Abstract
Reviewed by: Eithne Darragh, Affiliated to the University of Ulster, Northern Ireland
This book outlines the range of mental health conditions which a child or adolescent may experience, how these are categorised and the therapeutic interventions which may alleviate them. The objective of this book is to provide “a practical guide for social workers on promoting positive mental health in youth from a system of care perspective” (Preface). In my view, the book does not focus on positive mental health but explores the range of conditions likely to impact on young people and the range of treatments available to redress these. However, this book has many strengths. Three are highlighted here: the introductory section, which is extremely useful in explaining the roots and nature of mental illnesses, the use of the Diagnostic and Statistical Manual and the fundamental factors for good mental health. The details of the signs and symptoms of the range of disorders (chapters 4–16) – including depression, anxiety, PTSD, ADHD – are clear, simple and easily understood. The information provided regarding treatments – medication and therapy is extremely beneficial.
The foreword is particularly inspiring and thought provoking as it is written by a parent of a young person diagnosed with bi-polar as an adolescent. The simple advice provides important messages for social workers.
There are many useful exercises, case studies and checklists included in the text, which are accessible for both practitioners and students. Of special note are: The Exercise (p. 21), Is Path Warm? (p. 54); Risk factors (table 41). This is a valuable method to enhance both learning and application of the ideas.
Several issues explored in chapter 3 are also worth mentioning: the part played by stress – situational stress and serious/persistent stress, and the emphasis on recovery and the recognition of stigma as one of the main barriers to individuals who are seeking help. Also the therapeutic relationship is highlighted (e.g. with the social worker) and remains a vital component of any work with young people and is rightly emphasised in this book.
While acknowledging the value of the book as a valuable addition to the range of literature in this field, there is one main concern for the reader/social worker in the United Kingdom. This is a United States-based text which brings a general understanding to mental health problems for children and adolescents. The word American on the cover would clarify that all the material relates to the USA – some of the examples and explanations make this unhelpful and confusing for social workers working in the UK. This is a general comment on the book, but explicit examples are outlined as follows.
For instance, diagnosis in Northern Ireland is made by medical staff only. The range of clinicians referred to on page 5 of the book is unhelpful. The authors should either state that this list refers only to the USA or present UK information.
The explanation of ‘wrap around’ on page 16 is distinctly different from the current use of ‘wrap around’ in many contexts. The description in the book sounds more like the family group conference model used in New Zealand and adapted in the UK.
Explanation of evidence-based treatment does not resonate with current UK approaches, where NICE have provided the evidence base for treatment of a wide range of mental health conditions. The two examples of practices in the book that are not evidence based – Boot Camp and Re-birthing – are not practised in the UK and are therefore of limited relevance to our understanding in the context of UK practice.
While the information on self harm is very clear, the statistics relate to American studies. These studies are replicated in the UK and the Republic of Ireland and would be more useful if related to students/professionals/clinicians in those countries.
The details in this text on medication as a preferred treatment are based on American pharmaceutical provision. Given that this is a specialist area of knowledge for Medical and Pharmacy Clinicians, it is difficult to see the value of including this detailed information in the book, which is primarily intended for social workers. It would be sufficient to indicate that the evidence supports a combination of medication and psychotherapies in working with children and adolescents who have mental health needs.
Given the extensive use of US examples and explanations, I would not recommend this book to social workers working in the UK. However, an adaptation of this book with UK concepts, practice examples and the areas of strength outlined above would be a real asset to the literature in this field of work.