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Residential work with the elderly
Book reviews tion (e.g. object permanencel, language (e.g. the competence performance distinction), and social interaction (e.g. cyclical and reciprocal patternings), and the emphasis on behavioral change, Volume I might even be a useful addition to an advanced course in h u m a n development. Volume !I was intended as an exposition of observational methodology and a lab manual for conducting observational research. As such, it is only a start, but a good one. It offers some general advice on the construction of behavioral taxonomies and the selection of sampling techniques, a cautionary note about the problems with agreement indices of reliability, and an illustrated guide to recording devices ranging from checklists to digital keyboards. There are also several chapters summarizing statistical techniques for analyzing both sequential and nonsequential d~.ta. John G o t t m a n ' s chapter in particular is commendable for its clear description of the uses of potentially abstruse techniques such as Q-type factor analysis and multiple group discriminant function analysis. Readers will not be able to analyze their data on the basis of this volume alone, but they will glean some useful orienting information and in several instances will be directed to more detailed sources. To be sure, there is an unevenness of quality about both volumes and perhaps a few errors of omission. For instance, readers interested in the work primarily for its relevance to mental retardation may be disappointed to find that several contributors in no way even attempt to relate their ideas to issues and problems in mental retardation, while others merely append a short section on the topic that appears at best to be an afterthought. Readers with special interests in the statistical treatment of observational data may search in vain for discussions of: (a) path-analytic procedures by scholars encouraging more bidirectional conceptualizations of the nature of interpersonal influence; (b) cross-lagged panel correlation techniques by researchers interested in drawing strong inferences from correlational data gathered at several points in time; (c) interrupted time series procedures by observers of small numbers of subjects; and (d) nonequivalent control group designs by practitioners interested in assessing the effects of different kinds of community care facilities, to which residents are unlikely to be randomly assigned. On the whole, however, the collection deserves mostly praise. For its theoretical insights, its methodological critiques, its historical notes, its substantive advances and its questioning of some of the basic assumptions about mental retardation, as well as for its good practical advice on the day-to-day decisions concerning data collection, data management and data analysis, it will be of value to a wide range of psychologists and practitioners.
Department of Psychology and Social Relations Harvard Unicersity Cambridge, Mass., U.S.A.
BELLA M. DEPAULO
Methodologic Problems in Children's Spirometry, Vital and Health Statistics, Series 2, No. 72, National Center for Health Statistics, D H E W Publication No. (PHS) 78-1346, Public Health Service, D H E W , Hyattsville, M D 20782. 43 pp. No price given. This report from the National Center for Health Statistics is a companion piece to Series 11, No. 164. Together the two reports present spirometry data collected on children aged 6 - l l years in the United States during 1963 65. The major emphasis of this report is to detail the technical problems encountered and limitations involved in spirometry testing in children, and to suggest solutions to
289
those problems. Refinements in data collection, data processing and analysis as they will appear in future N C H S spirometry reports on children and adults are presented. New materials from two small studies which have not been published before are included. Figures and detailed tables amplify the text. Single copies of this publication are available free of charge from NCHS, Room 1 57, Center Building, 3700 East-West Highway, Hyattsville, Maryland 20782. Attn: M. MURRAY. or call (301) 436-NCHS.
