Book News

The Therapist’s Use of SelfJ. Rowan & M. JacobsBuckingham: Open University Press,

2002. pp. 156. £14.99 (pb). ISBN:

0-335-20776-6.

I must admit to a certain prejudice in

starting to read this �eclectic� book as

this word can elicit quite an allergic

reaction. It is written by authors who

have both a psychodynamic and

humanistic/integrative tradition. Part

of my prejudice stems from trying to

cross theoretical boundaries and a cer-

tain hierarchy of values and beliefs that

we all have about our own orientation.

These prejudices were swiftly dispelled

as the authors have produced an

impressive and comprehensive sweep

of many conceptual systems in a read-

able and informative manner.

The book tries and succeeds in integ-

rating different points of view from

many theoretical orientations of talking

therapies, focusing on different ways of

being a therapist. The key to any talking

therapy is the therapeutic relationship

and the book concentrates on the part

the therapist plays in different types of

therapy, including cognitive beha-

vioural therapy, psychodynamic,

humanistic/integrative and many

others.

The authors define three main types

of relationship and devote a chapter to

each: instrumental, authentic, and

transpersonal. Each theoretical orien-

tation is located in one of these posi-

tions. Although they deny a hierarchy

exists in these ways of being, there is a

covert implication that the list repre-

sents an increasing level of awareness

and sophistication that some readers

may find unsettling.

In the instrumental position, the ther-

apist is the expert, putting right the

client’s problems, who is held at a

distance from impacting on the therap-

ist with a set of techniques and rules.

The therapist at best adopts a persona

in conducting a therapy with aims and

focus that can be manualised. These

forms of therapy, epitomised by CBT,

are most easily researched. All forms of

therapy at some point adopt this posi-

tion.

In the authentic position (a term I

found personally off putting), personal

involvement with the client is more

acceptable and the therapist is closely

identified with the client and the rela-

tionship actively explored. Psychoana-

lytic therapies, humanistic and person

centred therapists work this way. The

issue of counter transference is clearly

relevant here and there is an impressive

discussion of the history and uses of

counter transference as well as types of

empathy. The authors summarise their

findings in very useful tables, referenc-

ing how counter transference and em-

pathy have been written about and how

they are used.

The section on transpersonal position

is the most difficult. It focuses on the

abolition of the boundaries between

people as both therapist and client

come to occupy the same space at the

same time. It tends to get esoteric and

even �mystical and bizarre� and difficult

for those of us not used to reading

things like this. However, the issues

described are familiar to a lot of thera-

pists with discussions about resonance

and linking (although not of the psy-

choanalytic type). The discussion

between the authors in the last chapter

of the book clarifies quite a lot of their

thinking about this way of relating,

which is helpful to the reader in making

their own links to what is being said.

There are some interesting discus-

sions about the role of self-disclosure in

therapy as well as the therapeutic use of

the emotions, thoughts and reactions of

the therapist. �The therapist must

incessantly struggle to bring his woun-

ded self into play in the therapy…In

fact, it is this struggling that develops

the self of the therapist. This struggling

is so central because ultimately the

therapist’s self is the instrument which

will be used in therapy� (p. 50).The role of personal therapy is also

interestingly explored including the his-

tory of a training therapy. The chapter

on training and supervision from the

point of view of the differing positions of

the therapists is also very revealing,

especially the role of the training insti-

tutions. The more instrumental the

training the more the development of

the true self of the therapist is curtailed

as imitation is so much a part of the

training process. This is clearly a con-

troversial point and one likely to pro-

voke strong feelings in the reader. The

dynamics of supervision according to

the three positions is also discussed,

including the use of the supervisors self

in the supervision. I found this one of

the most interesting parts of the book.

The authors end with discussing the

limitations of each orientation as a

point of view in working with clients

and the purpose of therapy and being a

therapist. They write: �Perhaps it is

neither ultimately about knowledge,

nor the questioning of knowledge as

about gaining wisdom. And wisdom

seems a fine objective for the therapists

use of self� (p. 114). A wise book indeed

and highly recommended.

