BOOK REVIEWS 203

Fontana’s book is a more serious and elegantly written essay in five chapters, with summaries variously termed Boxes, Exercises and Workshops. He also makes use of a few illustrative case studies. Although organised around a central theme, the ‘bittiness’ of much psychological theorising is evident even in this book of 93 pages. For example, ‘shyness’ is treated at some length in the last short chapter entitled ‘Managing Change’ normally associated with larger organisational issues.

It may be that British authors in contrast to the Americans prefer grand titles for their books. It is not easy to understand the scope of a book by reading the Contents or the blurb. A sub-title like “proven strategies for handling difficult situations at work”, or a description of what the reader is enabled to do after reading the book, may help to concentrate the authors’ minds as to the nature of the book they are writing, which presumably is applied psychology for everyman. In this type of book numbers sold may provide the main criterion against which its value to the public could be ascertained.

MIGEL JAYASINGHE

G. I. KEITNER (Ed.): Depression and Families-Impact and Treatment. American Psychiatric Press, Washington, D.C. (1990). 190 pp. E20.25.

This book is one in the Progress in Psychiatry series which bring together in published form information presented in symposia each year at the American Psychiatric Association Annual Meeting. As such, it consists of a series of eight papers on depression, each with a family perspective, and a very brief summary chapter drawing together the findings of the various presentations.

The book divides into three sections, the first dealing with depression and family functioning in general, the second focussing on the impact of parental depression on children and the third describing suggested approaches to treating families of people with depression. It is probably fair to comment that throughout the three sections we are reminded of some straightforward facts about depression which we were probably aware of already, and that overall the book tells us more about what we do not know about depression and its treatment than being able to provide us with clinical guide-lines about intervention methods.

Several of the authors comment on the complexity of depressive disorders and Coyne in Chapter 2 points out that we lack a comprehensive model which incorporates the parts played by genetic, biological, interpersonal and individual factors in the development of the disorder. Another common theme is that depression is a difficult disorder for family members to understand and live with, possibly because the behaviour of depressed people is not as aberrant as that of other disorders, and consequently more difficult to recognise as part of an illness. Several of the authors point to the fact that frequently pathology is found in family members, and the chapters by Merikangas et al. and Beardslee provide ample evidence of the increased risk for children of people with depressive disorders developing psychopathology themselves.

The data on the familial nature of depression, its impact on family functioning and the well-being of family members lead to the obvious conclusion that, if treatments for depression are to be effective, they must include close working with family members. Unfortunately, while four chapters describe various family interventions, there is a lack of sound empirical evidence for the effectiveness of these approaches. The chapters by Beardslee (Chapter 5) and Holder and Anderson (Chapter 8) describe psychoeducational interventions based solely on clinical experience which, however, have not been tested in controlled trials. Coffman and Jacobson (Chapter 7) present a rationale, model and one case history to describe their treatment but again no scientific evidence of its effectiveness. Clarkin et al. (Chapter 6) describe an approach which had a beneficial effect on females with bi-polar affective disorder but which had a negative effect on all others with depression in the study who were found to do better without the intervention!

On a positive note, this collection of papers indicates that there is a growing interest in addressing the issue of how to intervene with families in which one person is depressed. Sadly, however, it also makes us aware of the embryonic stage of this research and our lack of sound knowledge about which interventions are likely to be effective. People interested in research on depression will find this a useful reference book, but clinicians will not find in it suggestions for treatment which have been validated to inform their clinical practice.

GRAINNE FADDEN

JOHN STRANG and GERRY STIM~~N (Eds): AIDS and Drug Misuse. Routledge, London (1990). xii + 276 pp. f35.00 Hardback; E12.99 Paperback.

One of the most over-used words in a publisher’s descriptive vocabulary in relation to textbooks is ‘comprehensive’. Sadly few books claiming to be so fulfill their promise. However, although this word does not appear on the cover of AIDS and Drug Misuse, it is the adjective which immediately springs to mind to describe this collection. In bringing together the most impressive array of researchers and writers on issues of drug use, HIV infection and AIDS, the editors have saved those of us with an interest in this field from the task of searching the journals for the best papers on issues as wide ranging as the clinical management of drug users, the epidemiology of HIV and AIDS in this population, drugs policy in response to the epidemic and models of practice for drugs workers and professionals concerned with this rapidly developing field.

One of the most striking features of the collection-24 chapers and 35 authors-is the readability and lightness of touch of the writing. It is difficult to determine whether this is a consequence of the editorial efforts of Strang and Stimson, or simply a reflection of the quality of their contributors. Whatever the reason, the result is a book which it is possible to read from page one to the end, or to dip into for one’s own particular topic of interest. One area in which the editors have not ensured consistency, however, is in relation to the nomenclature for the population and its problem; drug users can be ‘misusers’, ‘takers’, ‘IDUs’, ‘IVDUs’, ‘addicts’ and ‘dependent’. However, if one is to benefit from the knowledge and experience of such a wide range of experts, stylistic inconsistency is a very minor price to pay.

