IPT Book Reviews

Title: Trust Betrayed: Munchausen Syndrome by Proxy: Inter-agency Child Protection Work and Partnership with Families
Editors: Jan Horwath and Brian Lawson
Publisher: Paul & Company Publishers Consortium, Inc. ©National Children's Bureau, 1996

Paul & Company Publishers Consortium, Inc.
c/o PCS Data Processing, Inc.
360 West 31 Street
New York, NY 10001
(212) 564-3730
$27.50 (p)

Munchausen Syndrome by Proxy (MSBP), in which a parent, usually a mother, covertly but deliberately inflicts damage to a child, thereby eliciting medical attention, is hard for health professionals to comprehend. Recently, however, as the possibility of this behavior has been more widely accepted, it has been diagnosed in increasing numbers. This has led some professionals to caution against over diagnosing MSBP.

This 266-page book consists of 15 chapters with references following each chapter. The book offers a useful and balanced discussion of the difficulties in making an MSBP diagnosis and is one of the first discussions of treatment of the parents and adult survivors. The key recommendation for treatment is that therapists should do what they know they do well and not strive to figure out new approaches. This may be a good suggestion for all therapists to consider. There are cautions about covert video surveillance and a series of suggestions as to how to get information necessary to understand what is happening. A separate chapter gives suggestions for probation and supervision of the parent who has been harming the child. A final section explores training and the level of cooperation necessary among professionals.

I recommend this book.

Reviewed by Ralph Underwager, Institute for Psychological Therapies, Northfield, Minnesota.

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