Textbooks, clinical guidelines and reading the latest papers give a psychiatrist a theoretical scientific knowledge necessary to do the job. However, being able to successfully apply that knowledge is the job.

It is not an easy task to write theoretically on the practical application of skills. In this book the authors attempt to describe tacit skills and knowledge that are traditionally learnt by apprenticeship, by trial and error and the gradual accumulation of experience. More recently, the teaching of clinical skills has become more explicit particularly in the very early years of training, for example courses on ‘communication skills’ at medical school. The sceptical view of many is that either you naturally have the ability to communicate well with patients or you don't – and if you don't, you can't be taught it. My recollection of the books I read at this stage did not help this perception as they frequently failed to do as they intended. It was too easy for their advice to appear either too obvious or to be too disconnected from the realities of clinical life to be useful.

I felt differently about this book, which is more impressive for the fact it is aimed at an experienced audience where the tacit skills to be acquired are more complex and difficult to codify. The majority must still be learnt in the traditional fashion: from the example of other clinicians, and from managing individual cases and situations. Above all, they are learnt by reflecting in clinical supervision and attempting to make complex clinical reasoning with all its contextual and experiential intricacies explicit. The reason this book works is that it feels like a series of expert clinical supervisions on the topics that are rarely discussed in textbooks but which actually comprise the majority of day-to-day work. It is comprehensive, looking at a wide range of themes, without over-simplifying and whilst still feeling like a true account of the subtle details of clinical life. An example would be the two chapters on Teams and Teamwork. This could have easily degenerated into cliché. Instead it is perceptive enough to pinpoint the issues that preoccupy real-life teams such as the boundary disputes about patients ‘meeting criteria’ for a team, to what the authors call ‘awestruck teams’ and a discussion on New Ways of Working (the term for one of the recent reorganizations of psychiatric practice within the National Health Service).

The reader may agree or disagree with the advice or opinions given on specific situations. However, this does not matter as the aim of this book is not to give the definitive management plan for a particular case example but to illuminate the processes involved in making clinical decisions. It is clearly and logically set out and written with sufficient humour to make it an easy read.

I would recommend the book to more experienced trainees or newly appointed consultants. The themes are taken from general adult psychiatry but are relevant to other psychiatric fields and to senior clinicians from other professions.