Residential Treatment for the Disturbed Child. Basic Principles in Planning and Design of Programs and Facilities: By Herschel Alt. New York: International Universities Press, Inc., 1960. 437 pp.

Alt covers the full range of the problems of residential therapy for children with balanced consideration of the total therapeutic milieu, the educational program, the place of individual psychotherapy, and the complexities of administration which underlie the

effective work of all such institutions. The expository sections of the book and the illustrative case reports reveal clinical practices that have grown out of thirty years of experimentation and self-study at Hawthorne Cedar Knolls School.

The description of methods for individual psychotherapy employed at Hawthorne will be of interest to analysts. Although the clinical program relies strongly on psychoanalytic thinking, Alt reports discouraging results in attempts to employ an analytic child therapy for the severe ego disturbances encountered among the children there. The individual therapy developed at Hawthorne is directed primarily upon the immediate experience of the child 'on the assumption that he is not capable of being involved in any earlier or deeper layers of his growth'.

We may reflect that child analysis has, as yet, made no significant contribution to the development of psychotherapeutic methods for the residential treatment center. This is all the more extraordinary when we consider that developments in child analysis during the past two decades have expanded the range of childhood disorders that can be treated by it to include a wide variety of behavior disorders and ego disturbances. In private practice the problem of 'analyzability' of such children often has less to do with the nature of the disorder than with the problem of treating the child within his environment. Here, of course, the therapist in the residential treatment center has the enviable advantage of working with these damaged children within an environment that is designed not only to support and augment the individual psychotherapy but to provide corrective experiences for the past.

Within this favorable environment, chi