Book Reviews -- Short-Term Parent-Infant Psychotherapy by Paul V. Trad

Article excerpt

Research has confirmed that the mother-infant dyadic relationship exerts substantial influence on the course of infant and early-childhood development. In recent years, psychopathology and emotional conflict have been detected with greater frequency in the contours of this relationship. Paul V. Trad, M.D. has devoted significant attention to this issue and, in his most recent work, has devised an efficacious treatment for the dyadic relationship by applying a short-term psychotherapeutic protocol averaging two to twenty-four months. His book is intended to disseminate the most up-to-date theoretical information in the field, as well as to provide assistance for professionals who deal with parents and infants, including child psychiatrists, child psychologists, family therapists, pediatricians, and social workers.

The text is divided into two parts. The first part discusses the evolution of a theory of short-term parent-infant psychotherapy. In this regard, the psychological status of the caregiver is subjected to rigorous analysis. From this analysis, Trad extrapolates a variety of offending factors that are likely to interfere with the establishment of an adaptive alliance between mother and infant. Among the factors enumerated are: postpartum depression, marital discord, and a maternal history of abuse and neglect during childhood.

Having provided a cogent and convincing rationale for intervention, Trad then argues persuasively for the initiation of therapy as early as the pregnancy period. Indeed, he observes that it is during this time of mild "developmental crisis" that the expectant mother may be most receptive to learning new representational patterns and re-aligning her perceptions along more adaptive pathways. Thus, clinicians working with pregnant women are urged to conduct assessments with these patients in order to determine whether early intervention is warranted.

In the event treatment is introduced during the pregnancy, Trad advocates use of an innovative technique--labeled previewing--that sensitizes prospective parents to the content of their own internal representations, as well as to the behavioral patterns they may be expected to manifest after the birth. The previewing process is inaugurated when the mother represents episodes of past and present interaction as well as to envision episodes of future interaction with the infant. This representational task may certainly be practiced during the pregnancy. The second phase of the previewing process involves rehearsal exercises whereby the mother introduces the infant to the physical sensations and interpersonal nuances of new developmental skills. This aspect of previewing is best integrated into the mother's behavior after the birth, yet the clinician should encourage the expectant mother to begin anticipating such rehearsals. The mother helps the infant master new developmental skills. Parental empathy to the infant's moods and emotions is yet another important feature of the previewing process. Clinicians are also reminded to be alert to the potential for parent-infant conflict in single-parent families, as well as in families with working mothers and adolescent mothers. Additional variables that may undermine the mother-infant dyad are marital discord, wife beating, alcoholism, HIV infection, and postpartum depression.

The second part of the book illustrates the use of short-term parent-infant psychotherapy in several clinical cases. …