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I am not sure when a series of volumes becomes an "institution";
this is the fourth annual volume of Critical Issues in American
Psychiatry and the Law, and each has been an extraordinary summary
of important forensic topics. This book makes the point that the
interface of psychiatry and law is not merely a legal one, but has
a great deal to do with clinical issues such as diagnosis and
treatment. Children and adolescents are not adults. This may come
as something of a shock to those who proselytize for equal rights
for children, and to those adults (including some psychiatrists,
attorneys, and judges) who advocate giving the child adult choices
and/or responsibilities. Children differ from adults in many ways.
The specialist in child or adoles cent psychiatry knows not only
that one must attend to special social and family issues for
juveniles, but that juveniles are more complex internally as well.
They attempt to survive in the world while rapidly growing and
learning, usually with physically and emotionally immature
resources. They have had few years in which to develop experience,
and do not have the psyche with which to integrate that experience
in ways one would expect of a mature adult. Sometimes this
frightens the patient, as in the case of a physically large teen
ager whose impulse control is impaired. Sometimes it is
frustrating, as in the case of a healthy child unable to escape
from a dysfunctioning family. It is always confusing, and usually
uncomfortable."
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