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been examined from a more critical perspective. In addition, the chapters are uneven in the amount of information they convey. These irregularities, perhaps an inevitable aspect of an edited book, may also reflect gaps and discrepancies in the diverse fields involved in the study of infant development.

In reading Studies in Abnormalities, one is impressed with the increasingly sensi- tive measurement techniques available to the researcher for assessing infant behavior. Based largely upon the principles of operant conditioning, we are developing viable methods of evaluating infants that once seemed merely in the realm of speculation. The more sensitively we can measure the behavior of the infant, the more skilled we can become in the early detection of gross deviations in behavior. Early detection of faulty learning patterns may ultimately lead to the prevention of many later defects in childhood and adult life.

Although it is not written from the perspective of the behaviorist, the readers of Behavior Therapy should find this book valuable because of its emphasis upon the conditions of learning in infancy. Much of the content is nornaative or descriptive in nature and the psychoanalytic influence is happily minimal. The authors base their statements on hard data rather than dynamic speculation. These infants may have eating problems but they are not being fixated at the oral stage! Some back- ground in the theories of Piaget and Hebb, together with experience either in neurology or developmental psychology, would be useful since this is by no means a book for the novice or casual reader.

For the behavior therapist, Hellmuth's book offers a deeper appreciation of the conditions of learning in infancy. It is not su~cient to acknowledge that individuals differ in biological potential and early experience. We must begin to understand the subtleties of these conditions in ways that will enable us to alter and/or com- pensate for the experiences. To understand fully adult behavior we must reassess the critical nature of what is learned in the earliest days and hours of life.

SANDRA L. HARMS Douglass College Rutgers, The State

University of New Jersey

STRUPP, HANS H. Psychotherapy and Modification of Abnormal Behavior. New York: McGraw-Hill, 1971. xii-4-209 Pp. $3.95.

The whole question of "'dynamic" psychotherapy has become a battleground. In the battle the first shot was fired in 1952 by Eysenck in his now famous and much debated report of the outcomes of psychotherapy. Over subsequent years the com- bative atmosphere that has surrounded discussions of psychotherapy has not made for objective presentations of the various issues that are involved. Professor Strupp, writing with an "admitted bias in favor of psychoanalytic psychotherapy" manages, nevertheless, to do so in an urbane and reasoned style and a more concerted effort after objectivity than many of his predecessors on this topic. Nonetheless, the bias shows through and has some effects upon the suitability of the book for its intended audience.

This volume is one of a series of paperbacks designed for the advanced under-

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graduate studying psychopathology or related subjects. As a general rule the reader is assumed to have some elementary preparation in psychology but little sophistication in the topic of the volume itself. In this rather important respect, then, the book has pedagogic purposes, and the presence of bias raises some difficulties although the scope of the contents seems entirely suitable.

Three central chapters are devoted to psychoanalytic therapy, client-centered therapy, and behavior therapy, respectively. These form the core of the book, to- gether with two chapters dealing with research. Introductory and closing chapters complete the contents, together with a chapter summarizing other forms of psycho- therapy. The level of discussion within these chapters is well chosen for the intended reader and Professor Strupp has done an excellent job of making rather complex matters clear without undue distortion in the process. A particular highlight of the book is the opening section of Chapter 6, entitled "Problems of Research." In it the author provides an admirable and succinct account of the variables and problems that must be considered in research on psychotherapy, a section that could be read with profit by professional audiences beyond the undergraduate range.

From the standpoint of the behavior therapist the major weakness of this book stems from its fundamental bias--and the assumptions that accompany it. The author, for example, believes that the essence of change in psychotherapy is tlae operation of a process of learning "new techniques for getting along with one's contemporaries and modifying those strategies which are shown to be maladaptive or self-defeating. Unlike any other educational experience, however, the subject matter is not a cognitive content (like French, Latin or any other subject taught in school) nor is it a motor skill (like ice-skating, piano-playing, or typing); the subject matter consists of the strategies, attitudes, feelings and behaviors one employs in interpersonal relations.'" The belief that there is some profound difference be- tween the principles that underly the learning of "cognitive content" and "motor skills", on the one hand, and "feelings, attitudes and behaviors", on the other, neces- sarily places Strupp in a position wherein the study of the former must be regarded as marginally relevant to work with the latter.

A second proposition to which Strupp appears to subscribe is that psychoanalysis has already been shown to be significantly effective and that the remaining major questions of interest bear upon discovering the specific patterns of patient-problem- psychotherapist that make for improvement rather than upon the more fundamental question of whether any such combinations show improvement at better than chance rates. In an early chapter he presents a reasoned and comprehensive account of the many variables that must be taken into account in any study of the efficacy of psychotherapy. After stipulating the kinds of controls, measurements, and samples that are necessary, he writes: "Today there are no studies which approxi- mate closely these stipulations, although there is abundant clinical evidence that an appreciable number of patients who are selected for a particular form of psycho- therapy benefit from the experience." Later, apropos psychoanalysis, "While precise data are hard to come by, numerous studies suggest that psychoanalytic psycho- therapy results in favorable changes in a fair percentage of cases (perhaps in the vicinity of 50 to 60 per cent)."

Unfortunately, Strnpp does not present the data from these studies, nor does he cite them, so that the undergraduate reader is left with the author's opinion and nothing more. It is difficult to reconcile the earlier statement that there have been no adequate studies of psychotherapeutie outcome with this later unsupported

610 BOOK ItEVIEWb

claim of improvement rates within quantifiable percentages, in the case of psycho- analysis.

