Their excellent review of research studies (Appendix A ) supports their second objective, to address the need for a treatment approach that focuses on the child’s family relationships. There is no evidence that distinguishing family organization patterns—such as particular family constellations—contribute to incest. With no single incest “story,” and each family scenario therefore unique, the authors call for clinical complexity. This constitutes their third objective, both in terms of relational schemas featuring challenging relational contradictions and in terms of the multiple choice-points for treatment interventions. Here, generalized family-experience themes are balanced with openness to variations on those themes. The authors tackle head on the therapist’s moral dilemma of sustaining a respectful colaborative connection with the family in the face of an egregious violation of the safety of the child, whose protection by the therapist is paramount. The authors make clear that family therapy has matured as it has abandoned functional–causal explanations of symptomatology that serve family organization (as though all members in equal measure contribute) in favour of recognizing feminist-derived information about gender-based power inequity, where male oppression, intimidation, abuse, and violence is dominant. One outstanding chapter discusses treatment of the offending (usually male) perpetrator, which may be coordinated with that of other family members under certain rigorous conditions.

Research into the foremost risk factors, effects, and mediating

variables is in its relative infancy. In general, the most consistent findings regarding risk factors point to the protective parent’s absence, the child’s prolonged separation from the nonoffending parent, and emotional distance between child and parent. The authors caution that these conditions not be viewed as features of an incestuous family but, rather, as problematic if associated with an abusive family member’s presence. A heavy focus on family risk factors may lead to underidentifying sources of family strength, and indeed, research into sources of family strength has been neglected. It is striking that a fair percentage of abused children appear to be asymptomatic. Attachment literature concerned with mediating factors increasingly identifies attachment difficulties following maltreatment. The critical, positive mediating influence on abuse’s impact on the child centres on her relationship to a safe, caretaking mother. (Most such children are female, hence the pronoun “she.”) Therefore, the “relational approach” focuses on making safe, restoring, and strengthening the mother–daughter bond. Research has found that parental support is the best predictor of freedom from clinical symptoms and is associated with the child’s maintaining social competence. Following this, Sheinberg and Fraenkel note that the development of personal agency and freedom from self-blame for abuse are goals for the child, while the nonoffending parent’s goals are to be a morally sound and protective caregiver—one who can tolerate the child’s expression of a range of feelings about the offender.

When nonoffending mothers of sexually-abused children access without shame and guilt their often-hidden yearnings for loving connection with their violent abusing partner, they can put their child’s safety first. The authors have found that the well-meaning desire of the extended family and the community to simplify the story of good and evil often results in secondary retraumatization, because family members feel bound to hide their own experiences. Described as the “Both–And” path, mixed feelings that are manifest in apparently mutually exclusive personal attitudes and family beliefs are actively explored, as is their link to loyalty bonds and enduring attachments.

There is a nod to contemporary attachment theory, particularly with regard to family systems affiliation concepts (that is, family as a secure base from which to explore), but it is something of a passing nod. The word “bond” is missing from the index, although not in the main text, and (loosely held) hypotheses regarding the internal world of working models are left out. As a motivational system, attachment is not accounted for by feminist, systems, or social constructionist ideas. It would make sense to me to recognize attachment theory as a fourth plank of integrated assumptions, embedded as it is in the research literature and in the excellent, rich, detailed, clinical examples, wherein therapists inquire about the missing closeness painfully felt by family members, not only with regard to the abused child but also with regard to their parents of the same sex. I also look forward to