Sage Publications, Inc. Description: The stated purpose of this 251-page book is "to serve as a resource for mental health professionals who must address the problem of child sexual abuse" (p.7). To that intended end Dr. Faller has prepared nine chapters organized in four sections. The first two chapters deal with the issue of what constitutes sexual maltreatment. Chapter 1 presents selected information about the size of the problem and how to recognize it. Chapter 2 asks the familiar question about the definition of child sexual maltreatment and proposes an answer. The second section deals with the institutions and other professionals with whom the mental health professional must relate. Chapter 3 describes a standard understanding of the relationship with the child protective services system and its personnel and then treats the interaction with the police. The interaction of mental health professionals with courts and attorneys forms the topic of Chapter 4. The third section presents material on the assessment of the situation and circumstances where there is a charge of sexual maltreatment. Chapter 5 gives advice and direction on how to decide whether abuse occurred. Chapter 6 offers a risk assessment procedure as a way of gathering information to guide the recommendations and actions of the mental health professional. The final section of the book has three chapters dealing with
special contexts that should be considered when the mental health professional
is attempting to act responsibly in dealing with child sexual maltreatment
charges. Chapter 7 raises the question of foster care and reports what Faller
calls her research based on her clinical experience. The chapter deals with the
reality that foster care is a dangerous environment for children who have been
sexually maltreated. Next, Chapter 8 discusses sexual abuse in a day care
environment. Again Faller reports briefly on a preliminary analysis of her
clinical experience with sexual abuse in a day care setting. Finally Chapter 9
examines the context of a divorce and the possibility of false allegations
occurring in this situation. Discussion: This book is supposed to be "useful both to those who have little background in sexual abuse and to those whose background is considerable" (p. 7). Covering such a wide range is difficult for anyone and Dr. Faller does not quite make it in the first two sections which include Chapters 1 through 4. The material here, while well organized and presented in a systematic fashion, is elemental. Anyone with passing knowledge of sexual abuse knows that a major problem is the definition of abuse. The discussion here does not contribute anything new nor does it suggest any knowledge by the author of the major theoretical issues in nosology and classification. The elementary nature of the presentation is shown in Chapter 3: "The responsibility of the police is to catch criminals" (p.80). There is no awareness that the role of a peace officer may be somewhat more complex than that presented on TV. There is no acknowledgment of the basic pursuit of justice and the role of a system of justice in any society. In discussing the interaction of mental health professionals and institutions, Faller demonstrates a simplistic and naive acceptance of institutional claims based on their face value, thus evidencing a limited awareness of reality. "Generally, as the expert for protective services, the guardian ad litem, or the court, the mental health professional will not encounter serious difficulties, because each of these entities is primarily concerned with the child's best interest' albeit from different perspectives" (p. 90). According to Faller, difficulties arise only when the mental health expert is involved with the parents. Apparently only parents are capable of having ulterior motives or anything other than the best interest of the child in mind. Chapters 5 and 6 attempt to provide information about discriminating between accusations that are accurate and those that may be erroneous. This is a necessary and laudable goal, which unfortunately, has not been advanced by these two chapters. The confusion of roles and assumption of competence beyond that of any mental health professional is evident in: "The goal of this chapter is to give the mental health professional essential tools for deciding whether or not children have been sexually abused" (p.113). This is an arrogant excursion into the function and responsibility of the justice system. There is nothing in the competence of any mental health professional that legitimizes the assumption of the fact-finding decision by them. These two chapters propose a dangerous use of two checklists that are unsupported by any empirical data and lack demonstrated validity or reliability. Nevertheless, scoring and interpretation of results is proposed with no data to support it. It is acknowledged that this approach is preliminary and some caution is at least implied. However, it is unlikely that anyone who would choose to use these two checklists would have the training and knowledge necessary to see them for what they are, hypotheses or guesses that need to be provisional at best. Rather, they are more likely to be used by persons who will think they are tests. This will increase false positives and may result in some decisions that children have been abused when they have not, an act which is inarguably not in the best interest of the child. The final three chapters deal with environmental circumstances that should be considered, a sound and crucial step in understanding child abuse. The material on foster care exposes the often overlooked issue of the danger to children in foster care placement. The assumption that the state can do a better job and foster care is benevolent and beneficial cannot be sustained. However, the material on abuse in day care and accusations in a context of divorce is flawed by the same elementary and simplistic level of understanding found in the earlier chapters. An example is the uncritical acceptance of research on abuse in day care that uses as a criterion measure the unsupported opinion of the initial investigator. The only time Faller critically assesses the quality of an opinion or statement is when it happens to be data that does not support her view. The reader cannot accept Dr. Faller's evaluation of studies without carefully evaluating the claims and the quality of the studies themselves. There is no conclusion to the book. It simply ends with the last chapter and a brief section on false accusations. This book may be of limited utility to a person who is without any knowledge of the problems and issues involved in child maltreatment if it is read with caution. It is not likely to be useful to anyone who has knowledge of the basics of science, the science of psychology, and the controversies in dealing with child abuse. Reviewed by Ralph Underwager, Institute for Psychological Therapies, Northfield, Minnesota.
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