Residential Work with the Elderly. by C. PAUL BREARLEY. Routledge & Kegan Paul, London, 1977. 107 pp. £10.25, (paper) £2.75 The author's stated intent in writing this book is "to bring together, in an organized way, some of the ideas, concepts and skills which seem to be relevant to the field (of residential care of the elderly)" (Preface). The book is primarily intended for residential workers in homes for the aged, and succeeds in outlining m a n y of the characteristics and needs of persons entering such care programs. Although written in Great Britain, the personal and social needs of the elderly which Brearley addresses are not geographically bound, but rather, are relevant to all care providers. His introductory chapter presents a brief, but rather comprehensive overview of the historical development of residential care in England. A concise review of relevant literature from England and America is used as a vehicle for understanding "the place of residential care in the totality of provision for the elderly and with the appropriate use and handling of residential resources to meet the individual needs" (p. 15). Chapters 2 5 address various aspects of the needs and patterns of behavior of the elderly, an understanding of which is necessary to the recognition that the "'key concept" in an effective use and delivery of service to elderly and infirm is flexibility. Brearley devotes approximately twenty pages to each of the following areas: (1) aspects of c o m m u n a l living; (2) special needs of the elderly; (3) entering residential care; and (4) working with the individual in a c o m m u n a l group. Anecdotal examples are utilized to illustrate particular situations or problems when an elderly person moves from one point in the continuum of care to another. While the importance of what is often a difficult task of determining the appropriate level of care for an aging or infirm individual is highlighted throughout the book, little attention is given to the importance of providing individualized service programs to persons in their own homes in order to prevent their entry into institutions. The relationship between physiological and social changes which occur within individuals and their external environments is presented as a key to the elderly person's satisfaction in, and adaptation to, old age. Each chapter builds upon material presented previously with the goal of providing the reader with a sense of the aged individual's totality of needs as he enters, becomes adjusted to, and potentially moves out of residential care. Brearley tries to identify the many roles which residential workers must fill in meeting the social, psychological and physical needs of the "patients". The role of the worker and the stresses of the work situation are discussed with the aim of underscoring the need for open communication a m o n g workers and a "channel for feeding ideas up to the agency's policy makers" (p. 91). Brearley's conclusions tie the book together in a concise manner and address future needs and alternatives in the light of current knowledge. He reiterates the need for careful consideration of appropriate service delivery mechanisms, and points out that there exist many options in the caring continuum. He summarizes by stating that there
290
Book
are two central considerations in working with elderly persons, particularly in residential settings: (1) aging is a process, or rather a collection of processes, and it is a process in which we are all involved; and (2) residential care is one part of a range of caring services available to meet the needs of the elderly who are unable to cope alone. These considerations form the perspective from which the book is written, and make it a useful introduction to some of the practical considerations in caring for the elderly in residential, as well as other settings. Hehrew Rehabilitation 1200 Centre Srreet Boston, MA, U.S.A.
Center
for
Aged
CLAIRE SYLVIA
E. GUTKIN SHERWOOD
Sexual Assault of Children and Adolescents, by ANN WOLBERT BURGESS, A. NICHOLAS GROTH, LYNDA LYTL~. HOLMSTROM and SUZANNE M. SGROI. Lexington Books.
Lexington.
Mass..
1978. 245 pp. $20.00
In 1974, Burgess and Holmstrom pioneered efforts to enhance the visibility and knowledge of sexual assault with publication of their first co-authored book entitled Rape. Victims of Crisis. As the first comprehensive publication in its field, that book very quickly became a basic referral source and training aid for professional and lay personnel involved in victim-treatment programs for adults. Those two authors, a nurse educator and a sociologist. have now been joined by a psychologist and a physician and have focused in on what has historically been viewed as the most taboo of subjects within this field: the sexual assault of children and adolescents. It is anticipated that this book. like the one previously referred to, will become a primary reference for students and practitioners from a wide variety of disciplines and agency settings who have contact with the types of children and families described. The book is divided into two parts. the first dealmg with offenders and the second dealing with victims. As is noted in the text. work in this area is relatively new and remains quite theoretical at this time. Hard researchers may be dismayed by the lack of scientific supporting data for the positions advocated by the authors. They draw heavily upon case examples or descriptions and interpret these in the light of their own varied educational and
reviews experiential backgrounds. However, the heuristic value of the book should be great and the authors clearly demonstrate that relevant research will involve a wide variety of fields including medicine, psychology, psychiatry. child protection services, law enforcement and school personnel. While the problem of the sexual assault of children is certainly not new to our society, our willingness to be sensitized to the issue and to mobilize a community response to it ought to be significantly aided by this book. As the authors repeatedly point out, community education and awareness are the first steps in developing a response system. As is succinctly illustrated. child sexual assault consists of much more than the stereotypical stranger enticing the young female into his car and sexually traumatizing her. Quite the contrary. Evidence to date indicates that most child sexual abuse involves intrafamilial perpetrators and. as Sgroi notes, many cases are missed because such abuse is frequently non-violent and/or non-traumatizing in its initial stages. Groth also challenges our societal assumptions by suggesting that, while more female children are identified as being sexually abused, offenders report much more abuse of male children than is reflected in our current statistics, The greatest strength of this book. its strong interdisciplinary approach, is also its greatest weakness. It is a potpourri of observations, theories, case descriptions, treatment approaches and varying dynamic models for consideration. This gap could have been filled, in large part, by a final summary chapter which would attempt to integrate and synthesize the vast amount of material covered in the book by the four authors and three contributors. However, the lack of closure one may experience at its conclusion is, in a larger sense. reflective of the stage at which we are in our knowledge of child sexual assault. We are at the very beginning of identification and understanding with regard to this issue. When viewed in this perspective, Srltuul Assault of Childrm and Adokscettts provides a strong stimulus for the further development 01 interdisciplinary training. research and program development in a hitherto neglected field. Departttlent of Psychiatric School of‘ Mediciur, The Uniacrsiry of’ New Me.~ico Albuquerque. NN Mrrico. U.S.A.
