Cognitive behavioural approaches have been used in the treatment of adult depression for many years, with much evidence of effectiveness. The paper discusses issues in the applicability of these techniques in interventions with depressed children and adolescents. Different models of CBT are discussed and a typical programme described using a case example. Work with parents, carers and other significant adults is emphasised.

It is widely argued that a more general ‘genetic literacy’ of the public is required so that appropriate use is made of the new human genetic technologies, such as DNA testing, and there is effective public participation in debates about the regulation and development of new technologies. Despite a century of popularisation and school education in Mendelian genetics, public understanding remains very limited. An hypothesis is put forward that suggests that the limited public understanding results from the existence of a lay understanding of inheritance that conflicts with the scientific account of Mendelian genetics and impedes its uptake. It is further proposed that the lay understanding of inheritance is derived by children from a developmentally earlier social understanding of kinship relations. Given that the lay knowledge of inheritance is grounded in social concepts of kinship that are sustained by every day social activities and relationships, it may be particularly resistant to change. A test of the hypothesis is described and evidence relating to the development of concepts of inheritance and family in children is discussed.

The quality of collaborative links between the NHS and Social Services in the field of child mental health is dependent on the culture of co-operation set at the highest level of government. There needs to be an understanding of the different theoretical models that underpin working practices. The importance of personality factors, power struggles and misperceptions is highlighted. Constructive suggestions are made on how to ensure that collaboration works effectively.

This study set out to evaluate the use of a video based parent training programme (The Webster–Stratton Programme) in the management of children referred to child mental health services for treatment of behaviour problems. Following diagnostic assessment children were assigned to one of two groups: parents of both groups completed the parenting programme and, in addition, in the second group the child received an intervention appropriate to his/her clinical presentation. The waiting list control group waited 3 months prior to allocation to either treatment group. Standardised rating scales were administered pre-treatment, post-treatment and at 6-month follow-up to both treatment groups, and at an interval of 3 months to the control group. Improvement was significantly greater in both the treatment groups than in the control group. Parenting training programmes are an effective intervention in the management of clinic-referred children with behaviour disorders.

This paper reviews the current position of the Milan Approach in the family therapy field. Over the past 20 years this approach has made a major contribution to the development of family therapy theory and practice in the U.K. However, the ideas have been modified in order to fit different client groups in a range of settings; until today, the Milan, or Post-Milan approach is an amalgam of the original concepts and new techniques. This paper describes the development of this approach and highlights the following topics as central to current thinking: language, power, narrative, family resilience, externalising, focusing on change, and solution focused approaches. Several techniques of the Post-Milan approach are demonstrated in a discussion of one case treated by the author.

This paper highlights the many complex psychological needs of paediatric patients in intensive care. The literature on the experience of children in intensive care and their relatives is reviewed and related to the work of a paediatric psychologist. Case examples are given of direct work with children and suggestions are made of ways in which the psychologist can work in a consultation/liaison capacity. The personal impact of this work is addressed, as is the need to disseminate information to other health professionals. Further research is called for, both on the child's experience and on the development of appropriate psychological interventions.

There is a growing concern about behaviour, violence, and moral attitudes. The following is an outline of the link between home and school and what might be done to encourage early-learning conditions; also there are warnings about how delinquency might start. There is the author's original description of the two main forms of play and of how to establish more constructive attitudes through Social Drama, particularly in Senior Schools. In dealing with delinquents, there is explanation of emotional ‘Experience without Sin’. Conclusions are based on nearly 70 years of careful observation of thousands of children.

The Framework for the assessment of children in need and their families (Department of Health et al., 2000) has been developed to provide a systematic way of analysing, understanding and recording what is happening to children and young people within their families and the wider context of the community in which they live. From such an understanding of what are inevitably complex issues and inter-relationships, clear professional judgements can be made. These judgements include whether the child being assessed is in need, whether the child is suffering or likely to suffer significant harm, what actions must be taken, and which services would best meet the needs of this particular child and family. The Assessment Framework was issued jointly by the Department of Health, Department for Education and Employment and Home Office. It was issued as Section 7 Guidance under the Local Authority Social Services Act 1970, which means it must be complied with unless local authorities can justify why not.

A scheme is described that involves close collaboration and joint working arrangements across agencies in achieving a tightly organised multi-agency specialist assessment of families in severe difficulties. It is presented as one model of multi-agency assessment work that fits with concepts in the new Framework document.

As the ‘decade of the brain’ comes to a close, it is clear that the field of neuropsychology has made many vital contributions to evaluation, treatment, and research issues in child and adolescent health care. In the study of brain-behaviour relationships, the neuropsychologist plays a unique role. The practice of child neuropsychology is differentiated from adult work because developmental and environmental influences have a significant impact on practice. The various goals of the child neuropsychologist may include psychoeducational and neuropsychological assessment, the exploration of brain-behaviour relationships, consultation with a variety of professionals ranging from teachers to neurologists, and rehabilitation training. Advances in medical treatment have contributed to an expanding population of children and adolescents with neurological and/or neuropsychiatric concerns. New research in this field has also provided evidence of disordered or dysfunctional neurological systems in a number of childhood disorders and psychiatric conditions. This paper reviews some contributions that neuropsychology has made to the health care of children and adolescents in the past decade.

