CORRESPONDENCE 283 in psychotherapy of the analytically orientated type. explanations must be considered. One is that treat They are encouraged to conceptualize and formulate ment has helped each group to different extents, the their patients' problems in the broadest sense; other is that treatment has harmed each group to treating them as members of a family group and differentextents.Clearlyseveralpossiblepermuta considering relevant cultural factors. Although by tions exist. no means abandoning the medical model, this is set The author considers that a pre-treatment measure in the much broader context of the whole person and is of secondary importance in answering the outcome his interaction with his fellow men. question.I suggestthatunlesssucha measureis As a medical student I found myself increasingly included we cannot decide whether a treatment has disenchanted with the dry narrow ‘¿scientific'view of been ‘¿moretherapeutic' than another or merely man. I was forced to the inescapable conclusion that ‘¿lessdamaging'. human suffering cannot be reduced to a series of A. V. P. MACKAY biochemical formulae, and unlike many I failed to MRCXeurochemical Pharmacology Unit, find patients who derived much benefit from medi Department of Pharmacology, cation, but found many whose suffering was in fact Medical School, Hills Road, worsened by misguided therapeutic zeal. It was for Cambridge CB2 2QD this reason that I chose psychiatry in the hope that here, at least, I could improve the quality of people's lives. It is therefore with growing disillusionment that IS PARENTHOOD TEACHABLE? I watch British psychiatry's love affair with medicine. If only the mountain had moved to Mohammed DEAR SIR, things might have been so different. The recent Government paper ‘¿Violenceto Looking at Britain from a distance one is immedi Children' ( 1), presented to Parliament in March ately struck by the quality of British contributors to I978, raises some controversial issues. I would like to the field of human understanding, who have made comment on one of them concerning ‘¿Education for so little impact on British psychiatry, while trans Parenthood' (Para 11—18). forming attitudes across the Atlantic. Melanie Klein, The reportencouragesthe spending of more Anna Freud, John Bowlby, Michael Balint, Donald money on ‘¿education for parenthood', since the Winnicott, Harry Guntripp, Ronald Fairbairn, Health Education Council has had its resources Wilfred Bion, Henry Ezriel . the list is endless. recently increased by £1 million. The report re Surely we should take pride in this psychological commends that ‘¿theGovernment should ensure that heritage and attempt to build on it. education for parenthood is available for boys and I, for one, willingly respond to Professor Jones' girls of all levels of intellectual ability'. This raises challenge. But will I be given the opportunity; or theimportantissueofwhetherparenthoodisteach forced to look elsewhere, where pastures are greener able. Can we in fact educate severely disturbed and and more receptive? Who will be the loser? violent people so that they become good parents? I. F. MACILWAIN Ido notthinkthatwe can. Department of Psychiatry, Paulson and Blake (2) have cautioned against University of Toronto, viewing battering parents as a function of edu St Michael's Hospital, cational disadvantage, and Steele and Pollock (3) 33 Bond Street, regardeducationalfactorsasirrelevantand placemore Toronto, Ontario M5B I W8 emphasis on the maladjustment resultingfrom violent childhood experiences. Kempe (4) found that MEASUREMENT IN PSYCHOTHERAPY all social classes were represented in his sample of DEAR SIR, battering parents, and it is the experience of many Any constructive comment on the vexed question clinicians that highly qualified and well-educated of how to measure outcome in psychotherapy is people are not immune to violence; they may have welcome. The suggestion by Adams (Journal, June all the knowledge of child care but they may be 1978, 132, 595—97) that Post-Test Only Control unable to apply what they know in real life. Group Design is adequate to identify statistically There is no convincing study to show that violent significant differences in morbidity between groups parents lack the knowledge of proper parenthood, exposed to different treatment schedules is statistically but most of the studies do show that they lack the attractive, but it surely allows room for dangerous ability to practise it. misinterpretation. For any significant difference in People learn to be good parents by following the severity between groups at least two rather different example of their own parents, and not by reading Downloaded from https://www.cambridge.org/core. 26 Sep 2021 at 00:35:51, subject to the Cambridge Core terms of use..