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interpersonal problems, eating disorders and substance abuse. The final chapter contains a discussion of the application of cognitive-behavioural therapy to the care in the community of individuals with schizophrenia, mental handicap and depression in old age. The book has a clear structure, each chapter preceded by a presentation of theoretical background. The language is direct and easy to understand, though I personally do not care for such turns of phrase as ‘going cognitive’ or the client ‘buying into cognitive therapy’. That besides, the volume contains much relevant information supported by the citing of research findings, and examples of clinical cases and treatment programmes. The Appendix contains a variety of questionnaires, inventories and assessment schedules for every problem area covered in the text. Regrettably, the information on how to use these instruments other than to derive a numerical score is nowhere to be found. The problems of reliability and validity, the norms or their lack, the interpretation of scores and how they should relate to treatment, are not even mentioned. This, unfortunately, is in keeping with the cook-book approach of this book, the aim of which is to encourage social workers to feel competent after reading it to go out into the world and practise as therapists. Dr Scott helps by often specifying the number of sessions needed for treatment of a given condition as well as the content of each. He tells us that apparently social workers are dissatisfied with their traditional role and are unlikely to succeed with their clients unless they tackle their problems ‘at the root’. They should therefore develop a ‘therapeutically oriented service’. He fails to acknowledge altogether that other professions, such as clinical psychology, counseling and much of psychiatry, including psychiatric nurses, are already providing such a service. Nobody could object to social workers gaining a proper training to qualify as therapists, but I for one would regret their departure from their traditional areas of expertise in which they are uniquely trained and badly needed.

I think this book is dangerous in that it presents cognitive-behavioural therapy as an easy option, “just a form of teaching”, as Dr Scott tells us, and implies that it can be carried out by anyone. Yet it contains much useful information about a selection of problems and therapeutic techniques as used by trained professionals. Social workers, nurses and other interested health service workers will find it helpful in their individual and multidisciplinary team work.

PETER E. HODGKINKIN and MICHAEL STEWART: Coping with Catastrophe: A Handbook of Disaster Management. Routledge, London (1991). x + 230 pp. f12.99.

Following the Bradford Football Stadium Disaster in 1985, Michael Stewart was seconded from his social work duties to work with survivors. Four years later, following the capsize of the ferry Herald of Free Enterprise in Zeebrugge harbour, Peter Hodgkinson was seconded from his clinical psychology duties to head a social work team in Dover charged with reaching out to survivors across the country. The two authors came together professionally, pooled their experiences, supported others facing later disasters and, eventually, left the shelter of statutory services to set up the Centre for Crisis Psychology offering training for all involved in the management of disasters.

This text, then, is a clear and poignant amalgamation of hard won personal experience informed by scholarly reviews of relevant literature. The first chapter discusses the phenomenology of distress reported after major disasters, concentrating mainly on loss and bereavement. There are graphic and moving descriptions of the experiences of many survivors. Chapter 2 describes what happened in many man-made disasters, concluding that these lead to high levels of distress in survivors-distress that may last for many years.

However careful we become, there will always be disasters; so local authorities need to incorporate planning for the psycho-social aspects in their major incident plans. Experience from recent disasters is incorporated in advice carefully spelt out in Chapter 3. Chapter 4 acknowledges that most victims are ordinary people who react ‘normally’ to an abnormal event. As such, they are ambivalent about seeking help and so there is a need for ‘outreach’ of services. The dilemmas facing outreach workers are carefully discussed.

Following initial contact, there may be a need for debriefing of rescue workers, consulting with groups of survivors and, later, individual treatment of Post-Traumatic Stress Disorder and abnormal grief reactions. These are covered in Chapters 5-7. .Given that no single therapeutic approach holds all the answers, bothcognitive-behavioural and psychotherapeutic interventions are discussed.

The text is at its best when the authors draw on their own experience to illustrate the suffering of the survivors and the challenges this places on the helping professions. Telling anecdotes are interspersed with scientific studies and both convince the reader that post-traumatic reactions are not simply transient adjustment reactions. Many victims’ lives are shattered by their experiences. Many more undergo fundamental re-evaluation of their priorities and emerge as fundamentally changed people. This text will help ensure that these transitions are somewhat less painful.

WILLIAM YULE

A. M. GROW and R. S. DRABMAN (Eds): Handbook of Clinical Behavioral Pediatrics. Plenum Press, New York (1990). xiv + 420 pp. S50.00.

This book aims to provide a practical, clinically oriented guide to the application of behaviour therapy in paediatric settings for health care providers and educators.

The term ‘clinical behavioural paediatrics’ is virtually unheard of this side of the Atlantic; however, it is an exciting and developing area of clinical interest. The editors’ aim is to provide a ‘how to’ book rather than a comprehensive review of research, the contributing authors being selected for their clinical eminence and expertise in various fields (psychology, psychiatry, paediatrics and nursing). The text is hefty but refreshingly readable with clear step-by-step descriptions of treatments and a liberal sprinkling of thought-provoking case examples.

The book is divided into four sections, the first part is devoted to discussions of the basic principles of behavioural clinical paediatrics. Areas covered range from the consideration of the psychologist as a paediatric consultant to a discussion of the potential impact of illness on a child’s development.

