The three books all in their own way attempt to answer the gnarly question of how best to do therapy. In light of the recent warnings about selective serotonin reuptake inhibitors and the best evidence that talking treatments should be first-line treatment for adolescent depression, this trio could not have come at a better time.
Depression. Cognitive Behaviour Therapy with Children and Young People is a welcome guide to treating depression in adolescents and young adults. One of the frustrations in clinical practice is seeing the success of cognitive–behavioural therapy in randomised controlled trials but not having access to manualised treatments that work in the real world where there are comorbidities and time constraints and few, if any, psychology assistants competing for cases. (For younger children, there is Think Good – Feel Good, by Paul Stallard (Wiley Blackwell, 2002). This compilation of worksheets, real-world case examples and practical information is a must-buy for any child and adolescent mental health clinician.)
Bipolar Disorder in Young People. A Psychological Intervention Manual was developed by clinicians working in the specialist bipolar team and the early psychosis prevention and intervention centre in Melbourne, Australia. This is not just a ‘how to do therapy’ book – it also deals with those difficult and specific developmental issues which child and adolescent psychiatrists are all too familiar with. For instance, there is a detailed case history with a verbatim transcript of how to apply motivational interviewing techniques to a teenager with bipolar disorder who sees his substance misuse as potentially helpful. I particularly enjoyed the sections on good-bye letters, working to reduce stigma and shame, and role play. The challenges of how to encourage adolescents to engage in social rhythm regulation are also explored. I have been trying it out in clinic. It works.
Both books contain a number of appendices and worksheets (including excellent resources to download) that allow clinicians to try out the techniques they have learnt straight away. My only gripe is that the section on assessment is rather long and wordy, and the sections on cognitive techniques rather shorter, but this is a trivial objection.
In Who Is It That Can Tell Me Who I Am?, psychotherapist Jane Haynes writes as the archetypal wounded healer. Although she says early on in the book that she dislikes the term, in the first half she focuses on her own psychotherapy and ends with a moving account of her murdered son-in-law, to whose children this book is dedicated. In the style but alas not the flair of Oliver Sacks, Haynes shares a number of case histories, including her own.
In contrast to the evidence-based manualised therapies presented in the other two books, Haynes's own analysis took place five times a week over 13 years. By her account, she was ‘ensnared into interminable analysis’. She describes how, as a child, her mother left her in a pram in the department store before eventually leaving her for good to be cared for by her father who suffered from a frontal brain tumour and bizarre behaviour.
The first half of the book is presented as a letter to Haynes's analyst, who has now died. I was by turns voyeuristic, curious and then bored. It was rather like discovering a box of someone else's love letters. I was uncomfortable with the accounts, in the second half the book, of Haynes's own patients. There appeared to be a lot of unlimited disclosure of confidential information, with retrospective justification. Patients were asked for permission butit ishardtoimagine feeling abletosay no to aclinician with whom one has such a close analytic relationship. The stories were engaging but I was unsure for what purpose they were being shared.
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