What can the matter be?

What can the matter be?, edited by Louise Emanuel with Elizabeth Bradley, London, Karnac, 2008, 294 pp., £18.99

What can the Matter be? Therapeutic Interventions with Parents, Infants and Young Children, is part of the Tavistock Clinic Series and showcases the work of the Tavistock Clinic's Under Fives Service.

The Foreword by Margaret Rustin gives an interesting historical perspective, as she chronicles the origins of the service in the 1970s, arising from her ideas about how to encourage families with babies and young children to access help. The emphasis in the academic literature at that time would have been on individual work with the child, so this thinking represented a shift towards applying ideas from child psychotherapy to the family rather than mainly focussing on the internal world of the child and towards applying the work within a brief therapy model. The book shows how successful this leap in practice has proved to be through the work and ideas of the contributors to this book: Paul Barrows, Elizabeth Bradley, Dilys Daws, Louise Emanuel, Michi Gurion, Juliet Hopkins, Meira Likierman, Lisa Miller, Janine Sternberg, Beverley Tydeman, Cathy Urwin and Isca Wittenberg.

The Introduction outlines the work of the clinic, summarising the theoretical framework and describing the intervention. The theory emphasises the importance of Bion's concept of containment, but in practice also integrates psychoanalytical concepts with other ideas.

An understanding of attachment theory, child development, and neurosciences research offers multiple perspectives to the work, and ideas stemming from systemic family therapy may also contribute to clinical practice with under fives. (p. 3)

The astonishing aspect of this brief intervention is the rapidity of change that can occur when working with the whole system at once. This doesn't happen all the time and sometimes children and parents will need to move into other therapies, but it is amazing that such productive change can happ