Clinical Handbook of Psychological Disorders: A Step-by-Step Treatment Manual, 4th ed

Clinical Handbook of Psychological Disorders: A Step-by-Step Treatment Manual, 4th ed

edited by David H. Barlow, PhD. The Guilford Press, New York, NY, 2008, 722 pages, $75.00.

Given the substantial number of psychopathologies and the constantly evolving array of psychotherapies developed to treat them, it may seem an overwhelming feat to gather one’s own resource collection of the most empirically supported and efficacious therapeutic approaches. The solution to this problem is definitively addressed with the publication of David Barlow’s fourth edition of the Clinical Handbook of Psychological Disorders: A Step-by-Step Treatment Manual. This book continues the tradition of previous editions by offering some of the most widely used treatment approaches, described in great detail by the developers of the protocols.

Health care policies at the government and facility levels are increasingly indicating the need to implement evidenced-based approaches in mental health treatment. While resistance to adopting therapies typically labeled as "brief" and "structured" continue to linger, this text, as with the previous editions, represents the embodiment of this growing trend in health care as a whole and remains the standard in the field for gathering and conveying information regarding the most widely utilized, empirically supported therapies. Each protocol provides the content, processes, and structure for treatment, representing the theoretical framework from which it was derived, while simultaneously offering the therapist the flexibility necessary to tailor each treatment to an individual’s needs.

The book is divided into 16 chapters representing various disorders and problems. As in prior editions, the anxiety disorders are well represented; the text includes chapters on panic disorder and agoraphobia, posttraumatic stress disorder, social anxiety disorder, and obsessive-compulsive disorder. There are 3 chapters covering different treatment approaches to depression, including cognitive therapy, interpersonal psychotherapy, and an interesting new protocol, behavioral activation for depression. Updated and new chapters are included on dialectical behavior therapy for borderline personality disorder, bipolar disorder, alcohol use disorders, drug abuse and dependence, sexual dysfunction, and couple distress. A new chapter outlining the use of cognitive-behavioral therapy for the reduction of positive symptoms of schizophrenia and other psychotic disorders (as an adjunct to pharmacotherapy) has also been added.

Unique to this edition is the inclusion of 2 chapters describing cutting-edge approaches that incorporate common components of treating various disorders into more broadly applicable therapies. Barlow and his colleagues describe their unified protocol for the treatment of anxiety disorders and mood disorders, as well as other conditions in which emotional dysregulation is a major component. Similarly, a chapter outlining a transdiagnostic protocol for the treatment of all eating disorders illustrates a cognitive-behavioral approach centered on perceived control of one’s weight and body shape and the import of one’s beliefs regarding these factors.

Chapters are similarly organized and typically include a description of the disorder, including a review of pertinent literature and the various treatments historically utilized; an explanation of the theory guiding the proposed treatment approach; treatment context and therapist and client variables; recommendations for assessment; and finally, components of treatment, with a case study including session-by-session descriptions and therapy transcripts. These transcripts provide vivid illustrations of the "meat and potatoes" of the protocols and will likely be the pages that receive the most wear and tear when your copy of this book is borrowed by supervisees and seasoned practitioners alike.

The Clinical Handbook of Psychological Disorders, 4th edition, has followed the successful formula of its predecessors, and there are few conspicuous limitations to the text. The chapters are generally concise and clearly written, and they provide a number of invaluable references. However, as with any edited text, some variability across chapters can be found with respect to the inclusion of the most up-to-date citations. Additionally, more figures illustrating completed monitoring and assessment forms (as exemplified nicely in the chapters on alcohol use and eating disorders) would be beneficial to the reader.

How can we provide patients suffering from various mental health problems with the most rigorously studied, efficient, and effective treatments? How do we best offer trainees in psychology, psychiatry, and other disciplines, as well as experienced clinicians, direction in the application of such approaches? This book proffers an excellent answer to both questions.

Howard R. Steinberg, PhD

Howard.Steinberg@va.gov

Author affiliation: Yale University School of Medicine, New Haven, Connecticut. Financial disclosure: None reported.

doi:10.4088/JCP.09bk05278

© Copyright 2009 Physicians Postgraduate Press, Inc.