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Treating Stress and Anxiety: A Practitioner's Guide to Evidence-Based Approaches.

NEJAD, L., & VOLNY, K. (2008)

Bethel, CT: Crown House Publishing

Pp. ix-188, ISBN 978-184590077-9

Treating Stress and Anxiety: A Practitioner's Guide to Evidence-Based Approaches, by Lillian Nejad and Katerina Volny, is designed to provide clinicians with a comprehensive resource for treating disorders of stress and anxiety. It includes chapters on different types of anxiety disorders, methods for developing treatment goals, and a variety of behavioral and cognitive intervention strategies. The book presents information on preventing relapse and addressing comorbid conditions such, as substance abuse and depression. Two CDs accompany the book and provide relaxation exercises and handouts to supplement the interventions. It is designed as an all-inclusive book for providers treating disorders of anxiety and stress and has a number of strengths that make it applicable to providers from a variety of disciplines. However, there are also some areas that could be improved and ought to be considered when determining the usefulness of this book. The purpose of this review is to highlight the strengths and weaknesses of this resource.

The book begins by defining both stress and anxiety and describing how to differentiate between these experiences. It also includes brief descriptions of the disorders of anxiety, along with the recommended treatments for each and information on how to develop a treatment plan. After this, the authors provide information on health, relaxation, and cognitive and behavioral techniques for treating these conditions. The last section contains considerations for posttreatment planning as well as information on providing group psychotherapy for these conditions. The strengths of this book include the presentation of the information, the comprehensive amount of information, and the additional handouts and CD resources that accompany the book. However, the features that make this a useful book also contribute to its weaknesses.

The book is written in simple, easy-to-understand language that could be useful for practitioners from a wide variety of backgrounds, including psychology, social work, and nursing. The basic language used to explain the topics provides the clinician with easy ways of teaching concepts to patients. The chapters provide descriptions of symptoms, disorders, and treatments, as well as examples of each, which are designed to help facilitate understanding for clients. These explanations would be very useful for beginning practitioners. However, seasoned practitioners, particularly those who work with clients with more serious illnesses or cognitive impairments, may need more detailed explanations as well as additional examples for each concept. Further, for the more difficult concepts, such as cognitive aspects of anxiety disorders, there is an inadequate amount of examples and explanations in the book. It would be difficult to use these explanations with patients with cognitive deficits, such as those with traumatic brain injuries and comorbid anxiety symptomatology.

Nejad and Volny's book is a comprehensive resource that addresses all aspects of providing treatment for anxiety disorders, including the emotional, physiological, and cognitive components. It is also nice to see information about each disorder, treatment planning, treatment components, and posttreatment planning all in one book. The range of topics will help this book meet its goal of serving as an off-the-shelf resource for practitioners from a variety of backgrounds. One downfall to this all-in-one style, however, is the limited amount of detail allowed on each topic. There is minimal space devoted to each disorder, and this could make diagnosis difficult for more complicated cases that generally necessitate more detailed information. Still, it could be very useful in guiding the practitioner through various types of treatments once more complicated issues are sorted out.

The handouts, worksheets, and CD resources that are provided with the book add to its utility as an off-the-shelf guide for providing these treatments. The numerous handouts and worksheets are useful for inclusion as part of an intervention and are likely to save the time of practitioners who otherwise would have to develop these handouts on their own. Practitioners can use the handouts to assist them in providing psychoeducation regarding the disorders and treatments and can use the worksheets as homework assignments to promote generalization of skills between sessions. Although it is helpful to provide these handouts on a CD so that they can easily be downloaded and printed for clients, one difficulty is that the documents are provided in a .pdf format, requiring a clinician to convert the items to Word format in order to be able to modify them. While these sheets contain useful information, most clinicians would agree that it is important to tailor treatment to meet the specific needs of each client. Thus, it would be useful for practitioners to be able to modify these in order to incorporate examples that relate to the client and previous issues discussed in session, as well as to modify the language to assist those with cognitive impairments in understanding the information. Converting a pdf file into a Word document can be time-consuming and, thus, the format of these resources decreases the book's usefulness for the therapist within the session.

Additionally, there is an impressive number of relaxation exercises that certainly allow the client a choice of activities. Having a CD with relaxation practices on it is a pleasant addition to a book such as this; however, the exercises can be difficult to follow at times. In particular, the explanations for how to tense and release muscles during progressive muscle relaxation may be hard for both the patients and therapists practicing them to understand. There are also some exercises that do not provide a clear ending, This can be challenging for many patients who need a little more guidance when it comes to relaxation practice. Still, it is unusual to have such a resource with a book like this, and there are a variety of different types of exercises presented on the CD, which allows for flexibility in choosing the most suitable type of relaxation.

Overall, this book serves its purpose as a manual that clinicians can use during sessions to help them direct their treatment, provide psychoeducation, and assign homework. The book is comprehensive and well organized and includes a number of extras, such as CDs and handouts, that are unique for this type of resource. Practitioners working with more complicated cases may need more detailed information on these disorders and may also re-quire additional explanations and examples that relate to their clients. Additionally, there are some minor challenges in using the handouts, homework assignments, and relaxation CD that could be improved. However, this book is recommended as an excellent resource for clinicians treating anxiety and stress and may prove to be particularly useful as an early training tool for young professionals. Lillian Nejad and Katerina Volny have put together a resource that is sure to become an important piece of any clinician's library.

Caitlin G. Schultz, Joanna Marino, John Campbell, and F. Richard Ferraro, University of North Dakota
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Author:Schultz, Caitlin G.; Marino, Joanna; Campbell, John; Ferraro, F. Richard
Publication:The Psychological Record
Article Type:Book review
Date:Mar 22, 2010
Words:1130
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