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Lyla E. Smith
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Gentling: A Practical Guide to Treating PTSD in Abused Children, 2nd Edition Review
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To start with, Krill does present some accurate and worthwhile information. Most of this would already be known to professionals, but in the interest of his target audience including parents, teachers, etc., there are some bits of good information to be gleaned from this work, even if such can easily be found elsewhere. That said, mounds of misinformation, or at best speculation, spatter his book. Perhaps the worst bit of misinformation is his directly and confidently describing posttraumatic stress as a "disease," a term that by definition describes reactions of an organic cause. Posttraumatic stress is of an environmental etiology, not an organic one, even if there are biological diatheses correlated to the development of PTSD or complex trauma. Numerous other examples string through Krill's book where he weaves in and out of a medical model, the implications of which he continually contradicts. He seems to build credibility by using medical terminology and citing (well, his citation system is rather unclear) biological processes, but there too he is just plain wrong much of the time.
Even more confusing is how Krill mixes various theories to justify his anecdotal observations. Eyebrows should be raised when he attempts to integrate the couples/sex therapy ideas of David Schnarch with intergenerational constructs of Murray Bowen to children who have been abused. Krill does not justify these types of theoretical leaps. He also suggests that direct trauma work and behavioral techniques do not work or are even harmful, which is a bold stance to take when a wide body of research strongly supports such trauma-focused therapies as TF-CBT, KIDNET, and EMDR.
What I found most disturbing was the "Child Stress Profile," a Frankenstein monster creation of Mr. Krill that is presented as an informal interview, but scored as a formal, normed structured interview or self-report measure. This "measure" is completely void of norms, reliability, validity data, and logic to back its use. It is obvious that this hodgepodge stab at a useful assessment measure is completely lacking any level of psychometric credibility. Additionally, the "profile" gained from the use of this "measure" would yield no more information than would be obtained from a quality clinical interview by a trained professional. Krill either has no knowledge of or chooses to ignore the numerous psychometrically sound measures available for the assessment of children and adolescents with trauma-based issues. More importantly, he denies the foundation of assessment resting within the clinical interview of a trained professional.
In the end, Krill obviously has the best intentions for the treatment of children who have experienced abuse. But do not be fooled by his catchy use of innovative terminology ("gentling," or "quick teach sheets"). In the process of reinventing the wheel, he undermines current "best practices" of the mental health field. Until Krill can deliver a better-informed argument and/or evidence to support his theory/treatment, "Gentling" should be avoided (and for professionals, this is an ethical issue) as a method to treat children with posttraumatic stress responses.
Gentling: A Practical Guide to Treating PTSD in Abused Children, 2nd Edition Overview
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