I was interested in reviewing this book as the service I work in has now expanded to incorporate the adolescent age group. I was particularly interested in thinking about the specific needs of the adolescent age group and the similarities and differences with the adult population.

From the outset, the editors' stated intention is to provide a comprehensive resource that presents not only theory, but also captures the innovative practices of CBGT in a variety of settings. The book sets out to provide an overview of the theory of CBT, the principles behind using it in a group setting, and specific strategies to use with young people. This book is helpfully divided into four parts, with 42 contributors; it addresses group therapy essentials, specific settings, presenting problems, and conclusions and future directions.

The introductory chapters provide useful advice on the components of effective group therapy. There is a useful checklist for “effective group therapy” that includes 13 items ranging from “clear and measurable goals for treatment” to “preparing for problems to occur”. An essential chapter on developmental factors highlights the wide range of complex, often changing and evolving factors that need to be taken into account when working with children and adolescents. There is an outline of developmental considerations incorporating biological, genetic and neurological influences. In particular, account is taken of possible hormonal effects on cognitions, affect regulation and behaviour e.g. polycystic ovary syndrome, which can be misdiagnosed as a mood disorder, or hypothyroidism, which can present as apparent depression, for which certain antidepressants are contraindicated.

There is also a useful chapter on legal and ethical issues that are important to clarify at the outset of a group, for example in terms of confidentiality and age as to what is shared with parents and guardians, and also issues of consent. How issues are dealt with when they arise, for example disclosure of drug use. and legal boundaries need to be clear from the outset.

With regard to age specific CBT, there are extensive examples throughout the handbook of age relevant cognitions. For example, a useful list of common cognitive distortions is provided that provides youth relevant examples: e.g. “mind reading”, “I know that my mother is disappointed in me” and “should” statements such as “I must always say yes when my friends ask for my help, because I shouldn't be selfish”. A wide range of creative and helpful child/adolescent friendly tasks are described, such as how to distinguish between a fact and an assumption, as well as protocols for group sessions. It is noted that in working with young people there is often a greater emphasis on behaviour than cognitions and goal setting techniques are often used. Creative strategies are also provided of ways to deal with common problems posed in groups, such as. “social loafing” (when individuals do not contribute within a group setting) by, for example, getting group members to write on a card, for example, “what made me angry this week” and discuss anonymously in the group.

The book outlines the wide range of settings (schools, outpatients, inpatients, residential and medical settings) where CBGT can take place and specific issues that arise in each setting. Within the education system a distinction is made between three types of groups: primary prevention groups e.g. for substance misuse, school dropout, suicide and pregnancy; secondary prevention, which targets “at risk” groups e.g. anger management; and tertiary groups, which provide intensive intervention for students with psychological symptoms.

The book embraces the idea that CBGT can be used effectively with wide ranging presenting problems and a sense that there is no limit to the problems that can be addressed in a group setting. The book provides protocols and helpful session outlines for a variety of difficulties, such as. “healing hearts” for grief and loss, treatment for child sexual abuse that provides session outlines for both children and parents/caregivers in understanding what the child is experiencing. The handbook is a very useful resource in outlining group programmes (e.g. adolescent coping with depression, with free download of the manuals and workbooks) and outlining the modules of a programme.

A very comprehensive range of issues are addressed with accompanying programme outlines: anxiety, PTSD, helping to deal with divorce, ADHD, anger and aggression, adolescents who substance abuse, self-injurious behaviour, adolescents with Asperger's disorder (using guided social stories), children who are ostracized or socially isolated, and dealing with chronic medical illness or eating disorders.

The editors conclude that there is a need for more research into the effectiveness of groups, with further work in community settings with homeless young people, schizophrenia, sexuality and next generation immigrants. In summary, this is a very valuable and useful handbook for conducting group CBT in a variety of settings. My main reservation is that it is written from a US perspective and this comes across in reference to specific youth and age issues that are pertinent only from such a perspective. The use of CBGT in schools also appears to be very different to the UK education system. It is noted that 10% of children and adolescents in the US meet criteria for emotional disorders that have a significant impact on their daily functioning.

The editors advocate a positive stance that views participants as capable of change, recovery, and growth and that mental status is not “carved in stone”. This stance is not only helpful when working with young people but is also valuable when treating people across the age range.