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This is the second volume in a series that seems destined to reproduce itself ad infinitum. I see two reasons for this: in the first place, the meetings of the American Orthopsychiatric Association have become hardy annuals that should continue indefinitely to provide the type of case study included in this collection; and secondly, there appears to be, judging by the demand for Volume 1, a real need for model presentations of this nature for use in clinic teaching programmes.
The traditional clinic method in America, as Dr. Gardner points out in his preface, has a three-pronged approach to the case. The psychiatrist, the psychologist, and the social worker combine to illuminate different aspects of the patient's problem. This at least was the original intention. Gradually, the psychiatric, the psychological, and the social assessments began to encroach on one another, and the triple division of function represented in 'the varidisciplinary approach' as Dr. Gardner terms it (for want of a better name, I presume), was fused into a single operation. Everyone became a therapist and everyone talked the language of Freud. The account given by the social worker differed from that of the psychiatrist only in its concern with a different age range, and not because the disciplines were essentially different. The kudos of being the all-powerful therapist led everyone to want to be just that. To do else was to do less.
The present volume covers a wide variety of disorders ranging over neurosis, psychosis, and psychopathy. Encopresis, which has become one of the more fashionable ailments of the modern disturbed child, is once again to the forefront. The papers are skilfully and attractively presented. If at the conference they were all as good as these, it must have been a joy to attend. I suspect, however, that Dr. Gardner has skimmed the milk for the cream. The book, as it stands, is such an excellent guide to American clinic practice as constituted today that one