The aim of this postal survey was to highlight differences in temperament and behaviour between 32 toddlers in Japanese families living temporarily in London and 36 in British families, all in London. Mothers completed questionnaires about demography, perinatal events, and their child's temperament and behaviour. UK toddlers were described as exhibiting fewer behavioural symptoms than Japanese toddlers. Significantly more of the Japanese toddlers scored above the cutoff on the Behaviour Check List, indicating higher levels of behavioural disturbance. An interesting item is ‘sleeping with parent’, which occurs commonly in Japanese families and is considered to be normal for that culture. On the Toddler Temperament Scale the Japanese toddlers proved more distractable and more intense than the UK toddlers when age had been allowed for. It was of interest that Japanese girls proved more distractable than Japanese boys and UK girls. Possible explanations for the differences are advanced.

Interpersonal psychotherapy for adolescents (IPT-A) is a short-term treatment for adolescents with major depression. Unlike most supportive, expressive forms of psychotherapy that are often used to treat depressed adolescents and are not standardised, IPT-A has a treatment manual available (Mufson et al., 1993) and specific training is required for the therapist. Unfortunately, there is no training centre yet in the U.K., although several groups, including ours, are developing expertise in IPT-A. This paper discusses the role of IPT-A, outlines the structure of sessions, and offers an analysis of the differences between this and other therapies.

In a series of recent judgements the courts have authorised the treatment of adolescents against their will. What effect have these judgements and other legal developments had on the legal basis of medical treatment for children? How do they affect the professionals involved in decision- making? This article attempts to address the most commonly expressed concerns and queries about the changing legal context of work in the field of child mental health. It is based on the authors' discussions with professionals from backgrounds in health care, social care, and justice during training we have carried out with multidisciplinary and multiagency teams in England and Wales. For the purposes of this article, we will, in keeping with The Children Act 1989 (s105 (1)), use the term ‘child’ and ‘children’ to refer to everyone under 18 years old.

Snowling and Coltheart and Jackson provide an excellent overview of the contemporary cognitive and linguistic approach to the description and definition of dyslexia. Both contributors consider dyslexia to be a disorder of written language. Snowling focuses on the origins of the difficulty in a central ‘phonological deficit’. Coltheart and Jackson emphasise the internal modular structure of the reading and spelling systems, suggesting that different components may be impaired in different individuals, resulting in distinctive (phonological and surface) patterns of dyslexia. Both conclude that future research might focus on implications for effective programmes of treatment.

Body Dysmorphic Disorder (BDD) is an excessive preoccupation with an imagined, or real, slight defect in normal physical appearance. The disorder, which usually begins during adolescence, tends to be chronic, and probably is much more common than is usually thought. This review presents an overview of the available scientific literature of BDD. It provides information about historical aspects, epidemiology, clinical features, aetiology, and instruments for assessing BDD. The relationship of BDD with other psychiatric disorders such as depression, obsessive-compulsive disorders, anxiety disorders, schizophrenia, eating disorders and personality disorders is discussed. Aetiological theories, including psychological and neurobiological explanations, are reviewed. Finally, psychopharmacological and psychotherapeutic treatment approaches are presented with special regard to treatment with serotonin-reuptake inhibitors, behavioural therapy and cognitive-behavioural therapy.

This paper describes attempts to implement a ‘functional analysis’ approach to the treatment of severe self-injurious behaviour in a 4-year-old boy living at home. Although a degree of success is reported, problems in systematically applying assessment and intervention procedures are described. The paper discusses the successes and limitations of such an approach in the home environment and in a crisis situation.

This paper describes the development of a new assessment service in Southampton for children with autism and related disorders. The evolution of the service is described and the multidisciplinary assessment process is outlined. The response of families to the service is evaluated and the current status of the service is examined critically. The importance of forging good working links with other local services for children is emphasised.

Child and adolescent deliberate self-harm is a common problem faced by medical services. In 1982 the Royal College of Psychiatrists recommended that certain guidelines be followed in all cases of child and adolescent self-harm. This paper examines to what extent these guidelines are being incorporated into child and adolescent self-harm policies in the West Midlands region. The implications of the findings are discussed for young people and the NHS Trusts who treat them.

The argument for evidence-based child and adolescent mental health services is irresistible. Indeed, I have yet to meet a mental health practitioner who has told me that his or her work was not based on evidence. The exam question, however, is ‘what is the best evidence?’ In a helpful contribution to the current debate about evidence-based practice, Ramchandani, Joughin and Zwi point out that the answer depends on what the question was in the first place. They argue that while some clinical questions are best tackled using quantitative methods such as randomised trials, other questions are better answered using different techniques. Traditional hierarchies of evidence that give primacy to randomised trials may not always be appropriate to child mental health practice.