Children's informed signified and voluntary consent to heart surgery: Professionals' practical perspectives.

Background: The law and literature about children's consent generally assume that patients aged under-18 cannot consent until around 12 years, and cannot refuse recommended surgery. Children deemed pre-competent do not have automatic rights to information or to protection from unwanted interventions. However, the observed practitioners tend to inform young children s, respect their consent or refusal, and help them to "want" to have the surgery.

Childhood depression: a place for psychotherapy. An outcome study comparing individual psychodynamic psychotherapy and family therapy.

Background: Although considered clinically effective, there is little systematic research confirming the use of Individual Psychodynamic Psychotherapy or Family Therapy as treatments for depression in children and young adolescents.

Aims: A clinical trial assessed the effectiveness of these two forms of psychotherapy in treating moderate and severe depression in this age group.

Methods: A randomised control trial was conducted with 72 patients aged 9-15 years allocated to one of two treatment groups.

Cost-Effectiveness of Individual versus Group Psychotherapy for Sexually Abused Girls.

Background:   Children who have been sexually abused may suffer from emotional and behavioural difficulties. Recent research found that individual and group psychotherapy have similar outcomes. In this study we compare the costs and cost-effectiveness of the two therapies and support for carers.

Reflections on 'an attachment-based treatment of maltreated children and young people'.

This paper considers the work of a skilled clinician (see this volume) who uses attachment theory but also his own vast body of experience. Many of the ideas will be of considerable help particularly to those working with children in substitute families. Caution is needed, however, as this work often involves the uncovering of unexpected abuse experiences which can provoke intense reactions.

Diagnosis and classification in child and adolescent psychiatry: the case of unipolar affective disorder.

Child and adolescent psychiatric classification is a broad domain in which the consideration of a developmental and longitudinal approach is essential. Some of the key issues involved are reviewed in this paper by focusing attention on childhood affective disorders, which are important both clinically and epidemiologically. It has been argued and demonstrated by Kovacs that in contrast to adults, children may not be capable of experiencing or reporting the symptoms thought to be representative of major depressive disorder.