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The psychological treatment of insomnia
137
BOOK REVIEWS
such as beliefs and attitudes, perception of control and self-confidence. The third section is about the psychological effects of exercise in both normal and clinical populations. The possible mechanisms which may operate when people perceive psychological benefit from exercise are also reviewed. The final section of the book outlines a number of ways in which health professionals can help people adopt and maintain exercise programmes. A number of cognitive behavioural strategies in promoting participation in exercise are discussed. In conclus?on, this-reader-friendly book provides a comprehensive review of the research literature bringing together the fields of exercise, psychology and public health. Professionals and students in health psychology and other related fields will find this book both of great interest and benefit. DANIEL LEGRANGE
W. DRYDEN and R. RENTOUL (Eds): (1991). xiv + 370 pp. f15.99.
Adult
Clinical Problems-A
Cognitive-Behavioural
Approach.
Routledge,
London
This book is aimed at recently qualified clinical psychologists, those in clinical training and psychology students, with chapters on depression, anxiety, anger, violence, eating disorders, alcohol and drug problems, schizophrenia, the elderly, mental handicap, interpersonal problems and family and marital difficulties. The first chapter discusses the historical context in which cognitive approaches have developed and considers methodological issues in adult clinical psychology. A standard format is then used for the subsequent chapters. Initially a cognitive-behavioural view of the area is presented. This is followed by a discussion of cognitive-behavioural assessments and treatments, with particular emphasis on the efficacy of different treatment components. Finally, future developments in each area are considered. While the format is similar across chapters, the emphasis varies considerably. This partially reflects the degree to which cognitive and behavioural approaches have become established in each particular area, but it means that chapters differ considerably in their practical utility. For example, Max Birchwood’s discussion of schizophrenia is very treatment-oriented, looking at different aspects of the multi-faceted approaches needed in the disorder and highlighting the increasing role of psychological interventions. This contrasts with the chapter on anxiety where the stress is on cognitive-behavioural models and theories of the disorders rather than on the particulars of treatment. Also, the coverage in each chapter is of necessity very different; a consideration of all the problems of elderly clients in 25 pages will obviously be more diverse and “bitty” than the same length chapter devoted entirely to depression. Chapters on the growth of cognitive approaches in areas where such developments are more recent, such as mental handicap, provide a useful overview for those not working in the area, but might be less satisfactory for those within that speciality. These points are inherent in the book’s structure and mean that, while it is generally well written, discussion of large or complex areas can be overly brief. It also makes it unclear what real role the book has. As an introduction to cognitive-behavioural approaches, it provides an interesting overview, but often lacks the practical detail needed by clinical students. Also, in some areas, greater discussion of general theory would be helpful as it sometimes assumes a degree of background knowledge inappropriate for undergraduates. However, while it does not necessarily provide a “systematic, in-depth coverage” of cognitive-behavioural approaches to adult clinical problems and their treatment, given its competitive price, it may be a fairly useful addition to clinical libraries. CATHERINECAMERON
C. A. ESPIE:The Psychological
Treatment
of Insomnia.
Wiley, Chichester
(1991). xvi + 260 pp. f16.95.
Insomnia is a widespread problem which catches up with most of us sooner or later. One of its main attractions to investigators lies in the ease with which some of its characteristics, notably time to fall asleep, can be defined and influenced. The first five chapters review the nature of sleep and insomnia, models of insomnia and the assessment of insomnia. The remaining five chapters, on treatment, are written like a Ph.D. thesis, critically appraising study after study. The author adopts that scientist-practitioner model which seeks mainly to make generalizations from such studies. For example, stimulus control is probably best suited to increasing the time spent in sleep; relaxation training is best at improving the quality of sleep. Very little attention is paid to single-case experimentation to determine unique influences on a person’s sleep or to test the effects of one treatment compared with another for that person. The chapter on assessment instead is mainly along traditional lines describing procedures for the measurement of the quantity and quality of sleep. The way in which the book is organised makes it difficult to find topics of particular interest such as influences on insomnia in the elderly or in children. Indeed, these topics receive little attention. The need for some elderly people to waken frequently to urinate might be met by the use of a nearby champer-pot rather than a weary, rousing trek to the toilet or a programme for stimulus-control or urinary retention. Altogether, this book presents a sound discussion of the psychological research literature on insomnia. Clinicians who are seeking answers to particular problems or ways of investigating them might be disappointed. The book is probably, therefore, best regarded as a valuable source book for researchers in insomnia. S.J. E. LINDSAY
BOOK REVIEWS
such as beliefs and attitudes, perception of control and self-confidence. The third section is about the psychological effects of exercise in both normal and clinical populations. The possible mechanisms which may operate when people perceive psychological benefit from exercise are also reviewed. The final section of the book outlines a number of ways in which health professionals can help people adopt and maintain exercise programmes. A number of cognitive behavioural strategies in promoting participation in exercise are discussed. In conclus?on, this-reader-friendly book provides a comprehensive review of the research literature bringing together the fields of exercise, psychology and public health. Professionals and students in health psychology and other related fields will find this book both of great interest and benefit. DANIEL LEGRANGE
