Rutter & Hersov's (Reference Rutter and Hersov1987) Child and Adolescent Psychiatry: Modern Approaches is the standard reference for those working in the field of child and adolescent emotional health, since it provides us with a comprehensive overview of theory and practice in this field. The only failing of this text, from a psychological point of view, is that its take on the subject is from the viewpoint of psychiatry, which implies an interest in pathology rather than health, of classification rather than the understanding of emotional meaning, and an interest in more physical types of treatment for emotional and developmental disorders. This is not to criticise this type of conceptualisation, but only to state that it may exclude alternative forms of understanding and practice.

To continue, for a moment, the comparison with Rutter & Hersov, this present book is written by a single author whereas the Rutter & Hersov text is written by multiple authors. This means that Carr's text can be more systematically organised: for example, where in Rutter & Hersov there are separate chapters dealing with differing theoretical takes on emotional difficulties (psychodynamic etc.), in the Carr book we are presented with differing theoretical conceptualisations (psychodynamic, behavioural, family-systems, etc.) about a disorder, practice, or theory, in each chapter. The effect of this is to allow the reader to form links, comparisons, and blends of these varying conceptualisations. Instead of what the reader might feel to be constricting systems of categorisation in the Rutter & Hersov volume, where the reader is not encouraged to make links and comparisons, the Carr text encourages us to make links and meaningful comparisons that are not the author's but which seem to be the reader's own. To write a book that gives us this sense is a high art.

Coverage of the field is encyclopaedic and practical. This is a book obviously written by a practitioner who is interested primarily in providing a set of tools for the clinician: this emphasis on practice concentrates on outlining the tools, whether these are conceptual, or tools to aid assessment or the process of clinical decision-making and therapy. This emphasis on tools for practice can be observed by merely quickly flicking through the pages: the observer will see numerous ‘smiley faces’, case examples, and lists of assessment questionnaires — this initial viewing may be taken to imply a superficiality of coverage which is far from being the case, since the text adds depth to these graphics.

Carr covers the most common problems encountered in clinical practice. His view of these difficulties is necessarily complex, given the need to consider developmental influences and difficulties, and also the influence of family and wider cultural and institutional issues in working with young people. His book is organised in a number of sections. The first outlines frameworks for practice, ways of thinking about psychological problems and the process of psychological consultation. Contained in this section are outlines of the process of normal development within a child's social context, most importantly that of the family, followed by a chapter on influences on problem development — where the organising concepts focus on risk factors, whether these are precipitating, maintaining, or protective, factors. The following chapter deals with issues of classification and treatment effectiveness — the ICD and DSM systems are reviewed and considered and the conclusion is reached that the evidence shows that these systems have reliability, coverage and comorbidity difficulties that compromise their validity — perhaps because emotional problems in children occur either as a result of complex interactional problems, or as dimensional psychological characteristics. Carr also raises some ethical problems with these classification systems, and he goes on to suggest alternative methods of classification, which he develops in the further course of the book. A final chapter in this first section examines the consultation process. This chapter is quite excellent. It contains masses of information that is very comprehensive, and that manages to encompass many different theories and practices in a coherent manner that is potentially useful to the practitioner. Thus, his coverage of practical issues, such as rooms and institutional context, is as good as his discussion of transference and counter-transference and ways of managing these issues.

Further sections are organised developmentally and deal with problems of infancy and early childhood, problems of middle childhood, and problems of adolescence. Two further sections deal with child abuse and adjustment to major life transitions such as separation, bereavement and foster placement. All chapters are similarly organised: they refer back to the organising concepts that were outlined in the first section, there are useful case examples, graphical tables that clearly illustrate concepts and differing theories, also tables of useful assessment instruments and treatment techniques. At the end of each chapter there are useful summaries, hints for further reading, and exercises that seem ideally designed for training purposes.

I find myself amazed that a single author has been able to produce such a huge, comprehensive, and useful text as this one. This book will become the standard textbook for trainees in clinical psychology, and will also prove to be hugely useful to qualified clinical psychologists. It should also be known and used by other practitioners. Alan Carr's book should now be in the working library of all those who come into contact with children, adolescents, and families who are experiencing emotional or developmental difficulties, where these practitioners need to form a firm basis of understanding of these difficulties in order to help their patients. This book adds a comprehensive, detailed and complementary (to Rutter & Hersov) coverage of the field of child adolescent and family emotional health. Buy it!