Ricky Emanuel

Royal Free Hospital, London

Supporting Families: Child Protec-tion in the CommunityRuth GardnerChichester: Wiley & Sons Ltd, 2003.pp. 177. £55.00 (hb). ISBN:0-471-49970-6.

This book is written from the standpoint

of the aims and objectives of the Na-

tional Society for the Prevention of

Cruelty to Children (NSPCC). It gives

an account of work undertaken with

parents and children by the project staff

of the NSPCC and it describes the

results of its work over a two-year

period with particular reference to im-

plications for policy and practice re-

garding child protection in the

community. Recent research findings

from other studies are also included as

part of the author’s aims to highlight

the important and multifactorial as-

pects of child protection in the commu-

nity. The author acknowledges that

�Because our sampling methods were

not scientific, the findings should be

treated with caution� (p. 36). Despite

this weakness, there is much to be

gained from the trend of the findings

and also from the other sources of

information reviewed by the author.

There are also verbatim statements

from parents about some of their own

experiences of abuse either as children

or in terms of domestic violence, and

from children and parents about neigh-

bourhood and family issues. All of this

adds to the richness of the book. This is

a book about the reality of vulnerable

families - children and parents - and

about services and the importance of

identifying the needs of such families

and providing better services against

the background of the principles of the

Children Act 1989. This book is more

likely to appeal to practitioners with a

Child and Adolescent Mental Health Volume 9, No. 4, 2004, pp 195–199

� 2004 Association for Child Psychology and Psychiatry.Published by Blackwell Publishing, 9600 Garsington Road, Oxford OX4 2DQ, UK and 350 Main Street, Malden, MA 02148, USA

particular interest in the area of child

protection, but it is nevertheless one

that researchers and teachers in the

field may also find useful.

Trian Fundudis

Fleming Nuffield Unit, Newcastle upon

Tyne

Early Reading Development andDyslexiaValerie MuterLondon: Whurr Publishers, 2003.pp. 212. £22.50 (pb). ISBN: 1-86156-327-2.

In Early Reading Development and Dys-

lexia Muter synthesises a broad sweep

of major research findings and makes

them her own. In so doing she provides

a persuasive account of the progress

that has been made over the past 10–

15 years in our understanding of how

4–7-year-old children learn to read, the

specific difficulties experienced by

those with dyslexia, and how we can

identify and help them.

The book, which provides an account

of the importance of phonological

awareness and other processes in read-

ing development and of the core phono-

logical deficit of dyslexia, is balanced

between research into reading develop-

ment and dyslexia� (113 pages) and the

practice of assessment and intervention

(99 pages). For those who are new to the

area, it is a very readable account with

technical terms that relate to cognitive

processes, research design, genetics,

brain structures and psychometrics

being clearly explained. The reader is

first introduced to the processes that

are involved in reading and dyslexia,

and then to factors that put children at

risk of reading delay, protective influ-

ences and factors that help children to

compensate for their difficulties. In the

second half of the book the reader is

introduced to procedures that can be

used to identify children at risk of

dyslexia and programmes that schools

can follow to reduce the incidence of

reading difficulties. Muter then guides

the reader through a comprehensive

model for diagnostic assessment and

introduces intervention programmes

that have been demonstrated to help

children with dyslexia. Well-positioned

case studies put flesh on theory and

practice, as they are expounded. Indeed

the account of Nicholas, a child whose

needs were not recognised in school, is

one of the clearest and most insightful

that I have read. The other five case

studies illustrate how a child’s profile of

reading skills can change over time and

how children with additional difficul-

ties, e.g. epilepsy and hemiplegia, can

be helped by a research-informed

assessment of their reading and other

educational needs.

The book provides a strong case

against the hands-off assessment fa-

voured by some educational psycholo-

gists, and should be required reading

on courses of training for educational

and clinical psychologists as well as for

those undertaking specialist courses in

reading and dyslexia. It should also be

of interest to Special Educational Need

Co-ordinators and to parents of chil-

dren with dyslexia.

Peter J. Hatcher

University of York

The Neuropsychiatry of EpilepsyM. Trimble & B. Schmitz (Eds.)Cambridge: Cambridge UniversityPress, 2002. pp. 350. £39.95 (pb).ISBN: 0-521-00516-7.

