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Book Reviews

Child and Adolescent Therapy: Cognitive-Behavioral Procedures (4th Edition)

Chung, Peter J MD; Soares, Neelkamal MD

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Journal of Developmental & Behavioral Pediatrics: June 2013 - Volume 34 - Issue 5 - p 378
doi: 10.1097/DBP.0b013e31829cf8be
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As the most recent edition of a well-regarded text on cognitive-behavioral therapy (CBT), this volume sets its goals high, seeking to educate the reader on disease processes, theoretical approaches, evidence reviews, and practical applications over an array of topics. Thanks to the paradigm set by the editor; the writers are able to accomplish this goal, despite a few missteps along the way.

The book begins with an excellent summary chapter that provides the scaffold on which the remainder is based. Key concepts like “flexibility within fidelity,” “therapist as coach,” and “cognitive distortions” versus “cognitive deficiencies” are established in the introduction and revisited throughout the text. The book is divided into subdivisions that cover CBT in specific disorders. In general, each chapter investigates the subtopic in a consistent fashion: an overview of the disorder, including epidemiology and disease burden; a review of evidence for CBT in that population; the clinical approach to the patient, including historical clues and diagnostic tools; and a case example of one CBT approach. The consistent structure between chapters unifies the volume as a whole. Clinical anecdotes of real patients help communicate concepts in a concrete manner, all through the lens of “flexibility within fidelity” that is presented in the initial chapter. As such, although the chapters can be read in isolation, they individually add to the understanding of CBT within the context of the entire volume.

However, there are some inconsistencies that are noticeable when the book is considered as a whole. For example, Kendall submits the goal of discussing “empirical support” for CBT—and indeed, a review of the literature is present in every section of the book, including updates of studies published since its last edition. However, the utility of this literature review varies from chapter to chapter. Most chapters provide excellent summaries, weaving together threads of evidence into a comprehensive statement regarding the “state of the research.” However, in other chapters, this literature review consists of short clips of information (i.e., equivalent to research abstracts) that are loosely piled under subheadings without an expert opinion to tie them together. Moreover, the clinical anecdotes contained within each chapter vary in the extent of detail with which the example therapy is discussed. As the book is not meant to serve as a therapy manual, this level of specificity can hinder comprehension with unnecessary or repetitive information. Finally, concepts of cultural competency are touched upon in some chapters but are not a priority within the book as a whole. However, the overarching theme of “flexibility within fidelity” reminds the reader that therapy must be culturally sensitive to the patient’s background.

The newest chapters on modular therapy, mindfulness, and dialectical behavior therapy rightly diverge from the standard format of the earlier sections, delving instead into the background and theoretical constructs of these less familiar modalities. Comparisons between these therapies and traditional CBT are fascinating and further cement their place within this textbook. Although the evidence reviews for these sections are understandably light, they pose interesting questions and directions for future research and clinical applications. Additionally, these chapters, along with others added in the third edition of the book, do an excellent job of pointing the reader to outside resources that the curious reader may investigate. It would be a welcome change if future editions of this volume added such a feature to all chapters and subjects.

Overall, this book mostly achieves its goal of educating the reader on the history and current applications of CBT in children and adolescents in a diversity of settings. It does not include specific treatment manuals; therefore, it serves more as a travel guide to the world of CBT rather than as a map to a specific destination. It is an excellent resource for students and clinicians who are interested in exploring this world. CBT novices will be drawn to the thematic consistencies and systematic approach, CBT experts may appreciate the broad survey of recent literature, and all will enjoy the glimpses into new and unfamiliar modalities.

© 2013 by Lippincott Williams & Wilkins