This is a very topical subject. As one of the more evaluable psychotherapies, adherents to cognitive–behavioural therapy (CBT) have generated an impressive corpus of evidence for efficacy. Coupled with a very strong brand image, hardly a set of treatment guidelines seems to go by without featuring a specific recommendation for CBT, often first-line. However, current CBT evidence has an Achilles heel, that of duration of effect, most recently emphasised by a UK National Health Service Research and Development health technology assessment (Reference Durham, Chambers and PowerDurham et al, 2005).
This illustrates the latest battleground for continued acceptance of CBT as a broad therapeutic approach, and is the very timely focus of this book. It is edited from a North American perspective (exemplified by a chapter on ‘Couple distress’), but with a fair smattering of UK contributors and fairly conventional diagnosis-specific chapters elsewhere it should appeal to most practitioners.
Each chapter stands alone, following a standard format which first provides an overview of the disorder and conceptualisation before moving on to review empirically supported treatments (not just CBT but pharmacological and even electroconvulsive therapy for some disorders), predictors of CBT outcome for each disorder and then the real meat of the book – practical strategies for improving outcome and predicting and preventing relapse.
All the overview sections are good (often extremely comprehensive) as literature reviews, but probably double the size of the book compared to what would be needed purely to cover the crux of what one needs to do to improve outcome, as suggested in the title. This may or may not be good for you, but I certainly found it helpful to put the treatment strategies in context.
Most of the contributors are careful not to discuss CBT to the exclusion of other treatments and explicitly mention evidence for combining treatment modalities – surely a helpful addition for practitioners working outside the selective academic centres where this is less likley to be the norm. Detailed and well referenced case studies end each chapter and serve well to illustrate the more theoretical emphasis of preceding sections.
This is a good book – comprehensive and replete with practical strategies to hone what one already does as a CBT therapist, but refreshingly with more of an eye on outcome rather than process, which can rather overwhelm some of the more manualised approaches. The authors deal with evidence in an even-handed manner, and it is this balance coupled with a wealth of practical tips that contribute to this book's strong clinical utility and likely longevity.