Treatment of Childhood Disorders. Second Edition

Abstract

Treatment of Childhood Disorders. Second Edition Eric Mash and Russell Barkley (Eds.)-New York: Guilford Press (www.guilford.com). 1998, 771 pp., $69.95. Published nine years after the first edition, substantial developments in the field of child and adolescent treatment clearly justify a second edition of Treatment of Childhood Disorders. As the editors observe, increased emphasis on developmental processes, prevention, and treatment in the context of the family have reshaped the direction of intervention with children. These new directions are captured in the second edition of this important resource for child clinicians and researchers. The stated aim of this volume is to be "both scholarly and applied," and the contributors to this volume consistently accomplish the difficult feat of bridging research and practice. By no means is this volume a collection of treatment manuals, consequently the clinician who is looking for a "how to" volume on child treatment should look elsewhere (but after reading these empirically based chapters on the development, assessment, and treatment of specific childhood disorders). Instead, what one finds in this volume is a theoretically sound framework supported by substantial empirical evidence that can be used for case formulation and treatment planning. Some years ago, Kazdin (1988) identified over 230 published forms of child therapy. Most of them, including such intriguing methods as "bark therapy" and the "color-your-life technique" are not included in the Treatment of Childhood Disorders. As the editors note, "fads, fancies, New Age remedies, dogmatic therapies, and the treatments dujour of the latest therapeutic gurus were to be eschewed in favor of a focus on treatments for which there were sound scientific rationales as well as evidence of efficacy and effectiveness" (ix). Not surprisingly then, virtually all of the chapters concentrate on behavioral, cognitive-behavioral, and family-based interventions. Although some may protest the relative absence of "traditional child therapies" in this volume, the failure of psychodynamic and play therapists to systematically evaluate their treatments undermines their claims of efficacy. It is noteworthy that alternative treatments are considered, especially pharmacotherapy, and that an inclusive developmental perspective is typically used to understand the etiology and course of various childhood disorders. After reading the chapters in this volume, it is clear that most childhood disorders cannot be understood in terms of single pathogenic processes, and correspondingly, most disorders cannot be adequately treated with single modality treatments. For example, the chapter on conduct disorder highlights the contribution of ineffective parenting, maladaptive child cognitions, and deviant peer influences in the evolution of conduct problems. In turn, integrated treatments, such as Multisystemic Therapy, that target multiple pathogenic processes have been shown to produce significant change. In fact, one of the main themes to emerge from this volume, and one familiar to many child clinicians, is that "child-focused" interventions, while important, are often insufficient to produce meaningful change. Instead, child therapists are challenged to address both individual deficits and distortions and processes in the child's social environment that contribute to dysfunction. In this respect, the volume offers a coherent "behavioral-systems" perspective that draws attention to reciprocal relations between child and family functioning. …