- Email: [email protected]
Treating Parent-Infant Relationship Problems.
B O OK R EV I EW S
for Affective Disorders. Finally, the concluding part of the book summarizes molecular genetics findings in the field through contributions from McGuffin and Hanson and looks into the future through contributions from Turkheimer and Gottesman. The volume is rich and powerful in conveying its messages, the principal one of which is that human behavior is complex but of a complexity that is penetrable and researchable. As Gottesman himself points out, it is amazing what the field has accomplished and how it has changed during the 40 years of his active presence in it. There is much to say about the role that Gottesman himself has played in the field in those four decades, reflected in this volume and, perhaps, in many more active years to be reflected in volumes still to come. Gottesman’s post-Festschrift publications (e.g., Gottesman and Gould, 2003; Turkheimer et al., 2003, among others) indicate that his contributions and his dreams are far from completed. Thus, there is more to come, and we will wait for it with eager anticipation. Elena L. Grigorenko, Ph.D. Yale Child Study Center New Haven, CT Disclosure: The author has no financial relationships to disclose.
Gottesman II, Gould TD (2003), The endophenotype concept in psychiatry: etymology and strategic intentions. Am J Psychiatry 160: 636–645 Turkheimer E, Haley A, Waldron M, D’Onofrio B, Gottesman II (2003), Socioeconomic status modifies heritability of IQ in young children. Psychol Sci 14:623–628
Treating Parent–Infant Relationship Problems. Edited by Arnold Sameroff, Susan McDonough, and Katherine Rosenblum. New York: Guilford, 2003, 304 pp., $40.00 (hardcover). The first few years of life play a crucial role in setting the stage for healthy and successful mental health development. This edited book presents contemporary approaches of observing and evaluating early relationship difficulties and promoting sensitive and responsive parenting and demonstrates how early intervention can foster optimal growth and development. The contributors are internationally respected experts in the field of child development and infant mental health. They represent various clinical and academic settings and perspectives, which makes this volume useful for a wide range of psychotherapists with different theoretical backgrounds. Working therapeutically with parents is one of the most challenging aspects of clinical work involving children. This book presents therapeutic approaches using up-to-
date knowledge of development to treat the infant–parent relationship as the identified patient, strategies that help to create a therapeutic working alliance with the parents. The editors have succeeded in their aim to encompass many aspects of infant–caregiver relationship problems through the ‘‘integration of theory and practice’’ (p. xi). The book is clearly organized. Its first part introduces major ‘‘themes’’ in parent–infant work that are elaborated in later chapters. Arnold Sameroff describes the importance of identifying the real patient as ‘‘the parent–infant relationship,’’ a concept that originated with Donald Winnicott’s notion that ‘‘baby’’ always implies a mothering relationship. Sameroff sets a tone for the rest of the volume with his introduction of Daniel Stern’s concept of ‘‘ports of entry,’’ that is, possible avenues of intervention, including remediation, redefinition, and reeducation. The reader will appreciate the clarity of Stern’s description of the new mental organization necessary to become a mother, which he calls the ‘‘motherhood constellation’’ and which has both interpersonal and intrapsychic components. Enlarging on Winnicott’s concept of the ‘‘holding environment,’’ Stern describes what would be the ideal ‘‘therapeutic holding environment’’ in caregiver–infant work. In the final chapter of this first section, Katherine Rosenblum discusses features, advantages, and limitations of various diagnostic systems to assess parent–infant relationship problems. She critically points to the overemphasis on disorder in the individual (the medical disease model) and the relative neglect of disorders of relationships (the relationship model). The chapters in the second part, ‘‘Variations,’’ introduce the reader to clinical approaches employed by different researchers, using various ports of entry, illustrating how differing interventions are beneficial in actual treatment situations. What they all have in common is an understanding that it is a relationship, or a family system, that is the target for change. Many of the contributors acknowledge the influence on their own thinking of Selma Fraiberg’s psychoanalytically informed pioneering work in parent–infant psychotherapy. Alicia Liberman examines the parents’ ability to provide developmentally appropriate understanding and responses, as influenced by both their own internalized history and by current life stresses. She describes the contribution of both children and their parents by reviewing empirical and clinical literature. She illustrates the commonly used ports of entry with vignettes to help clinicians in forming psychotherapeutic interventions. Liberman and other contributors to this volume underline the importance of the therapeutic relationship as a nonspecific but consequential mutative factor in parent– child work. Some writers use video feedback as a useful intervention tool. Susan McDonough uses it in interactive guidance, a
J. AM. AC AD. CH ILD ADO LE SC. PSY CH IAT RY, 44:2, F EBRU ARY 2 005
203
BOOK REVIEWS