Detailed criticism of research is forthcoming only in the case of two reports most vexing to psychodynamicists, that of Eysenck already mentioned and the re- cent research of Paul (1966). The criticism, unfortunately shows a fluctuating regard for the application of uniform standards of scientific rigor in the evaluation of research procedures. For example, the criticism of Eysenck includes detailed consideration of the measures of outcome that were employed with the observation that the high rate of recovery of the untreated groups must be regarded with suspicion because "Patients who are seriously disturbed typically do not 'recover' from their neurotic problems . . . . " while the recovery rate cited for the psycho- analytically treated patients can be accepted even though the judgment of im- provement was made by the therapist who was doing the treating! In brief, as we know that psychoanalysis works we can accept its reported successes and as we know spontaneous recovery does not occur we can reject any study that reports it. The question raised by Eysenck having been thoroughly begged by these assertions it is hard to know where we go next. It is unfortunate that the undergraduate student is not given the benefit of simi!ar methodological criticism of psychodynamic reports of treatment success.

Inevitably the commitment of the author to standards of scientific rigor on the one hand and to the viability of psychodynamic therapy on the other produces con- flict and ambiguity on several significant issues. We have already mentioned one of them, but it may be instructive to examine some others. For example, as a criticism of behavior therapy Sta'upp remarks, "Existing learning theories do not adequately account for the acquisition of behavior in seemingly simple laboratory situations and thus fail to do justice to the much more complex clinical phenomena with which the psychotherapist is concerned." Now it is possible to take the position that the central issue with any therapy is whether or not it is effective and that its relationship to theory is (although not unimportant) basically secondary. The most telling kind of criticism that might be considered about any therapy is that of ineffectiveness. Lack of articulation with an adequate theory is important, but less so. Indeed Strupp recognizes this elsewhere when, writing of psychoanalysis, he remarks "In order to deal with the shortcomings of psychoanalysis, it is neccessary to differentiate it from the psychoanalytic theory of personality and personality development, with which we are not here concerned." Either the relationship of a therapy to a theory is critically important or it is not. The author seems to be unsure of this and to apply this criticisna with variable consistency.

Strupp seems, in the eyes of this reviewer, to be unduly impressed by the con- tributions of the structural linguists to the study of learning. Chomsky, he states, has "severely criticized Skinner's model of animal learning and asserted that it does not apply to complex learning in human beings." Here again, one wishes that the undergraduate were provided with a clear statement of the alternatives proposed by Chomsky and evidence that they are more applicable to therapy than the principles of operant or classical conditioning. In fact, this reviewer would have found such evidence useful as he is unaware of any empirical data to justify such an analogy.

In sum, it appears that the author's biases have perceptibly affected the manner in which the issues have been presented to the undergraduate. However, he is frank about them and the intelligent student will have been sufficiently forewarned. Any instructor wishing to present the problems of behavior change in an objective fashion

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may well want to use this book provided that it is combined with some additional reading presenting the other side of the story.

BRENDAN MArina Department of Psychology Brandeis University Waltham, Massachusetts

BERGIN, ALLEN E., ~¢ GARFIELD, SOL. L. (Eds.). Handbook of Psychotherapy and Behavgor Change. New York: John Wiley, 1971. XVIII 4- 967 Pp. $18.95.

A number of years ago Victor Raimy proposed an amusingly cogent definition of psychotherapy which even today has a freshly contemporary flavor. Raimy noted that: "Psychotherapy is an undefned technique applied to unspecified cases with unpredictable results. For this technique, rigorous training is required."

One might quarrel with this oversimplification, but it is safe to assert that there are relatively few standard theories or techniques of behavior change which most practitioners would endorse with confidence. Nevertheless, as clinicians we do have innumerable individual and group theories and techniques at our disposal. Indeed, the list of psychotherapeutic interventions and the variations on each theme appear to be expanding at an almost geometric rate. Nowadays, almost everyone has an original therapeutic twist to offer and there seems to be no limit to the imagination and ingenuity people ean muster to invent therapies for all oceasions and needs. Al- though, at this iuncture, we have an abundance of ideas, I suspeet that the salient problems ttaimy raised in his definition are valid today. How understandable are our techniques? Can we adequately assess for the selection of appropriate treatment methods and can we estimate with any degree of certainty our potential for success? These are hardly academic questions and, while many mental health workers might prefer simply to skirt the issues or engage in unintelligible theoretical jargon, an aroused public might someday start asking pointed questions.

Fortunately for the clinician and researcher alike, Bergin and Garfield's handbook is a welcome antidote to the notion that psychotherapy and its sister, behavior change, have remained in a state of suspended empirical animation. Research has indeed moved forward, but it has often been so scattered and unsystematically related to theory and practice that only the hardiest clinician could fathom its meaning or even remotely use it in his clinical activities. Designed partially to fill the chasm that exists between research and practice in psychotherapy, the purpose of this volume is to survey and evaluate the data and to deal with the question, "Under what eonditions will this type of elient with these particular problems be changed in what ways by specific types of therapists?" To this end, the editors selected experts in a wide variety of clinically related areas and gave them virtually earte blanche to produce an integration of theory and research in their specialty. The net result is a truly mas- sive volume of original contributions with almost microseopic print. For the re- searcher or clinician who takes his field seriously this is unquestionably one of the best sources of encyclopedic integration for most topics in the broad psyehothera- peutic literature.

The handbook's 24 chapters are divided unequally into five parts; theory, method- ology, and experimentation; an analysis of client-centered, psychoanalytie, eclectic, and related therapies; an analysis of behavioral therapies; therapeutic approaehes to