ABSTRACT
Examination of prescribing practices or attitudes both in the UK and in the USA shows that the extent to which adolescent mental health professionals use biological treatments varies considerably and that this seems unlikely to be solely related to variations in the populations or disorders treated (Adams 1991; Bramble and Dunkley 1992; Parmar 1993; Kaplan et al. 1994; James 1996; Bramble 1997; Walter and Rey 1997). Physical treatments have been regarded as controversial not merely by the lay community but also by child mental health professionals, and concerns about the over-use of medication as a form of social control and the use of ECT as punishment continue to be expressed (Kaplan and Hussain 1995; Oxlad and Baldwin 1995). Empirical research on which to base adequate conclusions about appropriate evidence-based practice is still lacking for many treatments, due in part to the complexity of the issues involved (Fava 1996).