relatively unstructured approach to family intervention. At the University of Lausanne, Elisabeth Fivaz-Depeursinge and her colleagues invite a set of parents to play with their infant according to a predetermined, relatively more structured sequence of interactions. Videotapes of these interactions are then jointly reviewed with the parents. This process is especially useful when consulting with therapists and other professionals. Evaluating the use of a structured procedure, as compared with an unstructured clinical situation, might be an interesting area of investigation for researchers in this field. Winnie Dunn describes four patterns of sensory processing as a practical way of understanding different self-regulation strategies in an infant and its mother. Clinicians can help mothers identify their infant’s sensory processing style and develop appropriate strategies to support their adaptation. Dunn believes it is critical to include sensory processing approaches as part of comprehensive assessment and intervention programs. The chapter by Nadia Bruschweiler-Stern has several strong points to recommend it. Her multimodal approach emphasizes the need to recognize birth as a normal life crisis that can be used for prevention and intervention. The concept of integrating mother’s intrapsychic representation of her ‘‘imagined baby’’ with the ‘‘real baby’’ is a powerful tool to facilitate ongoing healthy development. In particular, she tries to locate and build on positive internal representations and parental strengths. Byron Egeland and Martha Erickson succinctly summarize the well-known STEEP (Steps Toward Effective, Enjoyable Parenting) preventive intervention program. Based in part on attachment theory, STEEP is an organized, focused program that trains ‘‘facilitators’’ to help parents modify ‘‘inner working models’’ toward the goal of more effective parenting. In Chapter 10, Julie Larrieu and Charles Zeanah describe a multimodal intervention program, working with multiple caregivers in cases of child maltreatment. Unlike many edited collections, this volume stands out in that the contributors clearly shared an ‘‘internal working model’’ of the editors’ vision, and this fact gives the book a rare sense of cohesiveness and focus. The contributions are interesting and engage the reader, who wants to keep on reading. The authors of the last chapter, Robert Emde and colleagues, bring the text full circle by providing a synthesis and integration of various approaches described in preceding chapters. They highlight the contributions of different pioneering workers and different developmental models and stress the importance of ‘‘leverage,’’ a construct that refers to finding the optimal opportunity for the therapeutic relationship to influence ‘‘the real patient,’’ the caregiver–infant relationship. The contributors are a positive and optimistic group in their various clinical approaches. However, all therapeutic orientations, intervention strategies, and therapists encounter resistance to change. Resistance is a ubiquitous phenomenon,
204
and the book would have been enriched with some discussion by these authors of how they handle the inevitable resistances that come up. Nevertheless, the reader is encouraged to appreciate the availability of different interventions, to understand the differences among them, and to choose appropriate interventions for differing circumstances. The book is commendable in its combination of solid research and clinical sophistication. Karam Radwan, M.D. Department of Child and Adolescent Psychiatry University of Michigan Ann Arbor Michael Singer, Ph.D. Department of Psychiatry University of Michigan Medical School Michigan Psychoanalytic Institute Ann Arbor Disclosure: The authors have no financial relationships to disclose.
Psychological Theory and Educational Reform: How School Remakes Mind and Society. By David R. Olson, Cambridge, UK: Cambridge University Press, 2003, 343 pp., $24.00 (paperback). Serving Two Masters: The Dilemma of Genuine School Reform
Although the history of public education in the United States is replete with crises, turning points, and major decisions that have affected the lives and aspirations of millions of people in the past century, it seems as though the battle over the roles of schools has only intensified as time has progressed. Part of the reason is that education is associated with both social and economic opportunity. At the same time, education is also associated with social and economic power, and in a democratic society, as Olson rightly notes, changes in schooling reflect underlying shifts in the power relationships between social groups and institutions. Over the past three decades, calls for school reform have become ubiquitous and incessant. The stakes are high because the fate and face of our society are tied to the decisions and consequences about our schools. However, despite their best intentions, most school reform programs have not lived up to their promise. Olson’s central thesis is that most people, including educators, policymakers, and citizens at large, either do not understand or ignore the unique roles of schools as institutions whose primary obligation is to the state that gives rise to them and that maintains their existence by providing resources. The
J. AM . ACAD. CHILD ADOLESC. PSYCHIATR Y, 4 4:2 , FEBRUARY 20 05
for Affective Disorders. Finally, the concluding part of the book summarizes molecular genetics findings in the field through contributions from McGuffin and Hanson and looks into the future through contributions from Turkheimer and Gottesman. The volume is rich and powerful in conveying its messages, the principal one of which is that human behavior is complex but of a complexity that is penetrable and researchable. As Gottesman himself points out, it is amazing what the field has accomplished and how it has changed during the 40 years of his active presence in it. There is much to say about the role that Gottesman himself has played in the field in those four decades, reflected in this volume and, perhaps, in many more active years to be reflected in volumes still to come. Gottesman’s post-Festschrift publications (e.g., Gottesman and Gould, 2003; Turkheimer et al., 2003, among others) indicate that his contributions and his dreams are far from completed. Thus, there is more to come, and we will wait for it with eager anticipation. Elena L. Grigorenko, Ph.D. Yale Child Study Center New Haven, CT Disclosure: The author has no financial relationships to disclose.
