Journal of Psychosomatic Research 52 (2002) 273 – 276
Early Diagnosis and Interventional Therapy in Cerebral Palsy: An Interdisciplinary Age-Focused Approach 3rd ed. In: Alfred L. Scherzer, editor. Series: Pediatric Habilitation Vol. 11. Monticello, NY: Marcel Dekker, 2001, 335 pp. US$55.00 Dr. Scherzer offers a comprehensive review of the diagnosis and management of the infant and young child with cerebral palsy (CP; birth to 3). This book includes interesting historical insights that are not commonly included in other texts, such as the earliest documentation of CP and the evolution of a systematic approach for making a diagnosis and classifying CP. Chapters 2 and 3 are particularly noteworthy due to their appeal to a large audience of physicians and therapists. Chapter 2 carefully presents the latest evidence regarding the causes of CP, walking the reader through the myriad of risk factors and cascade of events linked to prenatal and perinatal brain injury (and subsequent CP) in the preterm and term infant. This chapter importantly emphasizes the declining role of asphyxia as a cause of CP. Chapter 3 gives the reader step-by-step, detailed information, photographic illustrations and instructions to equip the clinician to be able to perform a comprehensive history, developmental assessment, physical and neurological examination and directs the clinician towards appropriate laboratory testing, when indicated, to search for progressive disorders masquerading as CP (Table 1A on p. 57 has a duplication of points 4 and 5). Chapters 4 – 6 cover management and treatment and highlight important issues and associated impairments that need to be considered and addressed. Dr. Scherzer and colleagues methodically but briefly review numerous treatment modalities, including accepted therapies and controversial or alternative approaches, providing the reader a wealth of information (and references) with which to make decisions. It is imperative that clinicians be aware of these alternative/nonmainstream strategies because parents frequently ask about them and many parents choose to pursue alternative treatments regardless of the ‘‘expert’s’’ opinions. Chapters 7 – 9 are most appropriate for therapists (PT, OT, ST) and may not appeal to most physicians. The photographs are helpful. These chapters underscore the importance of focusing on patient’s strengths and emphasize the need for setting functional goals for therapy. Most important are the family’s goals and priorities for the patient, and the family must be included in all treatment decisions. Many different data sheets and treatment charts
are included in these chapters that are very comprehensive and useful as guidelines, but may not be practical for everyday use in a busy treatment setting. In Chapters 10 and 11, Charlene Butler describes the evolution of research in CP, including the major ongoing effort that she has spearheaded with the American Academy for Cerebral Palsy and Developmental Medicine to review the levels of evidence supporting or refuting the use of various therapeutic interventions in CP, such as intrathecal baclofen and neurodevelopmental therapy. The ultimate goal of these efforts is systematically to identify existing gaps in conventional practices and understand CP in order to stimulate greater quality and quantity of pediatric rehabilitation research. Overall, this is a very useful resource on CP and early intervention in the infant and young child. There are portions of this book that will appeal to experienced clinicians as well as practitioners in training from a variety of backgrounds (child neurologists, pediatricians, physical medicine specialists, physical, occupational and speech therapists). Jan Brunstrom Pediatric Neurology Cerebral Palsy Center Washington University School of Medicine St. Louis Children’s Hospital One Children’s Place, Room 12E25 St. Louis, MO 63110, USA Tel.: +1-314-454-6120 Fax: +1-314-454-2523 E-mail address: [email protected]
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Handbook of Cognitive –Behavioral Therapies (second edition) by Dobson, K.S. (ed.) (2000). New York, NY: Guilford Press. 446 pages. $45.00 The idea that what we think influences our actions seems beyond controversy. But in the context of the behavioral revolution of the 1960s in clinical psychology, the legitimacy of this proposition was considered questionable. B.F Skinner maintained that cognition was merely an accompaniment of behavior, and did not play any role in the causal chain resulting in action1. While Skinner’s views were by
0022-3999/02/$ – see front matter D 2002 Elsevier Science Inc. All rights reserved.
Skinner, B.F. (1974). About Behaviorism. N.Y.: Alfred Knopf, Inc.
