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ON FIRST ENCOUNTERING STANLEY GREENSPAN'S WORK, ONE IS likely to become quite overwhelmed with its scope. At least this was one of my initial reactions to being introduces to his work about 20 years ago. Through the years that I have been studying and using his theory in my practice, I have found it tremendously useful in organizing my clinical understanding of developmentally challenged individuals. Since I anticipate that the reader of Greenspan's work that is being published in this journal is likely to have a similar reaction, I wanted, by way of introduction, to first explore the reason many people, clinicians, and nonclinicians alike, respond initially with some anxiety and trepidation.
In this brief introduction to Greenspan's work and to the Developmental-Individual Differences-Relationships-Based Therapy (DIR model), I will first describe the theory and the role of the clinician applying it. Then I will discuss the way Greenspan addresses the “core deficit” in autism, the deficit in linking affect and intention, and finally, I will illustrate the application of the theory with a brief case vignette.
The Greenspanian project is quite an ambitious one. In the papers that you are about to read, Greenspan delineates the factors that a clinician who treats children in general and children with severe challenges in relating
and communicating needs to consider. While many theoreticians and writers in the field list the many factors that may be involved in normal and pathological development, Greenspan expects the clinician not only to be aware of these factors and their impact on development but also to specifically intervene and include each of them in his treatment plan for the child and the family. Now this is often beyond what most clinicians have been trained to deliver to a child and family in therapy, and it puts a considerable responsibility on the clinician to familiarize himself and become conversant in