Clinical Infant Reports. Series of the National Centre for Clinical Infant Programs. Number 3. Infants in Multirisk Families. Case Studies in Preventive Intervention. Edited by Stanley I. Greenspan. Maddison,  Conn: Int. Univ. Press. $40.00.

This book, as the title implies, is likely to be mainly of relevance to those with a special interest in multi-problem families.

It is produced by the Clinical Infant Development Program under the auspices of the National Institute of Mental Health (USA) and is in the nature of a social programme for multi-problem families involving day-care and intensive psychosocial provision by a multidisciplinary team ranging from social workers to psychologists and psychiatrists. This is all observed in very great detail, together with the social context in which the families live. Its scope is in many ways huge. It is attempting to provide information about what kinds of provision and intervention have the best chance of reversing the cycle of deprivation. An important hypothesis is that the maladaptive patterns begin in infancy, and any attempt to reverse the cycle must begin at least during the early months of life, and preferably by identifying and responding to ‘at-risk’ mothers when they are pregnant. For this reason, the programme is directed at families with young children, most of which consist of single mothers with transient and changing partners.

While the study is not primarily psychoanalytic it is quite sympathetic to psychoanalytic ideas, and uses them in conceptualising psychopathology

Part of the programme consists in attempting to engage the mothers by a particular worker in a psychotherapeutic relationship using a modified psychoanalytic approach. Initially these very deprived mothers are interested only in what they can concretely get out of the therapist, and the therapist is responsive to this, giving extra analytic help and being available outside session times. Gradually the mothers come to perceive an emotional need, and in many cases it was possible to develop a relationship which more resembled formal psychotherapy, in which the transference developed and could be interpreted with resulting development of greater insight by the mothers, which certainly a