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The introduction to this valuable book summarizes what the authors undertook in the study on which their report is based: "(1)
How psychopathology develops and in what patterns and configurations in infants from multi-risk families as well as other types of families; (2) What ideal combinations of clinical techniques and service delivery models would be needed to have even a chance of reversing maladaptive patterns; (3) Which clinical techniques and service system approaches were effective for specific problems, examined on a case by case basis; (4) A comparison between comprehensive and less intensive intervention approaches and treatment outcomes; and (5) The relationships among perinatal risk patterns, the formation of therapeutic relationships, and subsequent development in the children and their families" (p. 3).
Begun in 1977, the study adopted a team approach, assigning at least two staff members to each family as well as providing the services of an infant center staffed by well trained specialists. The interdisciplinary teams, with members of differing skills and professions, comprised the service staff of social workers, psychologists, nurse practitioners, early childhood educators, child therapists, a psychiatrist, and psychologists. A refreshing and clinically sound plan was put in place. It began with therapeutic approaches derived from previous knowledge of multi-risk families modified on the basis of new information. The time, energy, and resourcefulness required to sustain the families, the staff, and the study are noteworthy.
Much of the approach and detail of the work is presented via case studies involving four families. As the authors report, "We tried to work with mothers whose lives were full of difficulty and pain to help them create an opportunity to grow emotionally and to learn to care for their infants with tenderness and intimacy, even though they had never experienced such a relationship themselves" (p. 9). Their chief focus was o