Mental health services are increasingly supporting recovery-oriented practice as a basis for service delivery. There is considerable overlap between the values and approaches associated with recovery-based practice and those already endorsed as good psychiatric practice. However, these agreed principles may not be consistently applied and further steps may be needed if the reorientation of the relationship between psychiatrists and people using psychiatric services is to fully reflect recovery principles. This article describes ways in which psychiatric practice could develop, including conceptualising medication as one of many possible recovery tools that a person can actively use to support their well-being, and a range of practices available to professionals to support people in taking up an active stance in relation to medication. It also identifies recovery-supportive practices for when someone is unable to fully participate in decision-making, owing to crisis, loss of capacity or concerns about safety.

In this issue of Advances, Baker et al describe a ‘recovery-focused approach’ to prescribing. They believe that there is a need for a paradigm shift in psychiatric practice. This commentary offers a brief introduction to the ‘recovery’ literature and a sceptical analysis of this bold claim.

PowerPoint slides are now almost expected of anyone preparing a presentation. The rise of the slide has generated considerable debate, with some people concerned that PowerPoint diminishes the potential of critical thinking by the audience, and others encouraging innovative graphic design as assisting the transmission of information. We examine these two viewpoints and offer steps and resources for incorporating design elements when preparing slides.

Gamblers Anonymous (GA) is perhaps the least used of the twelve-step approaches to dealing with addictions. This relative lack of visibility and use, at least in the UK, is reflected in healthcare professionals' lack of awareness and knowledge of gambling addiction and its treatment, including GA. In this article, we introduce the basic tenets of GA and discuss how these translate into treatment.

The General Medical Council suggests that leadership skills are a core requirement for all doctors. The NHS Institute for Innovation and Improvement goes further, stating that doctors have not only an intrinsic leadership role but also a responsibility to contribute to the effective running of healthcare organisations. The Medical Leadership Competency Framework (MLCF) outlines a structure with domains, elements and competency outcomes, all of which are clearly spelled out with examples and methods of learning for different stages of a medical career. The revised curriculum for postgraduate training in psychiatry contains many aspects of the MLCF, both complementing and supplementing its emphasis on the development of personal qualities and skills. This article highlights this approach and describes how the development of leadership and management skills fits with the current structures for training in psychiatry.

The case for better medical ‘leadership’ should be grounded in professional values and the need to deliver quality services for patients. But emerging ‘leadership language’ suggests that new ‘talent’ in management are in fact influenced by commercial imperatives. The profession needs to monitor such trends with care.

Consultant psychiatrists are familiar with mental health tribunals, at which they appear as key witnesses giving both factual evidence and expert opinion. They also commonly act as the representative of the ‘responsible authority’. The implications of this in terms of roles and responsibilities, and in terms of training and continuing professional development, have received little attention. Psychiatrists should not accept a representative role unless they are sure that they have the necessary competencies and resources – competencies that are alien to most clinicians and resources that are not available in many services. This article outlines those requirements so that psychiatrists can make better-informed decisions about whether or not to undertake the role and provides practical guidance for those who choose to do so.

Sexual dysfunction is one of the most common psychiatric disorders, but it is often ignored in assessment. It can be primary or secondary (a result of psychiatric disorder or medication). Success rates in managing sexual dysfunction are relatively high, with good response to psychological and medical interventions. In ICD-10 and DSM-IV-TR, sexual dysfunctions are broadly classified on the basis of the stages of sexual activity, from arousal to orgasm. There are major similarities between ICD and DSM in diagnosis and classification of sexual dysfunction, but both systems raise challenges. These include definitions of what is ‘normal’ and how abnormality is defined. In this article, we describe the role of the two systems and possible amendments that might help researchers and clinicians. We also present key principles for the assessment and treatment of people who experience sexual dysfunction. We consider problems that need to be managed in engaging and in the therapeutic alliance.

This article focuses on how to assess and manage risk in sexual offenders. It covers assessment issues, including interviews, taking a sexual history, assessing sexual deviance and assessing personality. The key step of case formulation is outlined and the development of risk management strategies, including monitoring, supervision and treatment, is described.

Violence between people is a complex social phenomenon involving both social and individual psychological variables. Prevention of violence includes attention to risk factors for violence; but also the provision of interventions for those who have been violent to others. This article explores the evidence that failures of the mentalising process are a risk factor for acts of violence, especially in mental health service users; and describes the implementation of potential therapeutic programmes that seek to improve mentalising in individuals who pose a risk of serious violence to others.

This article examines Charles Baudelaire's life, works and his most important collection, The Flowers of Evil. Baudelaire is regarded as one of the most important 19th-century French poets. He revolutionised the content and subject matter of poetry and served as a model for later poets around the world. He continues to exert immense influence on writers. He contracted syphilis early in life, experienced episodes of depression, and had intense and complicated relationships with his mother and other women in his life.