Adolescent Psychiatry in Clinical Practice, Edited By Simon G. Gowers. London: Arnold. 2001. 560 pp. £ 45.00 (hb). ISBN 0 340 76384 1

Evidence-based practice is the marriage of individual clinical expertise with the best available scientific evidence. This helpful and up-to-date textbook brings considerable clinical expertise to the available evidence in adolescent psychiatry and should be useful to practitioners from all disciplines who work with adolescents. Specialist adolescent psychiatry is still relatively undeveloped in the UK, but this book marshals an impressive array of talent among the chapter authors.

The text is divided into four sections: developmental influences, descriptions of disorders, service provision and treatment. However, in attempting to provide breadth of coverage, depth is sometimes sacrificed. For example, only 6 pages are devoted to depression in the affective disorder chapter, 18 pages to descriptions of conduct disorder and delinquency and 12 to psychosis — all major problems in adolescents. Nevertheless, the positives far outweigh the negatives in this book. The opening chapters on development and influences on development are clear and informative. Although brief, the descriptions of disorder convey a real feel for clinical work, and throughout there is a commendable emphasis on placing the adolescent in a developmental and social context. There are good chapters describing assessment and the delivery of services, important given the relative lack of specialist adolescent services around.

Adolescence is a minefield of potential ethical and legal dilemmas for the unwary clinician: for example, Gillick-competent children can consent to treatment without their parents being involved, but their refusal to consent to treatment can be overridden by parents. The chapter devoted to ethical and legal issues takes a problem-solving approach, presenting common ethical/clinical difficulties and applying basic ethical principles to suggest just solutions. This chapter and the one that follows, on responding to young offenders, also provide a helpful guide to the legislative framework within which adolescent psychiatrists must work. The final section, on treatments, covers the usual ground, but the inclusion of an entire chapter on prevention is welcome.

This is a good, basic textbook. The editor fulfils his ambition of producing a book that is readable, practical and scholarly. The fact that it is produced almost entirely by psychiatrists does not in any way detract from its utility for a wide range of professionals who come into contact with adolescents.