Cognitive-Behavior Therapy for Children and Adolescents

Cognitive-Behavior Therapy for Children and Adolescents

edited by Eva Szigethy, MD, PhD; John R. Weisz, PhD; and Robert L. Findling, MD. American Psychiatric Publishing, Washington, DC, 2012, 556 pages, $78.00 (paper with DVD included).

This edited volume is good news for anyone seeking a state-of-the-art, integrative text for use in training child and adolescent psychiatry residents how to deliver evidence-based psychotherapy and pharmacotherapy. While I suspect that Cognitive-Behavior Therapy for Children and Adolescents is especially suited to child and adolescent psychiatry training, it can be used equally well in child clinical psychology and other graduate programs, as well as by practicing professionals eager to learn state-of-the-art treatments for youth. Finally, clinical researchers will find ample ideas here as well.

The book contains 13 chapters covering detailed overviews of key issues and core clinical problems facing practitioners. The contributors are a stellar cast of some of the premier clinical researchers and practitioners in the fields of child and adolescent psychiatry and psychology. Each chapter includes an overview of the disorder, followed by concise, but detailed, discussions about the empirical status of cognitive-behavioral therapy (CBT) and pharmacotherapy for the disorder in question. Each chapter discusses the research findings from some of the largest and most comprehensive randomized trials in the field. Concise, practical descriptions of treatment manuals are provided, as are guidelines for implementation. These guidelines include discussions about the limitations of the treatment’s efficacy, including the impact of comorbid problems, family factors, and developmental issues. Each chapter ends with a summary of key clinical points, a detailed set of self-assessment questions, and ample references for further study.

The book begins with 4 chapters that set the stage for the clinical chapters: an overview of CBT, one on developmental considerations in using CBT, another on cultural factors in treatment delivery, and a final one on combined CBT and medication therapies. The lead-off chapter is an effective and comprehensive overview of CBT for youth, including both theory and techniques. The chapter is written by 2 clinical psychologists, including Dr. John R. Weisz, a leading researcher on applications of CBT to community settings. This is followed by a brilliant chapter on developmental factors in the delivery of treatment to youth. All who treat young people need guidelines on how to tailor CBT to them, and this chapter delivers. Next is an equally thoughtful chapter on treating children and adolescents from culturally diverse backgrounds. Drawing on research, the reader will emerge with a greater understanding of how to tailor treatment to the needs of African American and Hispanic youth and families.

The final introductory overview chapter covers the important topic of combined CBT and pharmacotherapy for youth. This chapter provides a detailed overview of the evidence, which is a must-read for trainees and practicing professionals. In an environment in which controversies abound regarding medication and overmedication of youth, it is vital that practitioners know the evidence, and its limits, for each disorder so that proper treatment selections can be made for CBT and medication singly or in combination. The results of the research, in contrast to the adult literature, may surprise the reader. I hope this teaser will invite a broad readership for this chapter, if no other.

Nine chapters follow, each covering a disorder or cluster of disorders for which substantial treatment evidence has accrued. Importantly, medical problems are covered in addition to the more common psychiatric conditions seen in child and adolescent psychiatry clinics. Chapters on depression and suicidal behavior, bipolar disorder, anxiety disorders, pediatric posttraumatic stress disorder, obsessive-compulsive disorder (OCD), disruptive behavior disorders, and encopresis and enuresis are presented. Each chapter is written by leading scholars and practitioners in the field, and each provides detailed treatment protocols, presented in a practical, "how to" manner, including handouts. Finally, chapters on chronic physical illness and obesity round out the clinical picture covered in this volume. The reader will learn about the research and treatment manuals used for the well-known Treatment for Adolescents with Depression Study (TADS) of youth depression, Phil Kendall’s Coping Cat protocol for anxiety, and trauma-focused CBT, among others. Each chapter focuses on assessment and how to engage children and families in treatment as well as how to incorporate psychoeducation and change strategies into treatment. The focus is equally on the scholarly and the practical, and each chapter will set the stage for further study by clinicians and researchers.

An added feature of the book is the inclusion of a DVD, which contains brief clinical simulations of CBT for 5 content areas: depression and suicide, anxiety disorders (using Kendall’s Coping Cat protocol), OCD, polycystic ovary syndrome, and disruptive behavior. The clinical interviews are conducted by experienced CBT practitioners and feature student actors who are highly credible in their portrayals of patients. Each vignette demonstrates a plethora of CBT techniques. One criticism is that more techniques are displayed in the vignette than are customarily possible in so short a time period.

This volume is truly a tour de force, a must-read book for practitioners and students in psychiatry and psychology. It should be seriously considered for use in any child and adolescent psychiatry residency program to insure that psychiatrists are well versed not only in medication treatments, but in the very powerful cognitive-behavioral therapies that have brought hope and healing to thousands of young people and their families.

Scott Temple, PhD

[email protected]

Author affiliation: University of Iowa College of Medicine, Iowa City.

Potential conflicts of interest: None reported.

J Clin Psychiatry 2014;75(3):e201 (doi:10.4088/JCP.13bk08942).

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