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Parts two and three cover various clinical disorders and describe the ‘how to’ of management and treatment. Part two focuses specifically on eight major clinical problem areas of behavioural paediatrics. The problems covered are paediatric pain, headache, eating disorders, cancer, diabetes, enuresis, asthma and sleep disorders.

In a somewhat brave departure for a substantive text book, the third section deals with relative newcomers to the field. Relatively recent interventions in areas such as paediatric burns, tics and Tourette syndrome, cystic fibrosis, allergies, dentistry, abdominal pain, blood pressure, growth hormone deficiency and neonatal problems are covered in ‘mini-chapters’. Again, case examples are provided as well as a comprehensive description of the problem.

The fourth and final section of the book contains chapters devoted to more general treatment issues. These include preparing children for hospitalisation and medical procedures, patient compliance and accident prevention.

This is a comprehensive and thoughtful volume which lives up to the title-it really is a handbook for clinical use. The work of psychologists in this field has developed beyond involvement in behavioural and developmental issues. The newer areas of assessment and treatment of illness and health related behaviour are well covered in this text.

New ideas are provided for child care interventions and health risk reduction prevention, which should stimulate researchers and clinicians alike. Most intervention descriptions are helpful and clear, with plenty of respect for a team approach. The orientation of such interventions is clearly behavioural; ignoring the value of psychotherapeutic and family therapy techniques in paediatric settings is a rather unfortunate oversight.

This handbook will find a welcome and long-awaited home on the bookshelves of paediatric psychologists and paediatricians working in nonpsychiatric medical settings. However, it is also an invaluable resource for all clinicians working with children and families and an important book for service planners and educators.

MICHELLE NEW

B. B. WOLMAN and G. STRICKER: Depressive Disorders: Facts, Theories, and Treatment Methods. Wiley, New York (1990). xii + 436 pp. $49.95.

Mendelson, one of the authors in this book, wrote in his chapter ‘Psychoanalytic Views on Depression’, that he “touched upon the metapsychological battles that made many of the psychoanalytic positions look as dated as the debates of the Medieval Schoolmen”. A good analogy. But it can be extended in that the 20 chapters in this book which cover, as well as psychoanalytic theories, existential, biological, behavioural, cognitive and psychosocial theories, leave one with the impression that ‘depression’ has about the same conceptual status as ‘God’.

The authors in this book seem well aware that depression remains a mystery but also seem quite optimistic about solving the mystery and are bravely prepared to go on prodding at the problem in the same old ways. For instance, Golden and Janowsky in their chapter on biological theories concluded that “because it is so difficult in clinical practice to delineate depression from related disorders, let alone isolate the possible subtypes of depression, it should not be surprising that a consistent biological correlate or marker has not yet been identified”. Two lines later, they wrote ‘Still, our understanding of the biology of affective illness continues to grow at a rapid pace”. Zavodnick, in his chapter on somatic therapies, began his final summary passage with the statement: “The somatic treatment of depression is far from ideal” and ended it with: “There is much to do while awaiting the millenium”. But there is no suggestion that we might need to change our approach. Incidentally, one is persuaded that somatic treatment is far from ideal on reading Zavodnick’s list of the possible side effects of treatment with antidepressant drugs: dry mouth, tremor, sedation, insomnia, confusional states, impotence, urinary problems, constipation, ophthalmologic problems, cardiovascular problems, psychosis. In view of this, one could not be blamed for trying to avoid depression by, like Sam Weller’s lighthouse keeper, doing anything for a quiet life.

The book is comprehensive in its coverage of relevant topics. Apart from the chapters on the various theories of depression, listed above, there are chapters on interviewing methods, projective techniques, self-report assessments, psychoanalytic therapies, somatic therapies, behavioral and cognitive therapies, interactional and interpersonal therapies, and marital and family therapies. There are also chapters on a miscellaneous set of topics: genetics of affective disorders, depressive states and somatic symptoms (which takes a psychoanalytic approach), mood disorders and self-defeating behaviors, and suicide.

All of the chapter authors have written good reviews of what has been said and done with respect to their topics, There is no discussion of conceptual and methodological issues so I do not recommend the book for the personal use of the well-informed psychopathologist. It would be a useful book for an instructor to use as the basis of seminars on depression.

There are no new ideas except for those presented in a chapter by Wolman, one of the editors of the book. But the ideas have a strong psychoanalytic flavour and readers of this journal are likely to be uncomfortable with terms such as dysmutual interpersonal relationships, interindividual cathexis, ecosomatogenic depression, destrudo cathexis, we-ego, and vector-ego. Although the chapter is basically psychoanalytic in approach it does attempt to integrate findings from a number of different research areas. It is Chapter 5 in a list of 20 chapters. It might have been preferable if a final chapter had been written by the editors, a chapter in which the material in the previous chapters was reviewed and some suggestions were made as to how we might proceed in the future in our attempts to solve the mystery of depression.

CHARLES G. COSTELLO

B. R. SARASON, I. G. SARASON and G. R. PIERCE (Eds): Social Support: An Interactional View. Wiley, New York (1990). xvi + 528 pp. E43.80.

This book is part of the Wiley Series on Personality Processes edited by Irving B. Weiner. The series addresses researchers and clinicians concerned with applying an understanding of personality processes to the amelioration of emotional distress. The study of social support promises to be particularly relevant to this issue. However, although the last decade has seen