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Treating incest: A multi-modal systems perspective
ChddAbusv& N&-c/. Vol. 13. pp. 303-305. Printed in the U.S.A. All rights reserved.
1989 Copyright
Q
0145-2134/89 1989 Pagamon
53.00 + .OO Journals pk.
BOOK REVIEWS
Treating Incest: A Multi-Modal Systems Perspective. Terry S. Trepper and Mary Jo Barrett, Editors. Haworth, New York, NY, 126 pp. 1986. Hardback, $22.95. EDITED BY TERRY TRAPPER AND MARY JO BARRETT, with contributions from distinguished American writers such as David Finkelhor and John R. Conte, the collection of essays in this little book is balanced, spanning psychology, social work, medicine, the law, and sociology, and reflects the attempts of the editors to present a wider view of incest, avoiding unitary theoretical models. The book is divided into two main sections, dealing with a conceptual framework for the assessment of intrafamilial sexual abuse in part one and the treatment of intrafamilial sexual abuse in part two. The introductory comments which review the effect of therapists’ values upon assessment, the controversy around individual versus the family focus, and multiple and contradictory dimensions of assessment, is excellently referenced; and by demonstrating the multiplicity of models currently available for understanding sexual abuse, it points to the need to review current thinking about incest. Trepper and Barrett propose an assessment model for incestuous families which is complex and involves both systems and psychodynamic elements. Larson and Maddock describe treatment approaches relating to the meaning of the incest experience for each of the four family types. For instance, the affection-seeking family benefits from a relatively gentle treatment approach with outpatient family therapy, supportive group work, and a structual/ strategic approach. By contrast, the violent rape family type needs in-patient treatment, separation of victim and offender, individual marital therapy, and possibly family therapy. A range of theoretical approaches is suggested for this type of family and the prognosis is poor. Although the chapter on the integration of medicine into assessment and treatment is admirably brief and quite well referenced, it does not really succeed in integrating the medical assessment with the other assessments described in the book. The chapter on court testimony by Schweitzer and Kurlychek is likely to be appealing to family therapists required to give evidence in these cases. Suggestions are made about giving expert evidence, such as not rising to the lawyers’ bait when provoked, and “‘in court, dress and act conservatively, politely, pleasantly, and professionally. Speak loudly and clearly . e _” The authors point out that pre-trial preparation is the key in transforming the family therapist into a poised, confident, objective, and valuable expert witness. Jon Conte’s final chapter at the end of the book, “Sexual Abuse in the Family: A critical Analysis,” makes the point that certain practitioners use systems theory to take a narrow, intrafamilial view of incest in a way which ignores the wider environmental or ecological factors which play into incest. He indicates that simplistic theories which suggest that a power skew within the family system can “explain” incest are not based on empirical research which would inform us about the prevalence of power skew of this sort for non-incestuous families. The chapter ends with a call for further research into both the demographic characteristics of incestuous families and into the outcome of treatment. This well-written book is stimulating and worth reading, even though European clinicians might wish for wider ranging references. The book will be of particular interest to family therapists working with incest. Eileen Vizard, M.R.C. Psych. London. England 303
1989 Copyright
Q
0145-2134/89 1989 Pagamon
53.00 + .OO Journals pk.
BOOK REVIEWS
Treating Incest: A Multi-Modal Systems Perspective. Terry S. Trepper and Mary Jo Barrett, Editors. Haworth, New York, NY, 126 pp. 1986. Hardback, $22.95. EDITED BY TERRY TRAPPER AND MARY JO BARRETT, with contributions from distinguished American writers such as David Finkelhor and John R. Conte, the collection of essays in this little book is balanced, spanning psychology, social work, medicine, the law, and sociology, and reflects the attempts of the editors to present a wider view of incest, avoiding unitary theoretical models. The book is divided into two main sections, dealing with a conceptual framework for the assessment of intrafamilial sexual abuse in part one and the treatment of intrafamilial sexual abuse in part two. The introductory comments which review the effect of therapists’ values upon assessment, the controversy around individual versus the family focus, and multiple and contradictory dimensions of assessment, is excellently referenced; and by demonstrating the multiplicity of models currently available for understanding sexual abuse, it points to the need to review current thinking about incest. Trepper and Barrett propose an assessment model for incestuous families which is complex and involves both systems and psychodynamic elements. Larson and Maddock describe treatment approaches relating to the meaning of the incest experience for each of the four family types. For instance, the affection-seeking family benefits from a relatively gentle treatment approach with outpatient family therapy, supportive group work, and a structual/ strategic approach. By contrast, the violent rape family type needs in-patient treatment, separation of victim and offender, individual marital therapy, and possibly family therapy. A range of theoretical approaches is suggested for this type of family and the prognosis is poor. Although the chapter on the integration of medicine into assessment and treatment is admirably brief and quite well referenced, it does not really succeed in integrating the medical assessment with the other assessments described in the book. The chapter on court testimony by Schweitzer and Kurlychek is likely to be appealing to family therapists required to give evidence in these cases. Suggestions are made about giving expert evidence, such as not rising to the lawyers’ bait when provoked, and “‘in court, dress and act conservatively, politely, pleasantly, and professionally. Speak loudly and clearly . e _” The authors point out that pre-trial preparation is the key in transforming the family therapist into a poised, confident, objective, and valuable expert witness. Jon Conte’s final chapter at the end of the book, “Sexual Abuse in the Family: A critical Analysis,” makes the point that certain practitioners use systems theory to take a narrow, intrafamilial view of incest in a way which ignores the wider environmental or ecological factors which play into incest. He indicates that simplistic theories which suggest that a power skew within the family system can “explain” incest are not based on empirical research which would inform us about the prevalence of power skew of this sort for non-incestuous families. The chapter ends with a call for further research into both the demographic characteristics of incestuous families and into the outcome of treatment. This well-written book is stimulating and worth reading, even though European clinicians might wish for wider ranging references. The book will be of particular interest to family therapists working with incest. Eileen Vizard, M.R.C. Psych. London. England 303