A better title for our purposes would be

�Some of the Neuropsychiatry of Epi-

lepsy in Adults�. The book is nicely

produced, extensively indexed, and

usefully referenced. Although men-

tioned in passing, specific discussion

of interictal psychoses, alternative psy-

choses, and affective disorders are

omitted. There are some welcome

reviews.

There is an interesting discussion of

epidemiological issues of neuropsychi-

atric disorders in epilepsy by Krishna-

moorthy and much of this is applicable

to children. In the chapter on limbic

connectivity, it is hard to disentangle

where the evidence comes from human

brains and where from speculations

from animal work. Janz contributes a

very interesting chapter on the psychi-

atry of idiopathic generalised epilepsy

and discusses personality types in dif-

ferent syndromes. He shows that post-

ictal and alternative psychosis occur at

similar rates in idiopathic generalised

epilepsies and temporal lobe epilepsy.

Postictal psychosis occurring after a

lucid interval is an interesting condi-

tion, usefully described by Kanemoto. It

is vanishingly rare in childhood if it

occurs at all, perhaps because it follows

an average 18 years after epilepsy

onset. Blumer explains that suicide

may occur many years after the onset

of epilepsy and may be related to inte-

rictal dysphoric disorder.

Stephen Brown’s beautiful chapter on

dementia and epilepsy includes discus-

sion of a possible mechanism for the

occasional deterioration of adolescents

who have temporal lobe epilepsy. The

chapters on behavioural and neuropsy-

chological aspects of frontal lobe epi-

lepsy, and the psychiatric effects of

surgery for temporal lobe epilepsy con-

tain useful Tables and are mostly about

adults. The antidepressant effects of

vagal nerve stimulation (Elger and

Hoppe) are an unexpected benefit for

those whose bodies now contain a vagal

nerve stimulator but whose seizures

remain poorly controlled.

Richard Brown includes a helpful

discussion of the uses/meanings of

dissociation in the context of non-epi-

leptic seizures. Another chapter argues

for a physical underpinning to pseudo-

seizures, but this is of less interest to

the clinician, who is more concerned to

clarify what is keeping them going. An

excellent but lightly referenced chapter

by Frank Besag is on epileptogenic,

reversible, cognitive and behavioural

problems that may appear fixed (state

dependent). It is the only one in the

book that is mostly about children.

Schmitz gives a clear and fair account

of anticonvulsant induced behavioural

problems, which includes children, and

there is an excellent summary of the

effect of seizures and medication on

cognition by Aldenkamp. Finally, a

cogent chapter by Schondienst recom-

mends non-compliance as an indication

for psychotherapy in the treatment of

epilepsy.

Michael Prendergast

Prudhoe Hospital, Northumberland

PACTS 2 Series: Parent, Adolescentand Child Training Skills – Series 2(8 booklets) Series Editor:M. Herbert, Guide Editors:M. Griffiths, A. Carr, S. Guerin,E. Hennessy, S. G. Mattis,T. H. Ollendick, D. Heyne,S. Rollings, C. R. Hollin, D. Browne &E. PalmerOxford: Blackwell, 2002. pp. 60(average length). £44.99 for set of 8.Titles also available individually. ISBN:1-854333-59-3.

The PACTS Series originally came out as

12 slim booklets published by the

British Psychological Society to cover

common disorders in children. They

were all personally written by Martin

Herbert and were excellent how to�guides. Now Martin Herbert had edited

a further eight guides addressing adol-

escence. Some of these are quite

196 Book News

outstanding guides for practitioners,

full of practical steps to take and

worldly wisdom as well as good theor-

etical grounding. The one on Panic

Disorder has Tom Ollendick as a co-

author and is up to date in using the

latest cognitive and behavioural

approaches. The one on Depression

and Attempted Suicide is by Alan Carr

and, again, is thorough and broad in its

approach, not shying away from medi-

cation if this is required in addition to

psychological therapy. Then there are a

couple on behaviours that are less

commonly covered in other places,

including Avoiding Risky Sex, and

Gambling. It is very welcome to have

these issues addressed in such a prag-

matic way, although often the evidence

of the outcome of what is proposed is

still thin. The approach taken to School

Refusal is also very sound, and there is

a general discussion in one booklet

about Social and Anti-Social Behaviour

by Martin Herbert himself. The booklets

on Delinquency and Offending (Clive

Hollin and others) and on Aggression

and Bullying (Guerin and Hennessy) are

more summaries of interventions rather

than step-by-step guides as to what to

do. In particular, the one on delin-

quency and offending had no reference

either to multi-systemic therapy, or to

treatment foster care, yet these are

perhaps the two best empirically valid-

ated interventions for this condition.