It would be invidious to select particular chapters for special mention, and so it only remains to once again affirm that this is a most comprehensive and thorough collection which will have a life well into the nineties as the text for anyone

204 BOOK REvlEWS

interested in the field of drug use, HIV and AIDS. Perhaps now the publishers can drag out that over-used word for the book’s cover.

GRAHAM HART

GL.ENYS PARRY: Coping With Crises. British Psychological Society, Leicester (1990). viii + 116 pp. E5.99.

This book is ‘written for those who are called upon to help people during a crisis as part of their everyday work’. Although it is not aimed at specialists like psychologists and psychotherapists, it may still be of some interest to those who work with traumatised patients. Glenys Parry attempts to analyse the concept of crisis and goes on to explore how problems are often intensified by the individual’s particular response. Coping skills are summarised and the importance of encouraging patients to make use of their own social support systems underscored. Finally, stress management strategies are briefly outlined. The book is clearly written and contains a number of exercises which the reader is urged to complete. These take the form of short questionnaires with an experiential flavour. Moreover, the book contains a number of example cases, which are used to explore issues raised in the text. There is very little in this book that clinicians will not be familiar with. However, it has two obvious uses for the skilled professional. Firstly, it might be used to structure a workshop on the topic of crises. The exercises provide ideal focal points for group work. Secondly, many clinicians will be able to explain the distressing sequelae of crises, and provide a rationale for intervention by way of a vocabulary replete with terms such as ‘emotional processing’ and ‘fear structure modification’. However, providing the patient with such a conceptual framework can be extremely taxing, requiring the talent of a United Nations’ translator, and a poet’s gift for metaphor. Glenys Parry’s book should furnish the practising clinician with some useful stock phrases when it is necessary to communicate academic concepts using language intelligible to the layman.

FRANK TALLI.Y

C. N. STEFANIS, A. D. RABAVILAS and C. R. SOLDATOS (Eds): Psychiatry-A World Perspective, Vols 1-4. Elsevier, Amsterdam (1990). Vol. 1 xxx + 1288 pp.; Vol. 2 xxi + 83Opp.; Vol. 3 xxiv + 1001 pp.; Vol. 4 xxvi + 1120 pp. DFl 1,230.

The Eighth World Congress of Psychiatry held in Athens in October 1989, had a vast scientific programme which covered various aspects of psychiatry. This is evident from looking at the four volumes of the proceedings of the Congress. According to the editors, over 6000 scientists contributed to the 3237 papers presented in nearly 500 sessions. What is offered here are state of the art papers on various facets of psychiatry.

The material and the style of presentation of the papers in these volumes are, perhaps inevitably, uneven. For the readers of this journal, the important volume is the third one, which includes 17 papers on cognitive and behavioural therapies, and numerous others on other psychological approaches including family crisis intervention. There are in particular two interesting essays on the use of cognitive therapy with personality disorder patients and manic patients. The combination of drug and cognitive therapy with manic patients needs to be tested with prospective studies. Various other researchers report their work using cognitive and psycho-educational therapeutic approaches. The interaction of social psychiatry and cross-cultural issues are also well covered.

The editing of these volumes represents a massive undertaking and the editors emerge with credit. The publishers deserve credit for investing in this clearly very expensive venture. Because of the price, not many individuals will buy these volumes, but many will be grateful to find them in their institutional libraries.

DINESH BHUGRA

C. EUGENE WALKER (Ed.): The History of Clinical Psychology in Autobiography. Brooks/Cole, Pacific Grove, Calif. (1990). v + 329 pp.

This book draws together the autobiographies of eight pioneers in clinical psychology. The focus is on the development of the profession as seen by those who took a major role in establishing its identity and subsequently defending its existence. The contributors were primarily research psychologists who have seen the profession through to its present thera- peutic/research role.

Seven of the authors contributed to the development of American clinical psychology (Albert Ellis, Sol Garfield, Molly Harrower, Margaret Ives, Alan Ross, Edwin Schneidman and Hans Strupp) and one to British clinical psychology (Hans Eysenck). They skillfully integrate accounts of their personal and professional lives as well as current developments in their field, with varying degrees of disclosure, emotionality and even poetry. They share many common themes, and the result is a delightful and instructive whole. They apply their ‘psychological thinking’ to their own backgrounds, influences, motives, decisions and self-analyses, resulting in a rich tapestry of insights and experiences.

The reader interested in the history of clinical psychology should be satisfied by the substantial information provided. Several themes set the scene and stand out as particularly strong influences, for example, the sinister roles of the second world war and anti-Semitism (seven of the eight contributors are of Jewish origin). Secondly, we are reminded of clinical psychology’s origins not as a therapeutic service, but as psychometric assessment services for the military. These first-hand accounts also illustrate how the transition from a measurement to a therapeutic role was hard won. Eysenck’s colourful account of his struggle against the medical powers that be to gain the right-for clinical psychologists to Practise behaviour therapy in Britain, provides one such example. For those of us who identify with the accounts of the difficulties in defending psychology’s patch, several of the authors anticipate our need and offer time-honoured advice.