Cognitive Behaviour Therapy for Children and Families

This volume, with several authors addressing a dozen differing topics, is well positioned. Cognitive behavior therapy is clearly advancing on multiple fronts, not only clinically. It emerged to underpin a large number of psychiatric research applications in Australia last year. Its theoretical appeal is obvious. Unlike many psychotherapies, cognitive behavior therapy has made itself available to empirical testing. For those who prefer to resist psychopharmacological approaches, cognitive behavior therapy is an alternative that retains scientific as against sect credibility. If it is found to be effective with children and adolescents, it would allow population-based interventions to be mounted, primary (as well as secondary) prevention to be advanced, and tomorrow the world.

As a longstanding clinical treatment for adult disorders, nevertheless, cognitive behavior therapy has come under some recent challenges. For instance, King (1) suggested that it has high “treatment principle credibility” for both clients and practitioners but that its benefits are not necessarily derived from treatment-specific factors. How then does it hold up for children when, for instance, we are informed here in a chapter by Harrington and colleagues that preschool children “only rarely show evidence of learned helplessness,” that there “is little evidence” of cognitive schemata in children, and that children may not be mature enough to undergo cognitive behavior therapy in the same way as adults?

Editor Philip Graham notes that cognitive behavior therapy has been claimed to have a place in the treatment of most psychological disorders experienced by children and adolescents, that behavioral treatments appear more effective than nonbehavioral and family treatments, and (presumably a non sequitur) that all American authors invited to contribute declined the invitation.

The chapter format is standardized. Each disorder is defined; the rationale for a cognitive behavior therapy approach explicated; salient assessment, measurement, and treatment techniques noted; case examples provided; current research issues sketched; and existing evidence for cognitive behavior therapy for the particular condition considered. This is useful for those who seek to consider only one or two topic areas, but for those who tackle the whole book, predictable redundancy and overlap lead to attention deficits.

An introductory chapter by Ronen provides a useful background based on discipline and developmental stage, detailing age-relevant nuances and treatment principles. Other authors cover issues central to cognitive behavior therapy for children and adolescents (e.g., the common need to meld cognitive behavior therapy with a strong educational component and with family interventions). These are well argued and explicated, and numerous useful clinical strategies are detailed. The topics (e.g., attention deficit hyperactivity disorder, obsessive-compulsive disorder, anxiety and depression, conduct disorder, learning difficulties, posttraumatic stress disorder, pain, eating disorders, and interpersonal and socialization problems) are appropriate. Most authors meet the editorial request for an “intellectually satisfying theoretical framework” and for its evidence base. For one author, however, to state that the “potential” for those with even quite “severe” expressions of a disorder to benefit from cognitive approaches has “been confirmed”—and for the reader then to find that such a definitive statement is referenced to a single 10-year-old conference abstract—does strain credulity. “To your room” would appear a clear, specific, and direct alpha command response.

Thus, this book is well positioned in meeting a need for both the specialist clinician and those who might seek to understand broader issues such as the applications and limitations of cognitive behavior therapy for children and adolescents.