Overall, I would recommend that this

series is present for anybody working

with adolescents, as they provide a very

useful guide for trainees to get stuck in

with treatment.

Stephen Scott

Institute of Psychiatry, London

Autism: From Research to Individ-ualised PracticeR. L. Gabriels & E. D. Hill (Eds.)London: Jessica Kingsley, 2002.pp. 288. £15.95 (pb). ISBN: 1-84310-7801-5.

The stated aim of this book is to close

the gap between research and clinical

practice, providing professionals with a

synthesis of research, theory and clin-

ical practice. Gabriels and Hill have

succeeded admirably in this goal, with

chapter topics ranging from diagnosis

and genetics through to services for

adults and families.

Unlike many books with chapters

written by different authors, this book

is coherent, with each chapter contri-

buting naturally to the development of

the reader’s understanding of current

theories of autism and their relevance to

intervention. Most chapters also stand

alone as valuable resources in their own

right, and I was particularly impressed

by the chapters by Gabriels and Kers-

tien detailing the development of a sib-

ling support group, and by Schuler and

Fletcher on making communication

meaningful.

My one disappointment was that

there was no critical discussion of the

relative values of different research

methodologies. For instance, in the

section covering treatment outcomes,

there was no mention of the need for

randomised control trials in order to

properly evaluate different approaches.

However, overall this is an excellent and

informative book that will be useful to

many professionals in the fields of

research, clinical practice or education.

Greg Pasco

St George’s Hospital Medical School

Treatment Manual for AnorexiaNervosa. A Family Based ApproachJ. Lock, D. le Grange, W. S. Agras &C DareNew York: The Guilford Press, 2001.pp. 270. £18.50 (pb). ISBN: 1-572-30836-2.

This manual is intended for clinicians

skilled in work with families, and offers

an approach to the understanding and

treatment of adolescent anorexia nervo-

sa (AN) based on the family therapy

model used in treatment trials under-

taken at the Maudsley hospital. �Man-

ual� implies something far more

prescriptive than is found between its

pages – a framework for a specific

approach more accurately reflects the

style. Nevertheless, the reader is direc-

ted to elements thought essential to the

treatment’s effectiveness, particularly

in the early stages of treatment. The

treatment is not �stand alone�. It is

intended to be conducted within a

multidisciplinary team, alongside med-

ical support and with supervision.

Treatment is in three phases: phase 1

involves refeeding the patient; phase 2,

the negotiation of new patterns of rela-

tionships; and phase 3, adolescent

issues and termination. At each stage

the how and why of therapeutic man-

oeuvres are explained, and example

sessions transcribed verbatim. The

family is seen as a resource for the

patient, and not, as many families per-

ceive themselves, to blame. Through-

out, the manual contains reminders of

the importance of the therapist’s stance

toward families.

We are increasingly familiar with dis-

order specific treatments from modali-

ties such as CBT. We also know that

clinicians, particularly those well sea-

soned, do not always welcome their

perceived limitations. In practice, I find

that I readily recommend the manual to

new team members and trainees, as

much for the principles of working with

families with this condition as the detail

of practice. I am grateful that Lock et al.

have captured those principles so

clearly and accessibly. Whether this

manual becomes a benchmark book

remains to be seen. Expectations that

clinical services deliver evidence-based

treatments are likely to increase rather

than diminish, and where a treatment

manual exists, evidence for its effect-

iveness is usually hot on the heels.

Dasha Nicholls

Great Ormond Street Hospital for

Children NHS Trust

Serious Emotional Disturbance inChildren and Adolescents:Multisystemic TherapyS. W. Henggeler, S. K. Schoenwald,M. D. Rowland & P. B. CunninghamNew York: Guilford Press, 2002.pp. 260. £26.95 (hb). ISBN: 1-57230-780-3.

