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Managing children with psychiatric problems, 2nd edition
  1. A West

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Edited by M Elena Garralda and Caroline Hyde. London: BMJ Books, 2003. £27.50, paperback, pp 225. ISBN 0 7279 1567 3

Emerging evidence, and political pressure have changed Child and Adolescent Mental Health Services a good deal over the past 10 years. It is mystifying enough to be part of these changes. I can only imagine what it might be like to be looking on. This second edition brings a useful book up to date. It is a sort of ambassador for Child and Adolescent Psychiatry and should go a long way towards explaining the discipline to associated agencies, professionals, and commissioners. It is likely to be better at this than at its prefacing claim to help professionals “address the psychiatric aspects of their practice”.

The overlap between editions is about 50%. There is certainly enough change to make it worth your library getting the second edition while hanging on to the first. Private purchasers might want to keep a couple of chapters that have been lost in the wash. Steinberg’s chapter on Consultative Work is one. Another chapter I would want to copy and keep is McAuley’s Counselling Parents in Child Behaviour Therapy. It would be an even graver loss had it not been replaced by an equally excellent chapter by Scott on Parenting Programmes. It would almost be possible to run a parenting group on the strength of a careful reading of Scott’s chapter, though I would not advise anyone to try.

It would most certainly not be safe to set out with a prescription pad having read only Prendergast’s manic romp through Drug Treatments. This is where it is most true to say that any textbook is out of date by the time it is published. Not mentioning recent problems with paroxetine and venlafaxine, or the rapid increase in the use of controlled release stimulants in hyperactivity, can be forgiven, but this chapter has a number of idiosyncrasies which I would not expect in an overview directed at non-specialists.

A great deal has been done to create consistency, while preserving the styles of the individual authors. Each chapter starts with a boxed overview and most include sections on indications and contraindications, techniques, and evidence base. This book comes out of the process well armed with chapters on the important therapeutic modalities, most areas of interagency working, liaison, and legal aspects. There are significant omissions, however. Paediatricians based both in hospitals and in the community are increasingly exposed to deliberate self harm and drug and alcohol misuse. We are encouraged by the new children’s National Service Framework to work together and we are increasingly doing so with, for example, autistic spectrum disorders and chronic fatigue syndrome. I would have thought that more on these areas would have been welcome The other gap, given current political and funding trends, is a chapter discussing changes in the working relationship with social services. As there is one chapter on child behaviour therapy and another on child behaviour therapy in groups, space could have been made for some of these important areas.

If the book deserves to sell well, it will not be on the strength of its illustrations, one of which greets us from the front cover. My son thought that some of them were drawn by an adult pretending to be a child which, if it were true, would not be an example of good psychiatric practice. They are not needed to break up the text, and the fact that pictures have migrated from one chapter to another between editions suggests that their positions are almost arbitrary. Somehow they contrive to be at once both condescending and perplexing.

Having got over this minor irritation, the more I looked into this book, the more I liked it. It is easy to read, is well referenced, and punches above its weight.

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