Aims and MethodLong waiting lists and failure to attend appointments are a common problem in child and adolescent psychiatry. We introduced a novel ‘triage’ stage waiting list initiative to decrease the long waiting time fora first appointment at our child mental health service.ResultsThe waiting time to first appointment was significantly reduced and increased satisfaction with this process was expressed by clinicians, the referred families and referrers.Clinical ImplicationsThe reduction in waiting time was sustained over time and the triage process has now been implemented as routine practice. Following this implementation, there is no longer a lengthy waiting list for treatment after initial assessment. We would recommend this initiative, which screened referrals more efficiently and accurately, as a successful model for other child and adolescent services with long waiting lists.

This study explored the counselling self-efficacy of students in a counsellor education programme, in regard to age, gender, and ethnicity characteristics. To assess counselling self-efficacy, the Counselling Self-Estimate Inventory (COSE) of Larson et al. (Counsellor Education & Supervision 41: 120–130, 1992) was administered at the end of a semester to counselling students engaged in different stages of a counsellor training program. No significant differences were found in regard to gender and age-group categories, but significant differences were found among ethnic groups. It was found that Asian and White students generally had similar and also lower counselling self-efficacy means than the other ethnic groups in the sample in regard to several counselling-specific categories. Implications for counsellor educators in training counselling students of diverse characteristics are discussed.

This study was designed to identify characteristics of family functioning that relate to suicide potential in an outpatient adolescent population. Participants included 51 adolescents between the ages of 14 and 18 who were involved in outpatient counselling. The Family Environment Scale and the Suicide Probability Scale were used to assess adolescents' perception of family social climate and degree of suicide risk respectively. Results revealed significant correlations between suicide risk and family systems characterized by heightened conflict and lower levels of cohesion, independence, and organization. A stepwise multiple regression analysis suggested that organization (related to clarity and structure in family activities and responsibilities) was the strongest predictor of suicide risk. Implications for research and practice are considered.

This paper describes a model of crisis intervention to families of adolescents below the age of 16 who deliberately harm themselves and summarizes the premises which guide our practice. The adolescent's “overdose” is understood as an attempt to resolve relationship conflicts and so the initial interview aims to explore the predicament for the adolescent and the family and decide what further help may be required. Verbatim extracts from one session illustrate this process.

BOOK REVIEWS to improve the training of medical students in psycho logical and social issues. Awareness ofthe importance of teaching and training has encouraged many excellent teachers, especially in North America. It has also meant that many other psychiatrists who work in general hos pitals have been both concerned about how to integrate their teaching with medical training and have often been dismayed at the slowness of progress. ing point for moving onto Phillips' Winnicott (1988, London: Fontana) which is an analysis of the more complex aspects of Winnicott's theory.