This is book is an excellent guide to

good clinical practice, relevant whether

or not clinicians wish to embark upon

multisystemic therapy. It is full of

enlightening guidelines to good prac-

tice. There are few books that tell us

how to cope with really complicated

psychiatric problems that might, for

example, include repeated suicide

attempts and on-going serious, danger-

ous anti-social behaviour. This book,

however, systematically writes down

how to work with the different contexts,

be they school, local community, peers,

family, and the justice system. I was

particularly struck by the idea of having

a local worker involved who knows

where the local drug spots are, what

constructive activities there are for

youth in the area, and so on. By keeping

the MST workers involved with this,

there is an opportunity to improve the

child’s functioning within their own

environment. This is far more likely to

lead to generalisation than �fixing� themin an in-patient unit or during a foster

care placement, after which they

resume their previous habits and re-

lapse once back home. MST takes the

Book News 197

opposite approach, whereby the MST

workers try to influence the treatment

regime even in in-patient units and

during foster care, so that there is a

relatively coordinated and seamless set

of treatment experiences for the young

person. Whilst taking a systems ap-

proach, MST fully recognises the use-

fulness of psychiatric diagnosis and of

medication where appropriate. It also

recognises that at times children will

need to be transferred to therapeutic

foster care if their parents are simply

unable to cope, but has clear ideas on

how to make this work and to maximise

the rapid return of the young person to

the family of origin.

Several randomised controlled trials

attest to the effectiveness of MST with

these seriously emotionally disturbed

children, a relatively new departure

from its use for recurrent delinquency.

This book is therefore very useful not

only for the seasoned clinician wonder-

ing what to do next, but also has the

MST approach backed up with evi-

dence based trials to persuade the

managers to take it on. I highly recom-

mend it.

Stephen Scott

Institute of Psychiatry, London

The Effects of Parental Dysfunctionon ChildrenR. J. McMahon & R. V. De Peters(Eds.)New York: Kluwer Academic/PlenumPublishers, 2002. pp. 230. $65.00 (hb).ISBN: 0-306-47252-X.

This book was published in 2002 and

reports on a symposium held in 1998,

so it is an unfortunate delay in publi-

cation date. It is a collection of nine

chapters taken from a symposium in

Banff. The chapters range fairly

widely, from the general review of the

causation of schizophrenia to longitud-

inal studies. However, there are inter-

esting and unusual nuggets to be

found. These include a very thoughtful

chapter on the association between

parent and child anti-social behaviour

by Paul Frick and Bryan Loney that

shows that fathers with anti-social

personality disorder have children with

higher rates of conduct disorder whe-

ther or not they are in contact with

them. A reflective piece by Mark Dadds

about the way parents of anxious

children can exacerbate the problem

by feeding into their anxiety is presen-

ted, and Serbin et al. present a longi-

tudinal study of aggressive and

withdrawn children that relates adult

outcome with parenting style in child-

hood. All too often longitudinal studies

report continuities, but are unable to

say whether these reflect on-going

continuity of the environment in which

the child and young person lives, or

whether it is a true characteristic of

the young person. However, unlike

many other studies, the anti-social

population in this study did not show

a great deal of continuity of this trait,

so it is hard to draw conclusions that

fit in with the rest of the literature.

Olson offers a clinician’s view of how

to help children with foetal alcohol

syndrome, and Catalano et al. report

a controlled trial of an intervention for

substance abusing parents and their

children. This found that it did indeed

reduce the use of drugs by the parents

but, unfortunately, the child behaviour

outcomes were not improved.

Stephen Scott

Institute of Psychiatry, London

Development and LearningM. L. WolraichLondon: BC Decker, 2003. pp. 373.$79.95. ISBN: 1550092243.

Research into disorders of development

and learning has increased substan-

tially over the past decade. This has not

only increased our understanding of

such disorders, but has enabled the

design of management and intervention

techniques. This book is aimed at pri-

mary care physicians; it is mainly des-

criptive rather than evaluative, which

gives it the feel of a basic reference

manual. Each chapter is written in a

concise clear manner, giving a brief, but

sufficient description of the area of

interest.

