Dr. Wilen’s experience of 15 years with the Pediatric Psychopharmacology Clinic and Research Program at Massachusetts General Hospital informs this interesting and useful book. Although it is directed to parents, it will help experienced practitioners to review their own attitudes and strategies when advising parents about the possible use of medication for their children. It will help residents and newly graduated child psychiatrists understand the intricacies and obstacles that can impede a seemingly straightforward and evidence-based recommendation for medication.
Parents seeking an assessment of their child’s emotional or behavioural problems are likely to be struggling with many myths and misconceptions. They have fears related to the still current stigma surrounding psychiatric problems, have likely been accused of poor parenting, have probably been told “he’ll grow out of it,” and may have already amassed a wealth of advice from friends, relatives, media and the internet. They may be adamantly opposed to the use of medication under any circumstances or desperately seeking medication as a quick fix.
“Straight talk” comprises three sections. The initial section encompasses basic information about psychotropic medications and their uses, the psychopharmacological evaluation, the diagnosis and treatment plan, and the essential collaboration between parents and practitioner. In addition, a question and answer format is used to address parents’ most frequently asked questions. The second section addresses common childhood psychiatric disorders, and the third describes the various classes of psychotropic medication. The approach is balanced, biopsychosocial, avoids parent blaming, and in the author’s own words (page 3) is “by no means an advertisement for psychiatric medications.” The book is written in plain language with definitions of all the medical and psychiatric terms used. Much practical advice is included. For instance: how to help your youngster accept an evaluation, and parents’ responsibility for keeping medications safe.
If you recommend this book to Canadian parents, you will need to point out its drawbacks. They can ignore helpful hints for surviving the U.S. medical system, such as tips about insurance and co-payments. Some of the information is not up-to-date. In particular, information about SSRIs is contradictory, probably hurriedly added as the book went to press. I tend to recommend the first section to parents wanting to gain some basic understanding of the rationale for prescribing medication to children, the process of assessment and treatment, and their constructive collaboration with the prescribing doctor. Sections two and three will also be helpful in most cases, but may need further discussion and updating.