Drawing on clinical insights from family systems thinking, psychodynamic play therapy, and cognitive-behavioral perspectives, this significant new work presents an innovative approach to therapeutic work with young children and their families. The author brings a thoroughly integrative orientation to bear in her understanding of how parents and children get entangled in patterns that cause grief to both generations.

Her approach - "child-in-family" therapy - although steeped in the systems outlook, offers a thorough consideration of the unique characteristics of the child in trouble and the specific developmental obstacles that he or she faces. This strategy enhances family therapy at times when a child's difficulties begin to take on a life of their own, and also brings the power of family systems thinking to individual efforts to help young children in trouble.

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Beginning with an introduction to the author's methods, the first chapter sets forth a rationale for combining the most valuable aspects of systems therapy with individual psychotherapy approaches. With much clinical detail, the book first explains how to effectively conduct meetings with parents alone, emphasizing ways to draw out parents' concerns about their children and distinguish distortions and projections from true observations.

The author also demonstrates the use of a valuable element from family therapy - a positive orientation that helps parents notice their children's strengths. Then, in addition to offering specific guidance on how to conduct family sessions with very young children, Ellen Wachtel gives family therapists the tools they need to begin including individual sessions with children as part and parcel of family therapy.

She also shares with readers numerous concrete suggestions on how to interact with young children in ways that foster emotional expressiveness.

In step-by-step detail, this book demonstrates how therapists can organize and evaluate the information gleaned through the different sessions so that the child is neither pathologized nor too readily pronounced "fine." Active interventions based on psychodynamic formulations are utilized to address such individual issues as the child's oversensitivity to criticism, low self-esteem, poor relationships with peers, and conflicts around aggression.

Interventions based on behavioral formulations are also described in detail. In the final chapter, the author presents five case studies that clearly illustrate the clinical use of the concepts and applications described. She shows how interventions at the family system level must be complemented by interventions that focus on the child.

These include not only the use of play and other projective methods for bringing to light the child's issues, but also active efforts to work with the child on changing his or her behavior.

Clinically sophisticated, humane, comprehensive, and powerfully integrative, this volume represents a major leap forward in our ability to help troubled children and their families. Presenting a ground-breaking new approach that combines the best elements from family system thinking and individual therapy, the book is an invaluable resource for all professionals.