Adolescence — Care and Counseling

Adolescence — Care and Counseling

Book Reviews The Principles and Practice of Health Visiting. By ROSEMARY HALE,MAP,IO/q K. LOVELAND and GRACE M. OWEN. Oxford, 1968: Pergamon Press. pp...

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Book Reviews The Principles and Practice of Health Visiting. By ROSEMARY HALE,MAP,IO/q K. LOVELAND and GRACE M. OWEN. Oxford, 1968: Pergamon Press. pp. 99: 30s. THiS BOOK is Volume 8 of the Westminster Series. It is a well presented volume and meets a considerable need. It should prove useful for Health Visitor students and others who are concerned with the work of HealthVisitors. It is a very readable book with the exception of the portion of Chapter 4 which deals with "the art and skill of interviewing." Some sentences of this section defy comprehension even on repeated reading. The position of the Health Visitor as a key member of the community health team is, of course, stressed. However, one feels that underlying the stress placed u p o n the need for team working and cooperation is the feeling that the health visitor is somewhat separate, it is noticeable that in the list of persons and organizations with whom she wilt need to cooperate, the District Nurse and the General Practitioner.come last. The emphasis throughout seems to be on the aftaehment of Health Visitors to a practice to work amongst the general practitioners practice patients rather than on any integration into a single team of those persons serving a common group of patients. This separation is one of the reasons that for so loI~g has caused the General Practitioner to view the work of the Health Visitor with suspicion. This suspicion is now becoming less marked and the work of the Health Visitor better understood and recognized for its real value. This book will help to consolidate this position. It comes late in the history of health visiting but not too late to make a valuable contribution. It is a little disappointing to find that the chapter entitled ,'The Health Visitor in the Health Centres" devotes ve~3, little space to the concept of the Health Centre and the effect on the Health Visitors work of the growing interest in this pattern of working. Adole.sce, c~........ Care and Counseling. Edited By GENE L. USmN, M.D. London, 1968: Sir Isaac Pitman & Sens Ltd./Philadelphia, 1967: J. B. Lippincott Co. pp. 238: 75s.] $7.00. TrtERE ~,rt'EARS tO be no end to the number of professional conferences on Adolescence, and the reviewer has participated in the planning stages o n a number of occasions. There is a regular pattern to the initial discussions. One member suggests a number &essential topics: drug addiction, delinquency, suicide, and sexual problems. Another one calls attention to cultural factors and points out the necessity to discuss the rapid changes in the structure of society and in our technical equipment. Yet another will point o u t the end3' of the adult world for the adolescence that the present-day youth enjoys, and it is seldom that we lack the familar quotation from Shakespeare's The Winter's Tale: "I would there were no age between ten and three-and-twenty, or t h a t youth would sleep out the rest; for there is nothing in the between but getting wenches with child, wronging the ancientry, stealing, fighting--". This book is the account of a symposium o n Adolescence held in December I966 in New Orleans. The participants were mainly psychiatrists and physicians from the vicinity and they gave their separate and collective wisdom On these very topics with some additional ones such as .learning problems, mental retardation, and the inner life of ~the adolescent. Views expressed in a conference s e l d o m have the kind of permanent value which publication of a book demands, and the reader should not expect more than illustrative background material, and a few case details, on a variety of topics.



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It is stated that the major theme is tolerance. There is, however, the dilemma which the authors have not escaped ~ either the therapist creates a professional distance which separates him from theadolescent, or he allies himself unrealistically with the rebellious side of the adolescent's complex and contradictory feelings.

Theory and Practice of Family Psychiatry. By JOHN G. HOWELLS with edited contributions. Edinburgh and I,ondon, 1968: Oliver & Boyd, pp. 9 5 3 : £ 9 9s. 0d. A BOOK with this title and ~f this size should call for a detailed review, but a good deal of the editbrs' own tiaateriai has already appeared before in Family Psychiatry (Oliver & Boyd; 1963). The papers of the other contributors, reprinted from a variety of sources, do not provide a Coherent system. The book begins with the statement: "Family Psychiatry, whereby the family is the functional unit, represents a practical and theoretical system for psychiatry. Individual psychiatry, taking the adult as the functional unit (adult psychiatry), the child as the functional unit (child psychiatry), or the adolescent as the functional unit (adolescent psychiatry) is obsolete." The editor gives no evidence by which he judges that all other systems than his own are obsolete, and, indeed, man), of the contributions that are included in the book, are themselves somewhat ephemeral. A more balanced approach would recognize individual clinical psychiatry and family psychiatr# as being differeut dimensions of the study of the same problems. The choice is One of convenience. There is, moreover, a third dimension which is that of community psychiatry in which one has to take into account factors in the social milieu which depend for th'eir s t u d y o n the disciplines of sociology, anthropology, and social psychology. No system ofpsychiatry can be all-embracing. Ever)' psychiatrist h a s to work within an organized theoretical system which has to be judged by its own logical consistency and by its practical effectiveness. Those who go beyond the psychiatry of the single individual have to learn to work on an equal level with others who share responsibilities for the educational, occupational and cpmmunity life of the individuals and families who seek their help. Dr Howells appears to take a limited view of the nature of psychiatry, but a very comprehensive view of the responsibilities and effectiveness of the psychiatrist. He introduces the concept of" Vector " therapy. in which the main approach is to rearrange the manner of living in the family setting, Various members of the family are described in clear terms wlfich imply his approval o r disapproval. The care of children is taken from a "badly adjusted" parent and given to the "well adjusted" parent, or to some relative or paid help. The following passage will explain the aims and methods of the system which is advocated: "To effect a change of emotional forces, a large number of facilities are called upon, even m .1-..,, one family. F o r example, in one family the following facilities were employed: (1) Duration of contact between a violent father and his son was reduced by father becoming a night worker. (2) More beneficial male influence came from encouraging the boy to spend time with his uncle, the pleasant's mother's well-adjusted brother. (3) The family moved nearer the well-adjusted maternal grandparents and away from the interfering, dominating paternal grandparents, bringing much relief and support to the mother and allowing the boy to spend time with the grandparents again to his advantage.