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Book Review   |    
Lon C. Herman
Psychiatric Services 2009; doi: 10.1176/appi.ps.60.10.1407
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by Aaron T. Beck, Neil A. Rector, Neal Stolar, and Paul Grant; New York, Guilford Press, 2008, 418 pages, $45

Mr. Herman is director, Best Practices in Schizophrenia Treatment (BeST) Center, Department of Psychiatry, Northeastern Ohio Universities Colleges of Medicine and Pharmacy, Rootstown, Ohio.

For graduate students, residents, current practitioners, and others seeking a single body of work to deepen their understanding of schizophrenia and treatment approaches benefiting those affected by the syndrome, Schizophrenia: Cognitive Theory, Research, and Therapy is made to order. Cognitive therapy is increasingly used as a treatment option for people with schizophrenia who experience persistent symptoms, and this volume provides a compelling, though even-handed approach, for considering this treatment option.

The authors are recognized leaders in promoting the cognitive model of schizophrenia and its treatment. Yet, this book goes well beyond the model by providing a concise, historic overview of how schizophrenia has been conceptualized and addressed and how contemporary biological knowledge can be integrated with the cognitive model to address this serious disorder.

The four primary symptom categories that characterize schizophrenia—delusions, hallucinations, negative symptoms, and formal thought disorder—are introduced through case studies, followed by grounding in the theoretical and practical strategies that can be utilized to engage and treat. The scientific evidence underpinning each of the treatment approaches described throughout the book is accessible and balanced. In addition, the authors have provided a series of tables and guides for assessment and treatment in each of the major symptom areas.

A separate chapter is devoted to the relationship between cognitive therapy and pharmacotherapy, with a focus on the need for integrating the two approaches among therapists and psychiatrists.

As a therapeutic intervention embedded within a recovery orientation, the authors stress the need for establishing effective, patient-empowering therapeutic relationships. To achieve this goal, the book provides a thoughtful examination of assessment options and methods. A brief review of assessment rating scales, interviews, and tests is presented, along with a description of their empirical support and practical administrative considerations. The basic structure of cognitive therapy for people with schizophrenia is laid out in a bullet-pointed table providing an overall structure for therapy; a second table outlines the components of a typical 25- to 50-minute cognitive therapy session.

The book concludes with the sharing of a number of useful instruments, such as the Beck Cognitive Insight Scale and the Cognitive Assessment of Psychosis Inventory.

In developing this book, the authors clearly set a high bar with an ambitious set of objectives: providing a historical overview of schizophrenia; describing the syndrome's etiology; synthesizing theory, research, and practice; offering cognitive and biological perspectives; and providing practical advice to treatment providers. In each instance, the book has met the challenge. It is recommended for professionals across health disciplines as well as others interested in state-of-the-art treatment approaches to schizophrenia.

The reviewer reports no competing interests.




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