edited by Cathryn A. Galanter, M.D., and Peter S. Jensen, M.D.; Arlington, Virginia, American Psychiatric Publishing, Inc., 2009, 744 pages, $85
Dr. Sitzer is a child and adolescent psychiatry fellow at Massachusetts General Hospital and Mclean Hospital, Boston.
Case studies are a widely used and effective teaching method. They offer descriptive, real-world examples and facilitate connections between theory and practice. The DSM-IV-TR Casebook and Treatment Guide for Child Mental Health, edited by Cathryn A. Galanter, M.D., and Peter S. Jensen, M.D., features well-written case studies organized into four sections, with each section highlighting progressively more complicated presentations of child and adolescent pathology. Each one of the 30 cases is followed by a formulation and by treatment recommendations from the psychotherapeutic, psychopharmacologic, and "integrated" perspectives. The case writer often provides the integrated perspective, but most often, a psychologist and a psychiatrist provide, respectively, the psychotherapeutic and psychopharmacologic views. As a trainee, I have often been advised to present one case to more than one supervisor to compare perspectives on or approaches to the same patient. This book provides the opportunity to, in effect, consult with at least three experts about the same case.
The cases are organized into "Classic Cases," "Comorbid Complexity," "Toughest Cases: Diagnostic and Treatment Dilemmas," and "Kids in Crisis: Psychopathology in the Context of Social Stressors." Although each case is placed in a specific section, it is quickly evident that complexity and comorbidity are the rule rather than the exception and that, as the editors acknowledge, the line between simple and more complex cases is often blurry. The three commentaries that follow each case are comprehensive, serving to reinforce the idea that the "psychopharmacologic" and the "psychotherapeutic" perspectives are often more integrated than not. The commentators are thorough in explaining the reasoning behind their diagnosis and treatment decisions. They often make recommendations on how to obtain further data and frequently include citations of relevant evidence-based studies.
A fifth section of the book, titled "Diagnostic and Treatment Decision Making," includes a very interesting and insightful discussion of theories on the conceptualization of illness and need for intervention. This section, although perhaps beyond the scope of the book's primary focus, challenges the reader to further consider the inherent decision-making challenges in child mental heath care, as suggested by the juxtaposition of three different perspectives on the same material.
The book includes a useful appendix listing screening tools and rating scales. In addition, a brief but descriptive biography of the more than 100 contributors is included at the end of the book; it reads as a "who's who" in child mental health and allows the reader to gain a sense of the various influences on the writers' approaches as well as on their potential biases.
Although most practitioners may not read this text cover to cover, they would appreciate reading specific cases that relate to their patient population. The book would be especially valuable as a teaching tool in a course on diagnosis and treatment of child and adolescent mental health because it provides comprehensive, relevant, and well-organized presentations of commonly seen disorders in a useful and thought-provoking format.
The reviewer reports no competing interests.