3), 460482. https://doi.org/10.1111/famp.12235Google Scholar
Miklowitz, D. J., & Chung, B. (2016). Family‐focused therapy for bipolar disorder: Reflections on 30 years of research. Family Process, 55(3), 483499. https://doi.org/10.1111/famp.12237Google Scholar
Miklowitz, D. J., Efthimiou, O., Furukawa, T. A., Scott, J., McLaren, R., Geddes, J. R., & Cipriani, A. (2021). Adjunctive psychotherapy for bipolar disorder: a systematic review and component network meta-analysis. JAMA psychiatry, 78(2), 141150.Google Scholar
Modini, M., Tan, L., Brinchmann, B., Wang, M.-J., Killackey, E., Glozier, N., Mykletun, A., & Harvey, S. B. (2016). Supported employment for people with severe mental illness: Systematic review and meta-analysis of the international evidence. British Journal of Psychiatry, 209(1), 1422. https://doi.org/10.1192/bjp.bp.115.165092Google Scholar
Mojtabai, R., Fochtmann, L., Chang, S.-W., Kotov, R., Craig, T. J., & Bromet, E. (2009). Unmet need for mental health care in schizophrenia: An overview of literature and new data from a first-admission study. Schizophrenia Bulletin, 35, 679695. http://dx.doi.org/10.1093/schbul/ sbp045Google Scholar
Mueser, K. T., Silverstein, S. M., & Farkas, M. D. (2013). Should the training of clinical psychologists require competence in the treatment and rehabilitation of individuals with a serious mental illness? Psychiatric Rehabilitation Journal, 36(1), 5459. https://doi.org/10.1037/h0094750Google Scholar
National Institute for Health and Care Excellence [NICE]. ( 2014). Bipolar disorder: Assessment and management. Available at https://www.nice.org.uk/guidance/cg185/resources/bipolar-disorder-assessment-and-management-35109814379461. Accessed 10/22/20.Google Scholar
National Institute of Mental Health. (1990). Clinical training in serious mental illness.(1990). Lefley, H. P. (Ed). DHHS Pub. No. (ADM) 90-1679. Washington, DC: Supt. of Docs., U.S. Govt. Printing Office. Available from http://babel.hathitrust.org/cgi/pt?id=mdp.39015050781247;view=1up;seq=3Google Scholar
Neimeyer, G. J., Taylor, J. M., Rozensky, R. H., & Cox, D. R. (2014). The diminishing durability of knowledge in professional psychology: A second look at specializations. Professional Psychology: Research and Practice, 45(2), 9298. https://doi.org/10.1037/a0036176Google Scholar
Olfson, M. (2016). Building the mental health workforce capacity needed to treat adults with serious mental illnesses. Health Affairs, 35(6), 983990. https://doi.org/10.1377/hlthaff.2015.1619Google Scholar
Patterson, T. L., & Leeuwenkamp, O. R. (2008). Adjunctive psychosocial therapies for the treatment of schizophrenia. Schizophrenia Research, 100, 108119. https://doi.org/10.1016/j.schres.2007.12.468CrossRefGoogle ScholarPubMed
President’s New Freedom Commission on Mental Health. (2003). Achieving the promise: Transforming mental health care in America. Final report. DHHS Pub. No. SMA-03-3832. Rockville, MD: Author.Google Scholar
Randall, M., Romero-Gonzalez, M., Gonzalez, G., Klee, A., & Kirwin, P. (2011). Competency of psychiatric residents in the treatment of people with severe mental illness before and after a community psychiatry rotation. Academic Psychiatry, 35 (1), 1520. https://doi.org/10.1176/appi.ap.35.1.15Google Scholar
Razzano, L. A., Jonikas, J. A., Goelitz, M. A., Hamilton, M. M., Marvin, R., Jones-Martinez, N., … Cook, J. A. (2010). The recovery education in the academy program: Transforming academic curricula with the principles of recovery and self-determination. Psychiatric Rehabilitation Journal, 34(2), 130136. https://doi.org/10.2975/34.2.2010.130.136Google Scholar
Reddy, F., Spaulding, W. D., Jansen, M. A., Menditto, A. A., & Pickett, S. (2010). Psychologists’ roles and opportunities in rehabilitation and recovery for serious mental illness: A survey of council of university directors of clinical psychology (CUDCP) clinical psychology training and doctoral education. Training and Education in Professional Psychology, 4(4), 254263. https://doi.org/10.1037/a0021457CrossRefGoogle Scholar
Roberts, M. C. (2006). Essential tension: Specialization with broad and general training in psychology. American Psychologist, 61(8), 862870. https://doi.org/10.1037/0003-066x.61.8.862Google Scholar
Roe, D., Yanos, P. T., & Lysaker, P. H. (2006). Overcoming barriers to increase the contribution of clinical psychologists to work with persons with severe mental illness. Clinical Psychology: Science and Practice, 13(4), 376383. https://doi.org/10.1111/j.1468-2850.2006.00051.xGoogle Scholar
