It is well-documented that in the United States, and around the world, rates of adolescent anxiety, depression, substance abuse, and self-injury are rising at alarming rates. In his timely and much-needed book, At What Cost? Defending Adolescent Development in Fiercely Competitive Schools, Dr. David Gleason describes the conditions under which students attempt to learn in many college preparatory high schools. Gleason has interviewed parents and educators in many of these schools who both worry about and decry the levels of dysfunction within their student bodies, yet simultaneously admit to causing their students distress as they create structures and routines that overschedule, overwork, and overwhelm their young charges. Gleason exhorts schools to look for systemic change to relieve some of the pressure they put on students and he outlines framing questions to promote empathy. Additionally, he offers suggestions to create reasonable expectations and structures that are more developmentally appropriate, based in research on brain development, and that do not create the kinds of pressure that undermines student growth, natural curiosity, and joy in learning. Gleason is deeply cognizant of the bind in which educators and parents may find themselves, but his message is practical and solution-focused with sections on scheduling, sleep, homework, and executive function. Many independent schools will find that this book resonates with them and might find parts useful for reading with particular constituencies as they look at their school through the lens of student wellness.