This textbook is written for psychiatrists and other clinicians interested in utilising cognitive-behavioural therapy (CBT) techniques in combination with more conventional pharmacotherapy. It recognises the time constraints placed on doctors during busy clinics and attempts to teach brief and practical interventions that can be utilised during 20-minute sessions as opposed to the traditional ‘50-minute hour’.
Most practitioners unconsciously adopt a CBT approach towards patients and this book simply suggests a more structured and productive way of doing this. The objective is excellent, with individual chapters dedicated to the more common problems seen in clinical practice - adherence, depression, maladaptive thinking, hopelessness and suicidality, anxiety, insomnia, delusions, hallucinations and substance misuse. The inclusion of various worksheets and checklists as appendices was very welcome. There is also a DVD demonstrating how to implement the techniques being taught. Although the somewhat outdated attire of the actors is slightly off-putting, it is useful to witness the experts in action.
The format of the book is logical and comprehensive, but the lack of colour and unrelenting text makes it aesthetically unappealing and difficult to dip in and out of. Concentration is required to wade through lengthy passages. However, as the book claims to be an ‘illustrated guide’, attempts have been made to break the monotony of text with occasional tables and diagrams.
The authors suggest a number of different formats for implementing combined CBT and pharmacotherapy. They attempt to maintain some flexibility with regard to who provides the sessions and the frequency with which they occur. Some of the suggested formats include joint patient care between a psychiatrist and therapist, with a mixture of both short and long sessions. This is perhaps a little optimistic and targeted towards our American colleagues with greater access to resources.
Overall, this is an excellent book and recognises the increasing expectations placed on doctors to approach patients in a more psychotherapeutic manner. It presents the use of CBT techniques in clinical practice as realistic, logical and achievable.
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