In 1988, Betty Neuman had the foresight to establish a Trustees Group that provides consultation and is the established body for sanctioning changes of her model. She has included a description of this group in an appendix that contains a list of members. Membership includes both domestic and international representation. The Trustees Group offers assurance that the model will continue to be advanced in the future. Members plan and conduct national and international conferences on the Neuman systems model. Without a doubt, establishment of groups such as this, the continued requirement to utilize nursing theory in nursing dissertations, and nursing theory courses required in graduate education will ensure that nursing theory is at the foundation of our science as a profession.The fourth edition of this book provides a comprehensive guide for nursing practice, research, education, and administration. The text is divided into six parts: an overview of the model; its application to clinical practice, nursing research, nursing education, and nursing administration; and future directions of the model. The overview of the model provides no changes in the basic ideas comprising the model. However, in this section, the spiritual variable has been described as a necessary consideration for a wholistic and caring practice. The analogy of a seed was utilized to clarify the statement that the spirit controls the mind and the mind controls the body. In this analogy, reference was made to the human spirit as the seed. The spiritual variable is to be assessed and followed with purposeful intervention. A tool has been developed by Carrigg and Weber (1997) based on the Neuman systems model. The Spiritual Care Scale (SCS) is a 30-item scale that measures three spiritual dimensions: faith, empowerment, and meaningfulness. The SCS differentiates spiritual care from psychosocial care. Further use of this scale with different populations would add further depth and breadthe to the application of the model.The clinical guidelines in the Neuman systems model lend themselves to a multidisciplinary perspective and have been revised to be useful to other disciplines. Eleven guidelines are identified in relationship to the model. Of interest is the seventh guideline, which is related to a diagnostic taxonomy. Ziegler (1982) initially developed a clinical tool focused on the diagnosis taxonomy. The tool organizes the taxonomy according to the client system, level of response, client subsystem responding to the stressor, source of the stressor, and type of stressor. The identification of a diagnostic taxonomy enhances the model and the practitioner's ability to utilize the model in a variety of clinical settings. Further development of the taxonomy is needed to be applicable to a variety of client systems.Utilization of the model for psychiatric nursing practice from a Canadian perspective is presented by John Crawford and Michael Tarko. Narratives are presented which provide insight into the usefulness of the model and how practice was chang...