Book excerpt: At a time of increasing financial pressure on families - as well as the services that support them - children are doubly disadvantaged. The economical mass-provision of proven approaches appears to be an unquestionable strategy. In this frank and revealing book, written by an experienced child and adolescent psychiatrist of eclectic and questioning persuasion, the argument is made that we are travelling in the wrong direction. A blinkered pursuit of empirical evidence and uniform delivery is leading us away from any sensitive and reciprocal relationship between caring professionals and the young individuals whose interests they are there to serve. Drawing on attachment and psychodynamic approaches, as well as systemic, values-based and mindful practice, Being With and Saying Goodbye describes an attitude that should be the prerequisite and medium of all child and adolescent work that has therapeutic intention. Unacknowledged, even reviled, this ghost in the machine is threatened with extinction.