Psychotherapy for Children and Adolescents : Evidence Based Treatments and Case Examples

This book, written by John Weisz, a leading child clinical psychologist in Los Angeles, USA is a highly readable account summarizing the current ‘state of the art ’ treatments for common emotional and behavioural disorders in childhood and adolescence. Weisz sets out the task he undertakes neatly and clearly in his introductory chapter entitled ‘the lay of the land’. He confines this volume to the evidence-based treatments for the DSM-IV categories of anxiety, depression, ADHD and conduct disorders. He organizes the structure of each chapter into three components, describing a fictional case, outlining in detail the treatments available and describing how they would be used in the ‘case’ and detailing the evidence base to support the use of treatments. This has the effect of making each chapter readily available for clinician and researcher alike. Clinicians will find an introduction to research trials methods, their application and success and failure, in each of the chapters. Researchers will see how their efforts to construct ‘manualized’ reliable and valid methods of treatment in research settings may or may not succeed in the real world of clinical practice. Each chapter is complete within itself and any reader interested in their clinical topic, say the treatment of conduct disorders, can dip in and find a comprehensive account without having to read the whole volume. Likewise if someone is interested in knowing how a treatment modality, say cognitive behaviour therapy has been investigated, they will be able to see in which clinical disorders this has been tried, how the therapy has been used, and the relative degree of success that has been achieved. A final chapter takes us into the looking-glass future with the ‘ issues and prospects’ summary. Here the author reminds us that there is a world of difference between developing efficacious treatments in the well-resourced enthusiastic research university clinic with young staff ambitious to obtain a trial ‘result ’ and attendant publication, and the reality of the clinical service world. Treatment trials researchers feature their successes in lectures, seminars, tutorials and ‘how to do’ manuals, but widespread dissemination, training and education of the clinical workforce is seldom achieved. As the author wryly comments on page 458 ‘the researcher gives a party but most clinicians stay at home’. He alludes in this final chapter to a key need to focus the next generation of treatment trials not only on crucial aspects of the trial itself (sample size, influence of co-morbidity, clinic and community-based interventions rather than selected universitybased studies) but also on what can be described as the science of delivery. Making things that are efficacious in principle become effective in everyday practice. There are inevitable shortcomings in a smallish volume (some 470 pages of readable text) covering these disorders. I expect that dedicated researchers will be turning to technical papers and more specialized texts and likewise clinicians will want to obtain more ‘how to do’ manuals and training videos and CD-ROMs. I judge overall that the author has done an exceptionally good job and recommend this volume highly to all clinicians who want to understand the principles underpinning clinical trials and how these have informed clinical practice to date. The author is completely honest in spelling out in the last chapter the marked shortcomings of research studies to date and gives us the scientific and clinical signposts of where we must do better in the future. In this regard he is to be commended for not pushing his personal choice treatment agenda. I have four quibbles. First, the book is almost exclusively about North American research and practice and European, UKandotherworldwide studies receive virtually Psychological Medicine, 2005, 35, 761–765. f 2005 Cambridge University Press Printed in the United Kingdom