The first half of the book (Chapters 1

to 8) details theories of typical develop-

ment, assessment procedures and

methods of screening and intervention.

Chapter 1 introduces theories of motor,

cognitive, language, behavioural, mor-

al, and gender development in order to

provide the reader with a basic know-

ledge of the processes involved in typ-

ical development. The following three

chapters list common measures of

development (general, motor, and lan-

guage). Assessment measures are des-

cribed in terms of their design

background, the domains that they

test, the subtests that they are com-

posed of, and how an individual’s per-

formance is classified. These chapters

may be a useful tool when choosing

assessment measures.

Chapters 5 to 7 describe methods of

screening and intervention. Chapter 5

discusses different screening methods,

and the importance of sensitivity and

specificity in detecting children who

would benefit from intervention tech-

niques. The chapter has a welcome

emphasis on application; how to ex-

plain results to parents, and how to

use screening efficiently. Continuing

the applied theme, chapter 6 empha-

sises managing the developmental dis-

order with the aim of realising the

child’s full potential through goals and

target outcomes. This chapter discus-

ses the role of the clinician as an

advisor and partner to the parent.

Chapter 7 talks about intervention.

The concept and goals of early inter-

vention are introduced, followed by a

discussion of research into the longi-

tudinal impact of early intervention,

and a brief description of the factors

considered to determine the success of

an intervention. Chapter 8 details the

interaction between child abuse and

developmental disabilities. It explains

that the difficulty in managing a child

with a developmental disorder can

lead to child abuse. Details are given

on how this might occur, how to

assess child abuse, and the types of

abuse that are most relevant to devel-

opmental disability. Management, out-

comes, and prevention are also

discussed.

The final chapters describe 14 devel-

opmental disorders in turn. Disorders

such as cerebral palsy, Down Syn-

drome and Fragile X Syndrome are

introduced in terms of epidemiology,

classification, diagnosis, and treat-

ment, before discussing aspects of

development specific to that syndrome.

Many chapters include useful tables

detailing the time course of develop-

mental problems, or the types of treat-

ment used with that disorder.

Chapters on Williams syndrome and

Prader-Willi syndrome are welcome

additions to this edition of the book.

In general, this section of the book is a

great source for brief but informative

descriptions of disorders of develop-

ment and learning.

The book is clearly written and is a

useful first-stop for learning more

about disorders of developmental and

learning, their assessment and man-

agement.

Emily Farran

University of Reading

198 Book News

Videos: Behind the Symptoms andBehind the Behaviour MentalHealth Media,London, 2001 (http://www.mhmedia.com) 32-32 mins. £39.95.

These two complementary videos last

about 30 minutes each and are aimed

at professionals from Health (Symp-

toms) and Education (Behaviour) work-

ing with primary age children. They

consist of short interviews with profes-

sionals working in the field, illustrated

by brief clips of role-played consulta-

tions. The videos will be most useful for

those working at the interface between

primary care, education and CAMHS,

particularly primary mental health/pri-

mary care liaison workers and special

educational needs co-ordinators.

Although there will be little new infor-

mation for these professionals, the vid-

eos would be a valuable resource in

schools and health centres. There is a

strong emphasis on the importance of

partnership between school and par-

ents and two particularly clear mes-

sages are outlined. The first is that

children with difficulties presenting to

professionals in primary care or educa-

tion are often doing so for the first time,

allowing an important opportunity for

intervention that should not be missed.

Second, it is stressed that even the most

complex situation can be helped by

often a very simple intervention such

as listening.

Chris Roberts

Surrey Oaklands NHS Trust

Social Aggression Among GirlsM. K. UnderwoodNew York: Guilford Press, 2003.pp. 252. £18.50. ISBN: 1-57230-865-6.

Marion Underwood, Associate Professor

of Psychology at the University of Texas,

has written a timely and much needed

book . She examines in a thorough way

aspects of girls� aggression, concludingthat girls for several reasons seem to

abstain from expressing anger in phys-

ical ways but turn to indirect means like

undermining an opponent’s social

standing by spreading rumours, cre-

ating isolation and manipulating rela-

tionships, to name but a few.