Rollins, A. L., & Bond, G. R. (2001). Psychology curriculum and psychiatric rehabilitation. Psychiatric Rehabilitation Skills, 5(3), 514533. https://doi.org/10.1080/15487760108415450Google Scholar
Rubin, M., Menon, G. M., & Vanek, M. (2012). Relevance of competency-based education to work with individuals with serious mental illness. Journal of Human Behavior in the Social Environment, 22(2), 213233. https://doi.org/10.1080/10911359.2012.647482Google Scholar
Satel, S. (2014). Delivering services to individuals with severe mental illness: SAMHSA falls short. Psychiatric Services, 65(9), 11601161. https://doi.org/10.1176/appi.ps.201400259CrossRefGoogle ScholarPubMed
Stacy, M., Klee, A., & Jansen, M. (2018). Postdoctoral psychology training in preparation for specialization in serious mental illness. Training and Education in Professional Psychology, 12(2), 96104. https://doi.org/10.1037/tep0000179Google Scholar
Stewart, J. A., Horn, D. L., Becker, J. M., & Kline, J. S. (1993). Postdoctoral training in severe mental illness: A model for trainee development. Professional Psychology: Research and Practice, 24(3), 286292. https://doi.org/10.1037/0735-7028.24.3.286Google Scholar
Stirman, S. W., Bhar, S. S., Spokas, M., Brown, G. K., Creed, T. A., Perivoliotis, D., … Beck, A. T. (2010). Training and consultation in evidence-based psychosocial treatments in public mental health settings: The access model. Professional Psychology: Research and Practice, 41(1), 4856. https://doi.org/10.1037/a0018099Google Scholar
Substance Abuse and Mental Health Services Administration. (2004). SAMHSA‘s National Consensus Statement on Mental Health Recovery. Rockville, Md, US Department of Health and Human Services, Substance Abuse and Mental Health Services Administration. Retrieved from https://www.cibhs.org/sites/main/files/file-attachments/10_fundamental_components_of_recovery.pdfGoogle Scholar
Substance Abuse and Mental Health Services Administration. (2005). Transforming mental health care in America. Federal Action Agenda: First Steps. (DHHS Pub No. SMA-O5–0460). Rockville, MD: U. S. Department of Health and Human Services. Retrieved from http://cretscmhd.psych.ucla.edu/nola/Video/MHR/Governmentreports/TRANSFORMING%20MENTAL%20HEALTH%20CARE%20IN%20AMERICA.pdfGoogle Scholar
Substance Abuse and Mental Health Services Administration (SAMHSA) (June 11, 2010). Mental health recovery: A journey of healing and transformation. https://www.mentalhealth.va.gov/featurearticle_may2010v2.aspGoogle Scholar
Substance Abuse and Mental Health Services Administration. (2012). SAMHSA‘s working definition of recovery updated. SAMHSA Blog. Retrieved from https://store.samhsa.gov/sites/default/files/d7/priv/pep12-recdef.pdfGoogle Scholar
Substance Abuse and Mental Health Services Administration. (2019). Key substance use and mental health indicators in the United States: Results from the 2018 National Survey on Drug Use and Health (HHS Publication No. PEP19–5068, NSDUH Series H-54). Rockville, MD: Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration. Retrieved from https://www.samhsa.gov/data/sites/default/files/cbhsq-reports/NSDUHNationalFindingsReport2018/NSDUHNationalFindingsReport2018.pdfGoogle Scholar
Tsang, H. W., Ching, S. C., Tang, K. H., Lam, H. T., Law, P. Y., & Wan, C. N. (2016). Therapeutic intervention for internalized stigma of severe mental illness: A systematic review and meta-analysis. Schizophrenia Research, 173(1–2), 4553. https://doi.org/10.1016/j.schres.2016.02.013Google Scholar
Vieta, E., Pacchiarotti, I., Valentí, M., Berk, M., Scott, J., & Colom, F. (2009). A critical update on psychological interventions for bipolar disorders. Current Psychiatry Reports, 11(6), 494502. https://doi.org/10.1007/s11920–009-0075-0CrossRefGoogle ScholarPubMed
Warner, R. (2010). Does the scientific evidence support the recovery model? The Psychiatrist, 34(1), 35. https://doi.org/10.1192/pb.bp.109.025643Google Scholar
Young, A. S., Cohen, A. N., & Miotto, K. A. (2016). Improving the quality of care for serious mental illness. Quality Improvement in Behavioral Health, 275–288. https://doi.org/10.1007/978-3-319-26209-3_18Google Scholar
Zipursky, R. B., Reilly, T. J., & Murray, R. M. (2012). The myth of schizophrenia as a progressive brain disease. Schizophrenia Bulletin, 39(6), 13631372. https://doi.org/10.1093/schbul/sbs135CrossRefGoogle ScholarPubMed

Save book to Kindle

To save this book to your Kindle, first ensure coreplatform@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×