Product reviews for Treating Stress and Anxiety

Bryan Royds MNZAC
Nejad and Volny are psychologists who work in public mental health, community health and private practice in Melbourne. They are to be congratulated for creating a very useful book for practitioners assisting adults with stress, anxiety and emotional resilience. The chapters and exercises are presented in a format that is easy to follow, with detailed references and Index. The Appendices provide recommended reading and websites for both clinicians and for clients. The chapter headings show the breadth covered:

  • A brief overview of anxiety and stress

  • Identifying presenting problems and treatment goals

  • Treatment for anxiety disorders

  • Maintaining emotional health

  • Relaxation and breathing exercises

  • The impact of thoughts

  • Facing fears

  • Relapse prevention

  • Other issues related to stress and anxiety

  • Group programmes to reduce anxiety

  • and enhance well-being

The approaches described are primarily from Cognitive Behavioural Therapy (CBT), supplemented with techniques from relaxation training, exposure-based methods and relapse prevention. There is also useful material on depression, substance abuse, self-acceptance, anger, communication skills, and healthy lifestyles (e.g. diet, exercise, sleep, social support and time management). All this advice for clinicians is supported by a CD with over 150 pages of handouts and worksheets that you can print for clients - the kind of resource it took me years to develop for my own practice.

These resources alone make this a valuable book for experienced CBT practitioners, and yet it is presented simply enough to be accessible for those new to CBT and the challenges of working with anxiety. Detailed strategies and worksheets are provided for the following generic treatment plan:
Nejad and Volny expect this to occur over seven to twenty hour-long sessions held a week or two apart. Of course this will depend on the clients capabilities and they do note that those with co-morbid Axis I and/or Axis II disorders may take considerably longer.

  1. Assessment and emotional health checkup.

  2. Provide education about stress and anxiety.

  3. Teach relaxation and breathing exercises to manage anxiety.

  4. Teach cognitive strategies to manage anxiety-provoking thoughts.

  5. Plan a hierarchy of anxiety- provoking tasks and plan desensitization activities.

  6. Develop relapse prevention strategies for future triggers and early warning signs.

This links to my only real disappointment with the book, namely that Nejad and Volny haven't really looked beyond CBT and conservative clinical psychology. There is a paragraph where they identify hypnosis as a useful evidence-based methodology “not covered here”, but there is no mention of other approaches. Either they don't know about these, or they believe that only CBT is sufficiently “evidence-based” - whereas I believe the leading edge of treatment methods is often years ahead of such research. Indeed, the work of CBT founder Albert Ellis was not evidence-based (in the limited academic-clinical sense) for over 20 years, but people still used their -˜radical new methods'. This book would be quite familiar to Ellis as a well designed application of his 30 year old methods, and it doesn't add a lot to what I learnt as a psychology student in the 1980's. Meanwhile many of us have been using methodologies such as NLP and SFT which developed beyond the basic CBT insights, which provide quicker and deeper solutions than those Nejad
and Volny describe, and which are only recently beginning to build an academic -˜evidence-base'.

However, this doesn't detract from the book's great value as a primer and manual of CBT-based approaches to assisting adults with stress, anxiety and emotional resilience. I fully recommend it for anyone looking for such a resource.
Guest | 16/06/2008 01:00
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