Underwood explores the link between

developmental stages and different

forms of aggression. Girls as young as

three encounter peer rejection when

physically aggressive – a message that

anger is unwelcome and therefore

needs to be �hidden�.

As girls become more verbally skilled,

conflicts are dealt with by �gossip� or

threatening social exclusion. We learn

that friendships of an intimate and

dependent nature are quite gender spe-

cific and thus render girls more vulner-

able to social rejection.

This becomes particularly evident in

adolescence when female aggression

can not only destroy another person’s

social reputation but also their roman-

tic relationships. Little exploration,

however, takes place regarding phe-

nomena like girl gangs, female terror-

ism or serious harassment.

Another factor might be that girls are

dealtwithdifferentlybyparentsand teach-

ers insofar as they are expected to talk

about feelings rather than act them out.

What can be done to prevent girls

becomingmean andhurtful? The author

cites models of school based interven-

tions (The Sheffield Anti-bullying Pro-

ject), strategies parents might be able to

undertake and �harnessing the power of

sisterhood�. It is here that the book is

rather �thin on the ground� and comes

across as naive and unconvincing.

Underwood is a scholar who certainly

bases her knowledge on a wealth of

studies (roughly 15% of the book con-

sists of references!) but remains some-

what in her academic �ivory tower�.

Birgit Berg

Consultant Child & Adolescent

Psychiatrist, London

The Clinician’s Guide to theBehavior Assessment System forChildren (BASC)C. R. Reynolds & R. W. KamphausNew York: The Guilford Press, 2002.pp. 288. £46.00 (hb). ISBN: 1-572-30772-2.

This well written book clearly describes

a multidimensional method of assess-

ment of children and adolescents. The

BASC was designed originally for psy-

chologists, but is employed by a range

of other professionals. The book begins

with a detailed description of what the

BASC is, along with the five compo-

nents that make up the scale (teacher

rating scales, parent rating scales, self

report of personality, structured devel-

opmental history and student observa-

tion system). Within these components,

the BASC considers a range of scales,

which address both internalising, and

externalising problems; school based

problems, and is applicable for children

2 to 18 years of age. A detailed descrip-

tion of each scale (for example, hyper-

activity, anxiety, locus of control,

aggression, somatisation, self-esteem,

and self-reliance) is then provided,

along with research to support it and a

very clear, concise scale interpretation

guide. Both age related and clinical

norms are available (non American

readers should be aware that these are

American norms).

Further into the book a very helpful

three-step guide is presented, which

assists the reader in making sense of a

child’s profile. A series of detailed case

studies illustrate the clinical utility of

the BASC alongside other psychometric

instruments and qualitative data. The

authors provide examples of written

reports based on this case material that

pull all the information together and

then translates it into meaningful rec-

ommendations for clinical practice. The

penultimate chapter pays particular

attention to the BASC ADHD monitor

and the student Observation System.

The authors describe how the main

BASC assesses �a broad sampling of

child behaviour� and, as such, the

symptoms of hyperactivity and inatten-

tion may be present but not necessarily

indicative of an ADHD presentation.

The ADHD monitor therefore permits a

more detailed assessment, with the aim

of hopefully reducing over diagnosis of

ADHD. Finally, the Student Observa-

tion System (SOS) is a structured way of

conducting a functional behavioural

assessment using momentary time

sampling. The authors point out, how-

ever, that while frequently used, further

research is needed to establish the

utility of both the BASC ADHD monitor

and the SOS. The final chapter is dedi-

cated to the application of the BASC in

specific settings (paediatrics and foren-

sics) and situations (prevention and

program evaluation).

Overall, this text is very readable and

succeeds in meeting its original aims

i.e. describing a structured behavioural

assessment system for children and

adolescents. I do not use the BASC,

but as a practising clinical psychologist,

explanatory texts of psychometric

instruments such as this are warmly

welcomed. I would therefore recom-

mend this book for those clinicians

who use or intend to use the BASC in

their clinical practice. Finally, on the

basis of this book, I would also consider

using these scales in complex cases,

where multiple informants and multi-

disciplinary team work is necessary.

Susan Bruce

Clinical Psychologist, Newcastle CAMHS

Book News 199