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This thoughtful, compassionate book makes a major contribution to our understanding of the Southern Appalachian child—his mental disorders and his adaptive strengths. Drawing upon his extensive fieldwork as a clinical child psychiatrist in Eastern Kentucky, Dr. Looff suggests means by which these children can be helped to bridge the gap between their subculture and the mainstream of American life today. The children described in this book, the author points out, are in a real sense not "all children." Since no child grows up in a vacuum, the children of Eastern Kentucky cannot be understood apart from the historical, geographic, and socioeconomic characteristics of the area in which they grow. Knowledge of the children requires some knowledge of the lives of parent, teachers, and the many others upon whom they are dependent. That is to say, mental disorder—or mental health—is embedded in a social matrix. Dr. Looff therefore examines the milieu of these Southern Appalachian children, their future as adults, and how they can achieve their potential—whether in their native or an urban setting. In viewing the children within their own cultural framework, Dr. Looff shows how they develop toward mental health or psychopathology, suggesting supportive techniques that build upon the strengths inherent in each child. These strengths, he suggests, rise out of the same culture that burdens the child with handicaps. Dr. Looff's position is one of guarded optimism, based on the successes of the techniques he has used and observed in seven years of work in Appalachian field clinics. Although he details instances of mental disorder in children, and instances of failure in family functioning, he notes at the same time family strengths and sees these strengths as sources of hope. Although this book is based on fieldwork techniques within a specific area and culture, it is paradigmatically suggestive of wider application. Dr. Looff demonstrates effectively and clearly the profound need for increased concern about what is happening to the rising generation—the children of Eastern Kentucky, the children of the Southern Appalachian region, and the children of the rural south.
The analysis of the developmental experiences and resulting personality patterns of Southern Appalachian children is based upon fieldwork in psychiatric clinics in eastern Kentucky, where diagnostic evaluation and treatment were provided for emotionally disturbed children. Observations on the mental health, or mental disorder, of the children are made concurrently with and in the light of observations on the ways in which eastern Kentucky families raise their children and on the kinds of adjustments to life that these children make. The historical, geographic, and socioeconomic characteristics of the region, in addition to characteristic family life styles and child rearing practices, are presented as the necessary context for understanding the children's mental health problems. Mental disorders are viewed largely as social phenomena and mental health or disorder is seen as firmly embedded in the social matrix. The study of family structure and interrelationships reveals three prominent themes influential in child development - emphasis on infancy of the children and family closeness, poor development of verbal skills, and the consideration of sexual maturation and functioning as a tabooed topic. Instances of emotional disturbance discussed are grouped accordingly: dependency themes, communication patterns, and psychosexual themes. (Kw).