Your Child in the Balance: An Insider's Guide for Parents to the Psychiatric Medicine Dilemma

Kevin T. Kalikow;
Cambridge, Mass: CDS Books, 2006
276 pages • $22.95 (hardcover)

Your Child in the Balance provides parents with a unique and insightful look into the role of psychotropic medications in the treatment of children and adolescents. Dr Kalikow does a stellar job of systematically and comprehensively addressing this complex and provocative topic in this guide for parents from the perspective of a practicing child and adolescent psychiatrist. He skillfully addresses the multitude of challenges parents face when deciding on a treatment approach for their child with a psychiatric disorder, helping to conceptualize the risk-benefit relationship of available treatments, accompanied by a crucial discussion of the risks of not treating at all. This book offers parents rare insights into the current landscape of pediatric psychopharmacology. It provides a glimpse into the decision-making processes of a thoughtful child psychiatrist as he proceeds through the assessment, establishment of treatment goals, treatment decisions, and clinical management of a variety of mental disorders.

One of the clear strengths of this guide is the use of numerous vignettes to describe the many everyday clinical challenges in the use of psychotropic medications. Dr Kalikow describes instances when a medication may be appropriately recommended and the subsequent struggles of parents in deciding how to proceed with such a recommendation. He does a particularly nice job in presenting clear-cut examples of situations when a medication may be more obviously indicated, juxtaposed with the vagaries of clinical decision making when considering a medication for which there is limited controlled data, limited guidance from practice parameters, or a lack of diagnostic clarity. Perhaps one of the most appealing aspects of the book is that it really does capture the essence of what many families face in their interactions with clinical psychopharmacology.

This book is not appropriate for the parent who is looking for a quick reference to focus in on specific facts pertaining to a certain class of psychotropic medications or who wants a listing of adverse effects for a particular medication. But for those who want a comprehensive overview of the topic, this is an outstanding resource.

Ultimately, the goal of the guide as described in the introduction is to help a parent to answer the question: "Is my child receiving psychiatric medicine after a careful evaluation and have my child's physician and I carefully reviewed all risks and benefits of medicine and compared them with the risks and benefits of alternative treatments, including no treatment at all?" Kalikow is clearly successful in assisting parents to be able to address this crucial and complex question.