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Clinical Handbook of Psychological Disorders: a Step-By-Step Treatment Manual (4th edn) Edited by David H. Barlow. Guilford Press. 2007. US$75.00 (hb). 689pp. ISBN: 9781593855727

Published online by Cambridge University Press:  02 January 2018

Gavin Andrews*
Affiliation:
University of New South Wales, School of Psychiatry, Faculty of Medicine, 299 Forbes St Darlinghurst, Sydney 2010, Australia. Email: gavina@unsw.edu.au
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Abstract

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Copyright © Royal College of Psychiatrists, 2009 

‘Books’, says Wessely, ‘are not very important for us’ (‘And now the book reviews’, British Journal of Psychiatry 2000; 177, 388–89). For once he is wrong. This is the fourth edition of what has become a standard American text, well nearly so – the chapters by Tarrier and by Fairburn, Cooper and Shafran keep the UK on the map. Barlow begins by extolling the virtues of evidence-based practice but for once he is only partly right. He discusses psychological therapies (cognitive–behavioural therapy plus variants) for the common mental disorders – anxiety, mood and substance use disorders, psychosis, eating, sex and borderline personality disorders, couple distress – but a chapter on generalised anxiety disorder is missing. Most chapters do review the available evidence and define the evidence base but the strength of this very good book is the depth of clinical advice. The authors have considerable clinical experience and publish therapy plans and transcripts of ‘who says what to whom’ to prove it.

I direct a service that provides cognitive–behavioural therapy for people with anxiety and depressive disorders. We treat 1000 new patients a year, face-to-face or via the internet, and so should be blasé about the first half of the book that deals with these disorders. I'm not. I am about to photocopy chapters to give to my staff who work with the relevant patient groups. It is that good. The opening chapter on panic/agoraphobia is a masterpiece and the chapter that describes a unified protocol for the treatment of emotional disorders is exploring what we all know to be true – the anxiety and depressive disorders are frequently comorbid and we need therapy models for such individuals. There are three chapters on the psychological treatment of depression, which is appropriate given that the burden is large and current initiatives do not seem to be reducing it.

The second half of the book deals with psychotherapy for the functional psychoses, borderline personality disorder and substance use disorders. All chapters are useful but for me the chapters on borderline disorder and alcohol use disorders suddenly made explicit how one might actually treat a patient with these disorders in a way that endless research reports have not done. For eating disorders the author attempts a transdiagnostic approach with a unified programme for anorexia, bulimia and eating disorders not otherwise specified, which seems eminently sensible to this ignorant reviewer.

In short, it is a great resource for psychotherapists. All staff should have a copy.

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