Psychiatric Bulletin (2001) 25: 38. doi: 10.1192/pb.25.1.38
© 2001 The Royal College of Psychiatrists
Psychiatric Bulletin (2001) 25: 38
© 2001 The Royal College of Psychiatrists
Child Sexual Abuse. Informing Practice from Research
by D. P. H. Jones & P. Ramchandani
Israel Kolvin, Bowlby Professor (Emeritus)
Tavistock Centre, London
Oxon: Radcliffe Medical Press. 119 pp. ISBN: 1-85775-362-3.
David Jones is a master of the review vignette and his skills emerge again
in this important volume on informing practice from research. His qualitative
analytical skills were notable in his joint book with McQuiston in 1986,
Interviewing the Sexually Abused Child, which preceded the Cleveland
Inquiry. He made a similar signal contribution to Child Sexual Abuse
— The Principles of Good Practice, which underpinned parts of the
Report of The Inquiry into Child Sex Abuse in Cleveland. These skills
continue to be exemplified in his editorials for Child Abuse and
Neglect. Over the years David Jones' technique has become more
sophisticated and his editorials constitute essential reading for those in the
field. His co-author, Paul Ramchandani, has rapidly learnt those skills that
have been applied to the task in hand. The net result is that this current
volume will constitute a mile-stone in advances of knowledge and clinical
practice in this subject. 
The volume is not intended as a definitive comprehensive account, but
rather the authors have explored options and selected themes that they
considered to be of major significance. It is a model of clarity. Each chapter
is introduced by a list of the main questions to be addressed. This is
followed by brief accounts of the relevant findings and their evidence base.
The authors deliberately avoid cumber-some detail but rather invite the reader
to consider the original articles to ascertain for themselves whether or not
they would place a similar weight on the evidence as given by the authors in
the comments section. An invaluable contribution is the implications on
practice section at the end of each chapter.
One is carried comfortably through nine themes — background factors;
associated problems for the sexually abused child; referral and early
planning; investigation and initial assessment; the Child Protection
Conference; comprehensive assessment and planning; implementation, review and
de-registration; psychological treatments; and measuring outcome.
It is a deceptively small book because it is so packed with clinically
significant information. For the practitioner in the field it is a compulsive
and quick read, but not too quick as one is likely to miss many gems. For me,
one strength is its willingness to re-examine the many clinical notions, and
even some long-standing myths that have emerged over the past decades and have
been elevated over time into clinical ideology without any attempt to
ascertain if they have a sound evidence-base, or at least face validity. Some
readers will not necessarily wish to place the same weight on the evidence as
that given by the authors, but when disagreeing they would be wise to provide
evidence for the disagreement.
The volume is modern and up-to-date, but like all work in this field some
of the notions and emergent guidelines will change with time. Nevertheless, it
should be in the library of every social services department and constitute
obligatory reading for those working in the field — primarily social
workers, mental health professionals and paediatricians — also those
working in family law.
