The subject of this textbook is a disorganised insecure attachment in children and young people and a therapeutic approach with which to effectively work with such presentation. However, at its core, this text is addressing that complex and confounding dilemma of psychosocial approaches to working with the traumatised child which is the potential for a re-experiencing of trauma during the helping process. There is a fascinating and profound contribution, from the Forward, by Peter Fonagy which reflects this, and in doing so, really does justice to the quality of this textbook as a whole. Professor Fonagy writes on page 10:There can be few topics of greater importance than understanding of a child who seeks refuge and safety in the relationship, which has generated the distress that calls for comforting. These human tragedies are probably more common than we recognise; probably all of us have both experienced and created moments when threat and safety are co-located.
In speaking to the heart of this matter, the textbook provides a wide-ranging theoretical discussion of three essential areas in addressing this problem in Chapters 2-4: attachment, trauma and mentalisation. I want to emphasise the degree of theoretical integrity in this textbook and in this therapeutic approach. This integrative approach is based on the theory and research within a range of subjects, from attachment theory, psychodynamic approaches, as well as humanistic, cognitive and social psychology, and also, social learning theory. It is important to acknowledge that the material on trauma includes a contemporary perspective on the neurological, neurophysiological and neuropsychological basis, and understanding, of this whole subject of trauma.
However, the value of this textbook goes beyond presenting an integrative approach, and includes one of offering some clarity that can be brought to the confusion and chaos of the work. The value of this textbook is also in the fact that the author offers a practical and helpful model for practice. The latter chapters, from Chapters 5 to 8, perform this task exceptionally well. This holistic model is called MAT, a mentalising approach to attachment – informed care and trauma-informed care. At one level, this model is very practical and very immediate in the sense that it will be obviously relevant and useful to even the most inexperienced colleague. In part, this is no doubt because of the immediate relevance and straightforward rightness of both attachment theory and mentalisation as ways of understanding problems of attachment. However, in part, it is also due to the fact that the author works well with these concepts, as one would expect from such a sophisticated and experienced practitioner.
This textbook will be of immediate use to all colleagues given the richness of the content and its excellent structure and organisation. Such is the author's commitment to communicating his ideas that the chapters even begin with some very useful learning outcomes with which the reader can measure their understanding. My only reservation is that I am not entirely clear the first chapter on Recovery is about the Recovery Concept but, more importantly, I am not entirely convinced it adds anything substantive to the main content of the textbook.
However, such is the depth and breadth of this rich material that this textbook will be of interest and value for all of us working in the therapeutic community world. The author works as a clinical lead at Bryn Melyn Care, an organisation providing a range of specialist services for young people in crisis, and does so as part of The Charterhouse Group and Community of Communities. Such is the importance of a therapeutic community approach to the work, the author specifically places the model within the context of the values of the Community of Communities, both implicitly and explicitly at different points in the text, particularly when dealing with the very demanding and highly specialist work of attachment-informed care and trauma-informed care at the midpoint of this book. Indeed, such is the importance of a therapeutic community approach to the work and to this textbook, the Core Values to the Community of Community Service Standards are reproduced in the appendix also. As such, I would recommend this textbook to all those who work directly with children and young people with disorganised attachments, and also to those working in the therapeutic community world as a whole.
