Incestuous Families: An Ecological Approach to Understanding and Treatment

Incestuous Families: An Ecological Approach to Understanding and Treatment

James W. Maddock 8 Noel R. Larson Evanston, IL: Norton 8 Company, 1995

The child and family services field has been presented with an abundance of books and reports on sexual abuse, while the more prevalent social problems of physical neglect, physical abuse, and psychological maltreatment remain under-researched, particularly with respect to developing cost-effective interventions.

What Maddock and Larson bring to this subject area is a depth of experience in treating sexually dysfunctional individuals and couples, in particular, sexually dysfunctional women - a high proportion of whom were sexually abused as children. The focus on incestuous families and family therapy helped the authors narrow their scope to provide more depth in this area. They use the term ecological to describe their approach because of the many social systems that must be considered when testing incest.

These authors draw heavily from psychodynamic and object relations theories and the work of Milton Erickson, but imbed their approach within a family systems framework. Not surprisingly, they emphasize family treatment more than victim advocacy. The comparison of the two approaches in a table format (pp. 8-9) helps to highlight the model differences but paints a more stereotypical view of victim advocacy that fails to achieve the balanced perspective that the accompanying text attempts to do.

To their credit, the authors are attempting to formulate an approach to treatment of incestuous families that addresses both the individual, family, and broader system factors. They establish a good rationale for why family therapy approaches are essential to the comprehensive treatment of incest. This book, when combined with expert consultation, can be a practical step in addressing the gap in our treatment repertoire.

In summary, this book should be read by those involved in treating incest and sexual abuse of children, even if one's practice model does not incorporate a family systems approach. The authors provide a practical view of the multiple uses of this treatment model and have integrated an extensive review of the literature into the various chapters. The authors acknowledge the appalling lack of solid evidence that any treatment approach is effective with respect to treating incest and are undertaking a research study themselves to help address this problem.

Peter J. Pecora

University of Washington

School of Social Work

Seattle, WA

Copyright Family Service America Nov/Dec 1998
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