Book reviews / Journal of Psychosomatic Research 52 (2002) 273 – 276
no means universally accepted, he did help create an environment in which the therapeutic focus on cognition was considered suspect. At the same time, it was becoming apparent to both clinical and experimental psychologists that a strict behavioral approach could not adequately account for a great deal of human behavior. Cognitive – behavioral therapy (CBT) emerged in the 1970s as an attempt to introduce cognitive concepts into behavior therapy without abandoning its commitment to observable behavior change and empirical validation of its methods. The second edition of the Handbook of Cognitive –Behavioral Therapies does an excellent job of introducing the field to both the beginning psychotherapist and the experienced therapist unfamiliar with behavioral treatments. Starting from the premise that what therapists need most is a conceptual framework that can guide their use of specific treatment techniques, editor Keith Dobson begins this volume with chapters on historical and philosophical bases, assessment, case formulation, and cognitive science. Part Two eschews an organization based on clinical disorders in favor of chapters describing the various strategies or models of CBT, e.g., selfmanagement, problem solving, rational – emotive, cognitive. Also included in Part Two are chapters on CBT with youth and constructivist approaches in psychotherapy. The purpose of the Handbook is not to prepare practitioners to conduct cognitive – behavioral therapy. It is not a ‘‘how to’’ book, but rather a ‘‘how to think’’ book. For clinicians who are interested in the specifics of conducting treatment, there are numerous references for treatment manuals. Similarly, the Handbook does not attempt to provide comprehensive literature reviews of the effectiveness of CBT, although illustrative studies are described in sufficient detail and references are included for other published research. The editor endorses the movement in the mental health fields toward identifying empirically validated treatment approaches. But the whole structure of this book conveys an appreciation for the notion that a cognitive – behavioral therapist should not be merely a technician, but rather a ‘‘doctor’’ in the original sense of the term: a learned person. This book successfully avoids two common weaknesses of edited handbooks: lack of coherence among the chapters and superficial treatment of individual topics. The editor’s belief in the importance of a theoretical and historical understanding of the field is a pervasive theme reflected in the organization of the volume and the presentation of each topic. The chapters on CBT treatments each present discussions of the history, theory, clinical applications, treatment procedures, and empirical status of the therapeutic models. The treatment chapters provide the right amount of depth to give the reader a good sense of the rationale and application of each approach, without getting too involved in the specifics of conducting the treatment. Similarly, research is described in sufficient depth to illustrate the findings in the literature without producing a litany of research studies.
The second edition of the Handbook of Cognitive – Behavioral Therapies provides an excellent introduction to the field of cognitive – behavioral therapies for graduate students and practitioners who want to learn evidence-based approaches for treating psychological problems. Perhaps the most important thing this book offers is conceptual frameworks for understanding how to choose and apply specific treatments for patients. Stuart G.Fisher Devereux Massachusetts, 60 Miles Road Rutland, MA 01543, USA Tel.: +1-508-886-4746 Fax: +1-508-886-2274 E-mail address: [email protected]
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Adherence Issues in Sports & Exercise Edited by Stephen Bull, Ph.D. West Sussex, England: John Wiley and Sons 1999, 328 pp. US$60.00 Since the days of Hippocrates, patients have often been less than honest when they say they have taken their medicine. Likewise, adherence and compliance often arise as concerns for athletes and exercisers. They are more likely to talk about a good workout than actually engage in one. To understand adherence among patients, athletes, and persons who exercise regularly, Bull and colleagues have edited Adherence Issues in Sports and Exercise. The book begins by discussing three main sources of influence on adherence—the group, the leader, and the family. The group optimally influences adherence by fostering a positive attitude toward exercise. The group gives feedback, support, and encouragement to continue to participate in an exercise program, thus building a sense of unity among group members. Group cohesiveness, driven by the social needs of humans, influences exercise adherence. Yet for many, group participation alone is not enough, and more individual instruction, especially from an ‘‘exercise leader,’’ is useful. Though empirical studies are sparse, the role of the exercise leader may be the most important variable affecting exercise compliance. The influence of primary health care providers and general practitioners can positively affect patients who are initiating or continuing an exercise program. Interestingly, a high percentage of physicians do not believe that their patients would do as prescribed. Therefore, they do not see the benefit of encouraging patients to exercise. Yet, for those who do (and receive training in how to deliver exercise advice), such advice appears to have a positive influence. Society must see the cost-to-benefit ratio of exercise to strongly influence behavior. The authors describe some specific approaches to adherence. The Transtheoretical Model of Behavior Change