Abstract
In an era characterized by high-tech medicine, high-tech diseases, lack of resources, pervasive audit, and enhanced consumer awareness, there are many challenges and controversies confronting child mental health clinicians. In outlining some of these, I take the opportunity to tilt at a few windmills, question some dogma, and stroke a few sacred cows. The only apology I offer is for my selectivity. If the occasional blood pressure is raised, a soap-box or two is mounted, or some letters of rage (or approval) are penned (or e-mailed) this paper will have served its purpose.

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