URING the past two years one of the major interests of our Association D has been to review, to evaluate, and to point up the trends of its first twenty-five years. A study of the contents of our Journal traces the gains made in the integration of our respective fields toward the synthesis we know as orthopsychiatry. In the achievement of this professional partnership we have also attempted to clarify-and to differentiate-the technique, the skills, and the contributions of psychiatry, psychology and social work, as they became coordinate in the team. Some of us who grew up professionally as the child guidance movement developed recall the controversies and the reconciliations that have figured in this business of working together and, at the same time, of preserving our professional identities. Many of us also recall the emphasis-and the pridewhich was associated with the phrase: the "fourfold study" or the "fourfold approach."But in detailing the adventures of this team effort our Association literature has been primarily concerned with only three parts of the team. What happened to the fourth member? Where was the pediatrician? Were we of the more recent specialities so challenged by our new-found dynamics that the more familiar, surer-footed, medical part of our team failed to engage our interest? Or did the pediatrician become so bored with the identifications and competitions among the other three members of the team that he failed to record the gains or losses to his specialty in this functional partnership?Whatever the situation, a review of our Association activities reveals the remarkable fact that except for a luncheon symposium in 1941 (1) we did not schedule a full-fledged meeting devoted to the relationships between pediatrics and orthopsychiatry until two years ago. This fact is indeed remarkable when we consider the large number of sessions given to other allied fields : sociology, anthropology, education, law, theology, industry, and so on. But in 1947 a special session was devoted to the subject "Pediatrics and Psychiatry." The five papers written by psychiatrists and by pediatricians were published in the fall issue (2). Similarly, our Journal reports little to show collaboration between pediatrician and social worker. One article written by a psychiatric social worker entitled "Functions and Limitations of the Social Worker in a Psychiatric Unit in a Pediatric Out-Patient Department" was published in 1936, and * Presented a t the 1949 Annual Meeting.

case is selected from the field of family welfare and represents a trend in social treatment that is receiving emphasis in the family agency today.

No abstract

No abstract

As emotional problems in children are closely rebated to disturbances in parent-child relationships, much of the discussion was focused around this aspect of the topic. Much of the pediatrician's activities with parents concerns itself with attempts to influence parent-child relationships for the benefit of the child patient. A great deal has been learned in child psychiatry about the management of untoward and destructive parental behavior. Much of this knowledge can be used by the pediatrician in his day by day practice. Although, some psychiatric techniques are not applicable in the practice of pediatrics, it is important for the pediatrician to understand his role and not to assume that he is or needs to be a psychiatrist in his attempts at solving difficulties which are presented to him. Psychiatry has learned some things of what the parent-child relationship shouldn't be. The question might then be raised, "What is a good one?" This can be defined as the capacity in the parent to meet with the child in all matters of day by day living without undue tensions, anxieties on preoccupations. Brenneman has pointed out that about 80% of the practice of pediatrics is in dealing with the parents and one most work through them in an effort to solve the child's problems. There is seldom a situation that involves only the child. It almost always involves the parents and their interaction with the child. Our understanding of many emotional problems has been furthered by our greater knowledge of child behavior and yet we are still too ready to categorize parents and especially mothers with such words as hovering, rejecting, cold, warm, etc., which have little real meaning in terms of understanding how they got that way.