Gottesman II, Gould TD (2003), The endophenotype concept in psychiatry: etymology and strategic intentions. Am J Psychiatry 160: 636–645 Turkheimer E, Haley A, Waldron M, D’Onofrio B, Gottesman II (2003), Socioeconomic status modifies heritability of IQ in young children. Psychol Sci 14:623–628
Treating Parent–Infant Relationship Problems. Edited by Arnold Sameroff, Susan McDonough, and Katherine Rosenblum. New York: Guilford, 2003, 304 pp., $40.00 (hardcover). The first few years of life play a crucial role in setting the stage for healthy and successful mental health development. This edited book presents contemporary approaches of observing and evaluating early relationship difficulties and promoting sensitive and responsive parenting and demonstrates how early intervention can foster optimal growth and development. The contributors are internationally respected experts in the field of child development and infant mental health. They represent various clinical and academic settings and perspectives, which makes this volume useful for a wide range of psychotherapists with different theoretical backgrounds. Working therapeutically with parents is one of the most challenging aspects of clinical work involving children. This book presents therapeutic approaches using up-to-
date knowledge of development to treat the infant–parent relationship as the identified patient, strategies that help to create a therapeutic working alliance with the parents. The editors have succeeded in their aim to encompass many aspects of infant–caregiver relationship problems through the ‘‘integration of theory and practice’’ (p. xi). The book is clearly organized. Its first part introduces major ‘‘themes’’ in parent–infant work that are elaborated in later chapters. Arnold Sameroff describes the importance of identifying the real patient as ‘‘the parent–infant relationship,’’ a concept that originated with Donald Winnicott’s notion that ‘‘baby’’ always implies a mothering relationship. Sameroff sets a tone for the rest of the volume with his introduction of Daniel Stern’s concept of ‘‘ports of entry,’’ that is, possible avenues of intervention, including remediation, redefinition, and reeducation. The reader will appreciate the clarity of Stern’s description of the new mental organization necessary to become a mother, which he calls the ‘‘motherhood constellation’’ and which has both interpersonal and intrapsychic components. Enlarging on Winnicott’s concept of the ‘‘holding environment,’’ Stern describes what would be the ideal ‘‘therapeutic holding environment’’ in caregiver–infant work. In the final chapter of this first section, Katherine Rosenblum discusses features, advantages, and limitations of various diagnostic systems to assess parent–infant relationship problems. She critically points to the overemphasis on disorder in the individual (the medical disease model) and the relative neglect of disorders of relationships (the relationship model). The chapters in the second part, ‘‘Variations,’’ introduce the reader to clinical approaches employed by different researchers, using various ports of entry, illustrating how differing interventions are beneficial in actual treatment situations. What they all have in common is an understanding that it is a relationship, or a family system, that is the target for change. Many of the contributors acknowledge the influence on their own thinking of Selma Fraiberg’s psychoanalytically informed pioneering work in parent–infant psychotherapy. Alicia Liberman examines the parents’ ability to provide developmentally appropriate understanding and responses, as influenced by both their own internalized history and by current life stresses. She describes the contribution of both children and their parents by reviewing empirical and clinical literature. She illustrates the commonly used ports of entry with vignettes to help clinicians in forming psychotherapeutic interventions. Liberman and other contributors to this volume underline the importance of the therapeutic relationship as a nonspecific but consequential mutative factor in parent– child work. Some writers use video feedback as a useful intervention tool. Susan McDonough uses it in interactive guidance, a
J. AM. AC AD. CH ILD ADO LE SC. PSY CH IAT RY, 44:2, F EBRU ARY 2 005
203
BOOK REVIEWS