JOAYM
W. STIXLING
Department of Psychology and Social Relations Harvard Unicersity Cambridge, Mass., U.S.A.
BELLA M. DEPAULO
Methodologic Problems in Children's Spirometry, Vital and Health Statistics, Series 2, No. 72, National Center for Health Statistics, D H E W Publication No. (PHS) 78-1346, Public Health Service, D H E W , Hyattsville, M D 20782. 43 pp. No price given. This report from the National Center for Health Statistics is a companion piece to Series 11, No. 164. Together the two reports present spirometry data collected on children aged 6 - l l years in the United States during 1963 65. The major emphasis of this report is to detail the technical problems encountered and limitations involved in spirometry testing in children, and to suggest solutions to
289
those problems. Refinements in data collection, data processing and analysis as they will appear in future N C H S spirometry reports on children and adults are presented. New materials from two small studies which have not been published before are included. Figures and detailed tables amplify the text. Single copies of this publication are available free of charge from NCHS, Room 1 57, Center Building, 3700 East-West Highway, Hyattsville, Maryland 20782. Attn: M. MURRAY. or call (301) 436-NCHS.
Residential Work with the Elderly. by C. PAUL BREARLEY. Routledge & Kegan Paul, London, 1977. 107 pp. £10.25, (paper) £2.75 The author's stated intent in writing this book is "to bring together, in an organized way, some of the ideas, concepts and skills which seem to be relevant to the field (of residential care of the elderly)" (Preface). The book is primarily intended for residential workers in homes for the aged, and succeeds in outlining m a n y of the characteristics and needs of persons entering such care programs. Although written in Great Britain, the personal and social needs of the elderly which Brearley addresses are not geographically bound, but rather, are relevant to all care providers. His introductory chapter presents a brief, but rather comprehensive overview of the historical development of residential care in England. A concise review of relevant literature from England and America is used as a vehicle for understanding "the place of residential care in the totality of provision for the elderly and with the appropriate use and handling of residential resources to meet the individual needs" (p. 15). Chapters 2 5 address various aspects of the needs and patterns of behavior of the elderly, an understanding of which is necessary to the recognition that the "'key concept" in an effective use and delivery of service to elderly and infirm is flexibility. Brearley devotes approximately twenty pages to each of the following areas: (1) aspects of c o m m u n a l living; (2) special needs of the elderly; (3) entering residential care; and (4) working with the individual in a c o m m u n a l group. Anecdotal examples are utilized to illustrate particular situations or problems when an elderly person moves from one point in the continuum of care to another. While the importance of what is often a difficult task of determining the appropriate level of care for an aging or infirm individual is highlighted throughout the book, little attention is given to the importance of providing individualized service programs to persons in their own homes in order to prevent their entry into institutions. The relationship between physiological and social changes which occur within individuals and their external environments is presented as a key to the elderly person's satisfaction in, and adaptation to, old age. Each chapter builds upon material presented previously with the goal of providing the reader with a sense of the aged individual's totality of needs as he enters, becomes adjusted to, and potentially moves out of residential care. Brearley tries to identify the many roles which residential workers must fill in meeting the social, psychological and physical needs of the "patients". The role of the worker and the stresses of the work situation are discussed with the aim of underscoring the need for open communication a m o n g workers and a "channel for feeding ideas up to the agency's policy makers" (p. 91). Brearley's conclusions tie the book together in a concise manner and address future needs and alternatives in the light of current knowledge. He reiterates the need for careful consideration of appropriate service delivery mechanisms, and points out that there exist many options in the caring continuum. He summarizes by stating that there
290
Book
are two central considerations in working with elderly persons, particularly in residential settings: (1) aging is a process, or rather a collection of processes, and it is a process in which we are all involved; and (2) residential care is one part of a range of caring services available to meet the needs of the elderly who are unable to cope alone. These considerations form the perspective from which the book is written, and make it a useful introduction to some of the practical considerations in caring for the elderly in residential, as well as other settings. Hehrew Rehabilitation 1200 Centre Srreet Boston, MA, U.S.A.
