Book Review: Alan Carr, The Handbook of Child and Adolescent Clinical Psychology: A Contextual Approach (2nd ed.). Hove: Routledge, 2006. 1190 pp. ISBN 1583918310. £32.99

T H I S I S T H E second edition of Alan Carr’s well-received, highly structured handbook, focusing on the practice of clinical child and adolescent psychology and now incorporating extensive revisions and up-to-date new material. The original structure of the book has been retained and, as before, the approach is developmental, employs multiple theoretical perspectives and embraces a view of the child’s functioning and the clinical interventions in the varying contexts of the family, school, and wider social network. Carr’s book is divided into six main parts, the first section providing a framework for the remainder of the book and divided into chapters on normal development; influences on problem development; classification, epidemiology and treatment effectiveness; the consultation process and intake interviews; and report writing. Subsequent sections address problems of infancy and early childhood, middle childhood and adolescence, while the final two sections focus on child abuse and adjustment to major life transitions respectively. The structure of each chapter follows the same general format throughout, beginning with a case example followed by discussion of classification, epidemiology, diagnostic and clinical features, aetiological theories, assessment issues, formulation, and treatment approaches. Also, Carr highlights important predisposing, precipitating, maintaining, and protective factors. The strong structural organization of the book serves to highlight Carr’s aim of providing a core textbook in the practice of clinical child and adolescent psychology for postgraduate clinical psychology trainees, although experienced practitioners and clinical supervisors would also find the book valuable. This second edition of the book has the advantage of many updated or re-written sections, tables, and figures on the aetiology, classification, assessment and treatment of problem areas. In addition, there are brand new sections on emotional intelligence, gay and lesbian identity formation, elective mutism, chronic fatigue syndrome, bi-polar disorder, cognitive behaviour therapy (CBT) for bulimia, CBT approaches to relapse prevention in schizophrenia, and parent alienation syndrome in relation to divorce. A cursory inspection reveals immediately many helpful resources including summary tables useful for quick reference, handouts, charts, recommended reading and useful websites. In addition, with trainees in mind, there are exercises at the end of each chapter designed to develop formulation, case planning, interview and consultation skills. As a single author, Carr has managed to produce a remarkable book of encyclopaedic proportions covering the most important clinical practice issues, all coherently organized throughout. The range of clinical presentations and problems covered is fairly comprehensive, although, as Carr acknowledges, some areas are considered in less depth than others, with priority being given to more commonly referred clinical problems. Nevertheless, it was disappointing to note that the relationship between chronic trauma attachment experiences and adverse brain development was not highlighted in the book. Indeed, although Carr provides descriptions of the emotional and behavioural characteristics of abused and neglected children, he does not mention how these characteristics are related to trauma-skewed brain organization and development (Schore, 2001). This is an important link that underlies many of the intervention strategies now being adopted in a growing number of children’s mental health services in the UK and elsewhere. There are also missed opportunities to make clearer the links between trauma attachment experiences and many of the problem areas covered, such as conduct disorder, attention deficit hyperactivity disorder and post traumatic stress disorder (van der Kolk, 2005). Finally, many adoptive parents and foster carers of CLINICAL CHILD PSYCHOLOGY AND PSYCHIATRY 12(3)