Applications of Cognitive Therapy With Diverse Populations: Cognitive Therapy in Clinical Practice: An Illustrative Casebook

Abstract

Applications of Cognitive Therapy With Diverse Populations Cognitive Therapy in Clinical Practice: An Illustrative Casebook pBeck establishes the purpose of the book hi the Foreword by indicating that although cognitive therapy (CT) has been highly successful in treating [outpatient] depressive disorders, the efficacy of treating other patient groups has yet to be fully established. Consistent with this theme, Williams and Moorey in the final chapter entitled "The Wider Application of Cognitive Therapy: The End of the Beginning" almost apologetically (although realistically) describe stages through which novel therapies must progress in order to be accepted for a variety of therapeutic patient concerns. They indicate that in order for a new therapy approach to be clinically feasible, researchers must show,"...first, that the therapy can (italics in original text) work with individual case examples; second, that it does work with a group of such cases in a clinical series; [and] third, that it works better than control conditions in a properly controlled clinical trial" (p. 227). Although these criteria have been met by cognitive therapists in the treatment of depressed out-patients, Williams and Moorey indicate that an important future challenge for cognitive therapists is to evaluate the utility of cognitive approaches for other clinical conditions outside the original domain. The specific purpose of the book is to address this important issue. Hie contributors to this volume do a fine job of achieving the editor's intended goal of demonstrating the viability of applying cognitive therapy to the treatment of a variety of difficult clinical problems. The strength of this text lies in its broad coverage of CT with difficult and seemingly distinct clinical groups - severely depressed in-patients, panic disorders and agoraphobia, obsessions and compulsions, hypochondriasis, cancer patients, eating disorders, drug abusers, offenders, and suicidal patients. Each chapter offers a brief synopsis of the respective topic, current status, and employs a minimum of one case in which the therapist transcribes portions of the therapeutic sessions. One of the benefits of reading the book is the honesty with which this group of distinguished authors present their own concerns with specific patients, and their reasoning for using specific interventions with distinctive patient types. The volume offers a breadth of information and ideas from knowledgeable individuals working in their respective therapeutic areas, with authors from both the United States and the United Kingdom. The breadth versus depth tradeoff with any edited book is inevitable, but most of the chapters offer an adequate and quite competent view of working with the individual problem types. This book will be most useful to individuals with a working knowledge of cognitive therapy. The authors do not spend a lot of time describing the specific strategies and nuances of their therapy outside of the case studies, merely reporting the application broadly and directing the reader to the appropriate references. One common difficulty with instructing students in CT is that many texts tend to rely on a strictly rationalist approach to the area. The editors of this book, however, allow the authors to go well-beyond this limited view. This book would make a fine addition to both practitioners and upper level graduate students, although the references cited in each chapter should complement the text with the latter group. In Chapter One, Blackburn introduces the reader to depressive disorders, with a refreshing focus on in-patients instead of the traditional out-patient therapeutic modality. Following a brief overview of the work with depressi ves in general, he shifts to discussing the purpose and problems associated with the use of CT with an in-patient (hospital) depressive population. The latter concerns include not only issues related to the severity of the depression, but also special problems associated with the physical restrictiveness of the hospital units, multidisciplinary teams with differing philosophies, and the process of transferring from high medication dosages to CT. …