332 Book Reviews

comprehension of truth, lies, and false beliefs which describes developmental norms between 3 and 8. Of considerable assistance as is the description of the ages of moral reasoning. The chapter by Schroeder, Alnstein, and Baker-Ward gives a helpful up-to-date view of the implications of research on memory development. Hewitt and Friedrich give an outstanding contribution on assessing and managing abuse allegations with very young children, drawing attention to the importance of the context of care of the child. They assert the importance of analyzing behavior against research findings, enabling the level of risk to young children to be accurately determined. Greuel and Kuenhne introduce important issues where adolescents have to be assessed, reviewing issues such as interrogative suggestibility and compli- ance within assessments.

In the section devoted to the interview itself, topics such as the language of the child abuse interview, assessment of reliability, psychotherapy and recovery of repressed memories, cognitive interview tech- niques, allegations of abuse in divorce/child custody and access disputes, and medical evaluations are all helpfully reviewed. Unusually, there is also a chapter devoted to the assessment of sexual preferences of alleged perpetrators by Barbaree and Peacock who review the phallometric findings. The assessment of children with disabilities is reviewed, a chapter by Conte on the context we work in, and a helpful overview of the investigation of ritual abuse by Charles is also included. Although the legal context described here is the North American one, there are many lessons for other countries.

Overall, this is an excellent set of contributons to this controversial field. It is the sort of book which those involved with the issue of true or false allegations will need to carry around in their briefcase; highly recommended for all practitioners.

Child and Family Psychiatrist Private Consulting Rooms Great Ormond Street Hospital for Children NHS Trust 34 Great Ormond Street London WCIN 3JH UK

DR. ARNON BENTOVIM

PII S0145-2134 (96) 00166-4

Evaluating Family-Based Services. Peter J. Pecora, Mark W. Fraser, Kristine E. Nelson, Jacquelyn McCroskey, & William Meezan. Aldine de Gruyter, New York.

Family-based services (FBS) are undertaken by increasing numbers of public and voluntary agencies, usually with the purpose of preventing out-of-home placement of abused and neglected children. Charac- teristically, FBS seek to support parents in their roles as primary caregiver and educator.

Such services are frequently extremely time-consuming, and therefore expensive. The need to increase the effectiveness of FBS programs has become paramount. However, even when this is recognized (and such insight cannot be assumed) the demonstration of effectiveness is not simple. This book guides the reader through the steps any organization should take to test whether they are getting the results they should.

Though the authors are writing for FBS practitioners, administrators, and policy makers, they assume a basic familiarity with research methods which may be more appropriate in the US than the UK. But the book leads the reader from the issues surrounding evaluation, through choosing the best evaluation method for each service and choosing the best measures of progress for family, child, and parents, to using the results of an evaluation to feed into policy development: This practical detail makes it a very worthwhile addition to any policy-maker's or practitioner's library.

The authors warn against having too high expectations of FBS; some aspects of family and parent functioning may be improved, but dramatic differences between those who do and those who do not receive the service or who receive a different service are very rare. Demonstrating effectiveness is thus not easy, and one of the most important tasks facing those who want to evaluate services to abusive or neglectful families is choosing how to measure "improvement." Measuring improvement or change in FBS implies that family functioning can be measured, that change can be picked up, and that the workers will all use the measures consistently. If these aims are not met, then the evaluation crumbles away to nothing. Our limited experience of evaluating change in abusive families suggests the authors are right to describe this as a "tall order!"

Book Reviews 333

The authors point out that the choice of measures should arise from the stated aims of the programs, and give many examples of instruments which evaluators can use to assess the progress of the children or the parents, with their advantages and disadvantages. In tune with the practical tone of the whole book, the reader is given addresses of the suppliers of these instruments. They also discuss the different ways in which program effectiveness can be assessed against costs. There is full recognition that simple number-crunching does not get at all the elements of program evaluation: Qualitative analysis of what is happening within a program is important, particularly when taking acount of the views of the recipients.

This valuable book takes as its purpose the goal of ensuring value for money, but adds the far less often mentioned, but equally valuable goal of ensuring that clients get the best services. Both these themes represent the "inescapable challenge of the next decade." With this book in one hand, there can be no more excuses about not knowing how to set about the task.

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ELIZABETH MONCK

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