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Despert's book of 128 pages represents a sincere attempt to describe, evaluate and contribute to the various methods of psychotherapy used at the New York Psychiatric Institute. Attention is directed to the routine examinations on admission to the hospital, which include physical, psychiatric and psychometric studies. Stress is placed on the physician's attitude, especially in the parental rôle and the need of representing the good parent-surrogate. The advantages of working with children in the hospital are ascribed to the numerous opportunities for direct observation impossible in the office, through the correlation of data from nurses, attendants and teachers; the removal of the child from the influence of the home, when the neurosis is especially stimulated in that environment; the socializing influence of contacts with other children; the possibility of a 24 hour controlled environment; also the possible benefit to the parents of a temporary relief from a difficult child. Attention is also given to the fact that the treatment of the child may have to be secondary to the treatment of the parent, or rendered hopeless when a fixed parental attitude is responsible for the difficulties presented. Disadvantages likewise are considered. A typical initial improvement occurs in many children who are hospitalized for treatment, with resulting early withdrawal by the parents.
It would appear from the variety of cases presented, that a number are not necessarily hospital cases, but accepted as proper material for teaching purposes and therapeutic experimentation. The particular problems that merit hospitalization, as compared with office treatment, have not been considered in any thorough-going manner. The juvenile psychotics who obviously require hospital care represent a small minority of the group. In general, children who require treatment under controlled environments, other than those who come constantly in conflict with the law, represent cases in which the