Cognitive-Behavior Therapy for Severe Mental Illness: An Illustrated Guide

Over recent years, cognitive-behavior therapy (CBT) has gained evidence of its effectiveness in improving the lives of persons with severe mental illnesses. Psychiatrists have learned through experience and research that medications alone cannot bring a person to recovery. We have also learned that the evidence base alone cannot bring even a motivated clinician to feel competent and confident in implementing best practices.

Cognitive-Behavior Therapy for Severe Mental Illness is an illustrated guide that provides a book, a DVD, and a bridge to improved treatment for persons with schizophrenia, bipolar disorder, and depression. All four authors are respected authorities in the field of CBT. Dr. Wright is author of five books, author of the first multimedia program for computer-assisted psychotherapy, and founding president of the Academy of Cognitive Therapy. Dr. Kingdon and Dr. Turkington, both from the United Kingdom, provide a depth of experience and expertise in the area of CBT for schizophrenia. Dr. Basco, also internationally recognized in CBT and a founding fellow of the Academy of Cognitive Therapy, is an expert on CBT for bipolar disorder.

The authors construct foundation chapters, which include the building blocks of engagement and assessment, normalizing and education, case formulation, and treatment planning. With this groundwork completed, the reader builds skills further with CBT strategies to target the illnesses' core components that affect daily living, which range from impaired cognitive functioning and negative symptoms to mania and depression to challenging interpersonal problems. The authors generously share their knowledge by providing worksheets and checklists in an appendix to help clinicians and patients implement CBT.

The chapters include a range of educational modalities for learning CBT: case formulations, key points for clinicians, concepts and skills for patients to learn, scripted therapist-patient dialogues, and learning exercises that engage the readers to understand empathically the patient's situation. In addition to the well-written text, the DVD provides video illustrations of each of the authors working in five patient scenarios, addressing the challenges for persons with schizophrenia, bipolar disorder, and chronic depression. The 18 video episodes of clinician-patient sessions also elaborate on specific techniques to address crucial topics, including CBT for treatment adherence and suicide risk, as well as treatments for the hopelessness of depression, the grandiosity of mania, and the resistant delusions and hallucinations of schizophrenia.

Some noticeable absences are worthy of mention. For example, the authors chose not to address the use of CBT for co-occurring substance use disorders. However, given their high co-occurrence with severe mental illness and especially given the high impact of alcohol and substance use on function, morbidity, and mortality for this population, attention to CBT for this high-risk area would have been welcomed. Although suicide is addressed, more focus on use of CBT for risk reduction strategies for aggression would have been helpful. Also, given the expertise, experience, and teaching skills of the authors, having video illustrations of supervision with the clinician explaining clinical strategy would have provided another dimension for learning.

Despite these absences, this innovative volume is a "must have" for clinicians who serve persons with schizophrenia, depression, and bipolar disorder. It is also a fine resource for peer support specialists to consider. Cognitive-Behavior Therapy for Severe Mental Illness is truly an illustrated guide not only to read but to experience, including the DVD, with or without popcorn.