98/ FAMILIES, SYSTEMS & HEALTH Directors of development: Influences on the development of children's thinking. Hillsdale, NJ: Lawrence Erlbaum Associates. Behavioral Medicine: A Primary Care Approach by H. Russell Searight, Ph.D. Brunner/Mazel, Philadelphia, 1998, 246 pages The concept of "answer" is interesting. An answer is generally regarded as a reply to a question. I suppose, in a way, books are written as a reply to a set of questions, either directly asked or indirectly anticipated so the text can be thought of as a way of formally exchanging information, essentially answering questions in a field of study. In this instance, Behavioral Medicine: A Primary Care Approach was written to sensitize mental health providers to "psychological disorders as they arise in a medical setting," and "to sensitize all health care providers to psychosocial aspects of many common illnesses." Further, the author's goal is to "help mental health professionals acquire basic knowledge and skills so that they can work effectively" in the changing healthcare context. These are admirable intentions. Several books have been recently reviewed in this journal on generally the same topic, e. g. , A Family Approach to Psychiatric Disorders (Perlmutter, 1996); Managing Mental Health Problems: A Practical Guide for Primary Care (Cates & Craven, 1998); Primary Care Psychiatry: Brief Office Treatment and Management Pathways (Feinstein & Brewer, 1999). Still, there is always a need for other perspectives on the fertile topic of mental health issues as a part of primary medical care. The first chapter of Behavioral Medicine: A Primary Care Approach provides an overview of primary care focused on three major themes: the necessity for the primary care providers to attend to the mental health of their patients, the decline in healthcare utilization when mental health issues are addressed, and the need for mental health professionals to be aware of the primary care providers' values concerning treatment of patients. These values might not be overtly expressed but are usually present to some degree. They are pragmatism, efficiency, preference for brief symptomatic treatment, respect for psychotropic medication, attention to the role of medical illness in behavioral symptoms, and a healthy tolerance for ambiguity. The next two chapters address psychiatric disorders in medical settings and cover mood and anxiety disorders, somatization, alcohol abuse, personality disorders, and schizophrenia. Generally, each major disorder is addressed individually with a brief description of the disorder and its prevalence, followed by the presentation of symptoms that might be observed by a provider or described by a patient during a medical visit. The sections are punctuated by patients' stories as they might appear in a medical practice, and conclude with treatment-specifically pharmacological interventions, with a brief description of general psychotherapeutic interventions. Chapters 4 and 5 concern pediatric disorders and a concise overview of family dynamics as they relate to medical health and medical dis-ease. In summary, Chapters 2-5 are mainly descriptions of behavioral pathologies as they relate to mental disorders that may be observed in the primary care medical setting. Chapters 6-11 describe the psychological impact of various medical disorders including: cardiovascular disease, respiratory disorders, diabetes, eating disorders, infectious disease, neurological disorders, and pain. There are also sections that discuss lifestyle issues such as smoking, weight loss, and sexually transmitted diseases as they might be observed and approached in the primary This document is copyrighted by the American Psychological Association or one of its allied publishers. This article is intended solely for the personal use of the individual user and is not to be disseminated broadly.