relatively unstructured approach to family intervention. At the University of Lausanne, Elisabeth Fivaz-Depeursinge and her colleagues invite a set of parents to play with their infant according to a predetermined, relatively more structured sequence of interactions. Videotapes of these interactions are then jointly reviewed with the parents. This process is especially useful when consulting with therapists and other professionals. Evaluating the use of a structured procedure, as compared with an unstructured clinical situation, might be an interesting area of investigation for researchers in this field. Winnie Dunn describes four patterns of sensory processing as a practical way of understanding different self-regulation strategies in an infant and its mother. Clinicians can help mothers identify their infant’s sensory processing style and develop appropriate strategies to support their adaptation. Dunn believes it is critical to include sensory processing approaches as part of comprehensive assessment and intervention programs. The chapter by Nadia Bruschweiler-Stern has several strong points to recommend it. Her multimodal approach emphasizes the need to recognize birth as a normal life crisis that can be used for prevention and intervention. The concept of integrating mother’s intrapsychic representation of her ‘‘imagined baby’’ with the ‘‘real baby’’ is a powerful tool to facilitate ongoing healthy development. In particular, she tries to locate and build on positive internal representations and parental strengths. Byron Egeland and Martha Erickson succinctly summarize the well-known STEEP (Steps Toward Effective, Enjoyable Parenting) preventive intervention program. Based in part on attachment theory, STEEP is an organized, focused program that trains ‘‘facilitators’’ to help parents modify ‘‘inner working models’’ toward the goal of more effective parenting. In Chapter 10, Julie Larrieu and Charles Zeanah describe a multimodal intervention program, working with multiple caregivers in cases of child maltreatment. Unlike many edited collections, this volume stands out in that the contributors clearly shared an ‘‘internal working model’’ of the editors’ vision, and this fact gives the book a rare sense of cohesiveness and focus. The contributions are interesting and engage the reader, who wants to keep on reading. The authors of the last chapter, Robert Emde and colleagues, bring the text full circle by providing a synthesis and integration of various approaches described in preceding chapters. They highlight the contributions of different pioneering workers and different developmental models and stress the importance of ‘‘leverage,’’ a construct that refers to finding the optimal opportunity for the therapeutic relationship to influence ‘‘the real patient,’’ the caregiver–infant relationship. The contributors are a positive and optimistic group in their various clinical approaches. However, all therapeutic orientations, intervention strategies, and therapists encounter resistance to change. Resistance is a ubiquitous phenomenon,
204
and the book would have been enriched with some discussion by these authors of how they handle the inevitable resistances that come up. Nevertheless, the reader is encouraged to appreciate the availability of different interventions, to understand the differences among them, and to choose appropriate interventions for differing circumstances. The book is commendable in its combination of solid research and clinical sophistication. Karam Radwan, M.D. Department of Child and Adolescent Psychiatry University of Michigan Ann Arbor Michael Singer, Ph.D. Department of Psychiatry University of Michigan Medical School Michigan Psychoanalytic Institute Ann Arbor Disclosure: The authors have no financial relationships to disclose.
Psychological Theory and Educational Reform: How School Remakes Mind and Society. By David R. Olson, Cambridge, UK: Cambridge University Press, 2003, 343 pp., $24.00 (paperback). Serving Two Masters: The Dilemma of Genuine School Reform
Although the history of public education in the United States is replete with crises, turning points, and major decisions that have affected the lives and aspirations of millions of people in the past century, it seems as though the battle over the roles of schools has only intensified as time has progressed. Part of the reason is that education is associated with both social and economic opportunity. At the same time, education is also associated with social and economic power, and in a democratic society, as Olson rightly notes, changes in schooling reflect underlying shifts in the power relationships between social groups and institutions. Over the past three decades, calls for school reform have become ubiquitous and incessant. The stakes are high because the fate and face of our society are tied to the decisions and consequences about our schools. However, despite their best intentions, most school reform programs have not lived up to their promise. Olson’s central thesis is that most people, including educators, policymakers, and citizens at large, either do not understand or ignore the unique roles of schools as institutions whose primary obligation is to the state that gives rise to them and that maintains their existence by providing resources. The
J. AM . ACAD. CHILD ADOLESC. PSYCHIATR Y, 4 4:2 , FEBRUARY 20 05