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The Complete CBT Guide for Anxiety Roz Shafran , Lee Brosan and Peter Cooper (Eds.) London: Constable & Robinson, 2013. pp. 505, £14.99 (pb). ISBN: 978-1-84901-896-8.

Published online by Cambridge University Press:  01 September 2014

Harriet Rankin*
Affiliation:
Institute of Psychiatry, Kings College London
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Abstract

Type
Book Review
Copyright
Copyright © British Association for Behavioural and Cognitive Psychotherapies 2014 

This Overcoming publication is a comprehensive self-help guide for all anxiety disorders using evidence-based CBT techniques. It covers the spectrum of anxiety, with each disorder written by international experts in the field who have developed these evidence-based treatments recommended by the NICE guidelines.

The book is split into three sections. Part one outlines common ideas and techniques of CBT, and prepares the reader for what is involved in therapy. The second part comprises 7 chapters covering specific phobias, panic disorder, GAD, social phobia, health anxiety, OCD and PTSD. It is important to note that the guide acknowledges the lack of evidence suggesting self-help is beneficial to PTSD and therefore instead this chapter is presented as information about where to access effective CBT. This gives the patient knowledge and expectations of the treatment they should be receiving, so they can ensure they can access the best possible therapy.

Part three focuses on maintaining progress and tackling other issues that may interfere with recovery, such as relationship difficulties and mood. The appendices provide a breadth of resources including questionnaires to measure progress, blank tables and models to formulate difficulties, and extra reading for each problem. The length of the book can seem daunting, but the reader is advised to read part one, and then consult only the chapters in part two that are relevant to their problem, providing as they do a brief description of each problem at the beginning to aid the reader. A concern with this approach is the probability of readers self-diagnosing, something that the health anxiety chapter itself discourages. However, this is addressed at the start of the book, and readers are frequently advised to consult their doctor, particularly if the problem is ongoing.

The guide has an excellent structure, using tables, bullet points and diagrams to break up blocks of text. In this way, it is symbolic of the importance of structure in CBT, a point that is emphasized in part one of the book. The book reflects therapy itself, guiding the reader to plan 20 or so “sessions” over a number of months, using agendas and setting goals each time.

Although marketed primarily as a “self help guide”, it establishes a common language, which speaks to both those experiencing anxiety problems and those supporting them. This addresses the issue of existing books frequently having content useful to both audiences, but always aimed at one or the other. In part 1, it encourages the reader to work through the book with a supporter, e.g. a therapist, family member or friend. Each section includes a number of “tips for supporters” boxes, advising a “firm but empathic” approach and emphasizing collaborative working.

The book is very engaging and welcoming. It manages to build a kind of rapport with the reader in the absence of a therapist, through informal language and light-hearted phrases. Real life quotes and case studies make the book personal, following the characters’ progression throughout the book. These case studies are used to explain core CBT techniques such as virtuous vs. vicious cycles, safety behaviours, and cognitive errors. Personal accounts from the authors of their own anxieties also help to establish trust with the reader.

The clear and accessible language also makes the book very readable and easy to follow. In addition to the obvious benefits to those working through the self-help guide, it could be a good tool for clinicians who are looking to articulate psychological terms and CBT techniques to patients using simple terminology. The various different ways in which anxiety is explained, such as through continuums and evolutionary examples, help to normalize anxiety and reassure the reader.

A major challenge in self-help is the user staying motivated throughout treatment. The book tackles this through frequent encouragement and tasks to strengthen commitment, such as “a list of reasons why you want to change”, to refer back to when feeling disheartened. Various other barriers are addressed, such as the suggestion for those with dyslexia or learning difficulties to use a Dictaphone to self-monitor instead of written record sheets.

Overall, the book fits well in the current context of mental health problems in today's society. It takes into account that this is a time of economic downturn where there are a number of real threats and real problems that invoke anxiety, such as job loss and debt. It uses IAPT measures for disorders and materials from the IAPT handbook, which would appeal to local practitioners. It was published before the DSM-V but this doesn't make it redundant by any means, considering its trans-diagnostic approach. It also makes the important acknowledgment that mental health problems are frequently complex and comorbid, and treating just one manifestation of an individual's anxiety is not always sufficient. For these reasons, I would recommend this book for anyone wishing to tackle an anxiety problem and those supporting them, including mental health practitioners.

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