Lillas and Turnbull first establish that the significant advance in our knowledge of human development and psychopathology comes at a price, namely the increased fragmentation and separate languages of highly specialised professionals, each of whom works with one part of the person. The whole is lost, and the treatment of one part of the whole is less effective, unless its connection to the whole and to the multi-determined nature of the problem becomes evident.
Lillas and Turnbull's excellent new book proposes a neurorelational framework for understanding and treating young children and their families in a comprehensive and integrated manner. They propose that each problem is assessed from the perspectives of the four systems of brain functions (regulation, sensory, relevance and executive) as well as the developmental factors both in the individual and in the parent–child relationship. Why is the relationship and relationship-based therapies given such a primary place? As the authors note, ‘Relationships are the dominant influence for the developing brain’ (p. 39). Why must all four brain systems be considered? Because the brain is a highly organised organ that functions holistically. Given the complex richness of the authors' framework, the value of a multidisciplinary practice is apparent.
The authors go into great detail in demonstrating developmental features of each brain system along with problems that emerge within each system and their interrelatedness with problems from other systems. Most importantly, a range of interventions that address each system's problems and their overlap is provided in great detail. Lillas and Turnbull clearly value the excellent assessment and treatment strategies provided by the organisation Zero to Three. They easily give credit to individuals and programmes that provide a full range of interventions consistent with their framework.
I believe that the neurorelational framework truly does reflect both the dynamic, non-linear nature of the functioning of the brain and holistic needs of the unique child and family.
This is truly an important work for making more comprehensive what we know, how we communicate what we know, and how we best influence the unique development of each child and family in our care. Were this book to be ‘perfect’, it would describe the theory of infant intersubjectivity presented by Trevarthen, as well as making greater mention of attachment researchers such as Sroufe and the developmental psychopathology concepts of Cicchetti.
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