Center
for
Aged
CLAIRE SYLVIA
E. GUTKIN SHERWOOD
Sexual Assault of Children and Adolescents, by ANN WOLBERT BURGESS, A. NICHOLAS GROTH, LYNDA LYTL~. HOLMSTROM and SUZANNE M. SGROI. Lexington Books.
Lexington.
Mass..
1978. 245 pp. $20.00
In 1974, Burgess and Holmstrom pioneered efforts to enhance the visibility and knowledge of sexual assault with publication of their first co-authored book entitled Rape. Victims of Crisis. As the first comprehensive publication in its field, that book very quickly became a basic referral source and training aid for professional and lay personnel involved in victim-treatment programs for adults. Those two authors, a nurse educator and a sociologist. have now been joined by a psychologist and a physician and have focused in on what has historically been viewed as the most taboo of subjects within this field: the sexual assault of children and adolescents. It is anticipated that this book. like the one previously referred to, will become a primary reference for students and practitioners from a wide variety of disciplines and agency settings who have contact with the types of children and families described. The book is divided into two parts. the first dealmg with offenders and the second dealing with victims. As is noted in the text. work in this area is relatively new and remains quite theoretical at this time. Hard researchers may be dismayed by the lack of scientific supporting data for the positions advocated by the authors. They draw heavily upon case examples or descriptions and interpret these in the light of their own varied educational and
reviews experiential backgrounds. However, the heuristic value of the book should be great and the authors clearly demonstrate that relevant research will involve a wide variety of fields including medicine, psychology, psychiatry. child protection services, law enforcement and school personnel. While the problem of the sexual assault of children is certainly not new to our society, our willingness to be sensitized to the issue and to mobilize a community response to it ought to be significantly aided by this book. As the authors repeatedly point out, community education and awareness are the first steps in developing a response system. As is succinctly illustrated. child sexual assault consists of much more than the stereotypical stranger enticing the young female into his car and sexually traumatizing her. Quite the contrary. Evidence to date indicates that most child sexual abuse involves intrafamilial perpetrators and. as Sgroi notes, many cases are missed because such abuse is frequently non-violent and/or non-traumatizing in its initial stages. Groth also challenges our societal assumptions by suggesting that, while more female children are identified as being sexually abused, offenders report much more abuse of male children than is reflected in our current statistics, The greatest strength of this book. its strong interdisciplinary approach, is also its greatest weakness. It is a potpourri of observations, theories, case descriptions, treatment approaches and varying dynamic models for consideration. This gap could have been filled, in large part, by a final summary chapter which would attempt to integrate and synthesize the vast amount of material covered in the book by the four authors and three contributors. However, the lack of closure one may experience at its conclusion is, in a larger sense. reflective of the stage at which we are in our knowledge of child sexual assault. We are at the very beginning of identification and understanding with regard to this issue. When viewed in this perspective, Srltuul Assault of Childrm and Adokscettts provides a strong stimulus for the further development 01 interdisciplinary training. research and program development in a hitherto neglected field. Departttlent of Psychiatric School of‘ Mediciur, The Uniacrsiry of’ New Me.~ico Albuquerque. NN Mrrico. U.S.A.
JOAYM
W. STIXLING