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CBT for Adults: a practical guide for cliniciansL. M. Drummond London: Royal College of Psychiatrists, 2014. pp. 284, £28.50 (pb). ISBN: 978-1-909-72627-7.

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CBT for Adults: a practical guide for clinicians L. M. Drummond London: Royal College of Psychiatrists, 2014. pp. 284, £28.50 (pb). ISBN: 978-1-909-72627-7.

Published online by Cambridge University Press:  10 August 2015

Louis Dennington*
Affiliation:
Clinical Psychologist in Primary Care, iCope: Camden and Islington NHS Psychological Therapies Service
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Abstract

Type
Book Review
Copyright
Copyright © British Association for Behavioural and Cognitive Psychotherapies 2015 

True to its title, this slim book is light on theory and packed with excellent case examples of cognitive behavioural therapy (CBT). All of the most common mental health problems are discussed in relation to recent evidence. There are chapters on depression, generalized anxiety, phobias, and sexual dysfunction, to name a few, and a welcome commentary on combining CBT with other therapies.

Each treatment chapter gives an overview of the mental health problem in question, a short critical review of the evidence, and clear explanations of the most frequently used treatment strategies (e.g., exposure hierarchies for phobia, or motivational interviewing for addictive behaviour). Drummond has used the new categories from the fifth Diagnostic and Statistical Manual for Psychiatric Disorders (American Psychiatric Association, 2013). This entails grouping obsessive-compulsive disorder (OCD) and hoarding together as “obsessive-compulsive disorders”, and not as anxiety disorders.

The presentation throughout is concise. The initial chapters on the history of CBT and assessment are succinct to the point of being rather dry, perhaps aimed at those without prior training in therapy. The writing on the mental health problems themselves is more engaging. The case studies in particular, which make up about a third of each chapter, are detailed, interesting and varied, sometimes covering different presentations of the same condition.

The focus here is very much on pressing for change, and those kinds of change that can be observed or measured in concrete terms. There is advice on questionnaires, and short summaries of some key debates (e.g. Exposure and Response Prevention versus Cognitive Therapy for OCD). Readers from dynamic, systemic or acceptance-based trainings may find the psychiatric orientation of the book to be lacking in complexity or emotional vocabulary. Clients are represented mostly from the outside in behavioural terms, and the therapist's voice is often authoritative and directly challenging, rather than Socratic. For example, in the chapter on depression, the bereaved client is “asked to say ‘goodbye’ to her mother in this letter and to say that she was going to ‘move on’ with her life” (p. 132).

However, this book is not written uncritically, nor without compassion. The different branches of CBT such as mindfulness are given a supporting role, and the pros and cons of prescribing psychoactive medications are aired. Cognitive methods are covered more briefly – in some detail in the chapters on depression and psychosis – and there is little about comorbidity, or about overcoming obstacles in therapy. It would be difficult for new clinicians to translate the chapters on eating disorders, personality disorders and psychosis into meaningful treatments, but they do provide a thorough overview and each chapter has a list of further reading.

In short, those looking for a clear, compact and up-to-date overview of how to formulate and treat common mental health problems with CBT will find what they need here. There is plenty of fodder for the generalist and I will be using the book as a tidy refresher of how to stay “on model” in change-based therapy.

References

American Psychiatric Association (2013). Diagnostic and Statistical Manual of Mental Disorders (5th ed.). Washington, DC: Author.Google Scholar
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