W. DRYDEN and R. RENTOUL (Eds): (1991). xiv + 370 pp. f15.99.
Adult
Clinical Problems-A
Cognitive-Behavioural
Approach.
Routledge,
London
This book is aimed at recently qualified clinical psychologists, those in clinical training and psychology students, with chapters on depression, anxiety, anger, violence, eating disorders, alcohol and drug problems, schizophrenia, the elderly, mental handicap, interpersonal problems and family and marital difficulties. The first chapter discusses the historical context in which cognitive approaches have developed and considers methodological issues in adult clinical psychology. A standard format is then used for the subsequent chapters. Initially a cognitive-behavioural view of the area is presented. This is followed by a discussion of cognitive-behavioural assessments and treatments, with particular emphasis on the efficacy of different treatment components. Finally, future developments in each area are considered. While the format is similar across chapters, the emphasis varies considerably. This partially reflects the degree to which cognitive and behavioural approaches have become established in each particular area, but it means that chapters differ considerably in their practical utility. For example, Max Birchwood’s discussion of schizophrenia is very treatment-oriented, looking at different aspects of the multi-faceted approaches needed in the disorder and highlighting the increasing role of psychological interventions. This contrasts with the chapter on anxiety where the stress is on cognitive-behavioural models and theories of the disorders rather than on the particulars of treatment. Also, the coverage in each chapter is of necessity very different; a consideration of all the problems of elderly clients in 25 pages will obviously be more diverse and “bitty” than the same length chapter devoted entirely to depression. Chapters on the growth of cognitive approaches in areas where such developments are more recent, such as mental handicap, provide a useful overview for those not working in the area, but might be less satisfactory for those within that speciality. These points are inherent in the book’s structure and mean that, while it is generally well written, discussion of large or complex areas can be overly brief. It also makes it unclear what real role the book has. As an introduction to cognitive-behavioural approaches, it provides an interesting overview, but often lacks the practical detail needed by clinical students. Also, in some areas, greater discussion of general theory would be helpful as it sometimes assumes a degree of background knowledge inappropriate for undergraduates. However, while it does not necessarily provide a “systematic, in-depth coverage” of cognitive-behavioural approaches to adult clinical problems and their treatment, given its competitive price, it may be a fairly useful addition to clinical libraries. CATHERINECAMERON
C. A. ESPIE:The Psychological
Treatment
of Insomnia.
Wiley, Chichester
(1991). xvi + 260 pp. f16.95.
Insomnia is a widespread problem which catches up with most of us sooner or later. One of its main attractions to investigators lies in the ease with which some of its characteristics, notably time to fall asleep, can be defined and influenced. The first five chapters review the nature of sleep and insomnia, models of insomnia and the assessment of insomnia. The remaining five chapters, on treatment, are written like a Ph.D. thesis, critically appraising study after study. The author adopts that scientist-practitioner model which seeks mainly to make generalizations from such studies. For example, stimulus control is probably best suited to increasing the time spent in sleep; relaxation training is best at improving the quality of sleep. Very little attention is paid to single-case experimentation to determine unique influences on a person’s sleep or to test the effects of one treatment compared with another for that person. The chapter on assessment instead is mainly along traditional lines describing procedures for the measurement of the quantity and quality of sleep. The way in which the book is organised makes it difficult to find topics of particular interest such as influences on insomnia in the elderly or in children. Indeed, these topics receive little attention. The need for some elderly people to waken frequently to urinate might be met by the use of a nearby champer-pot rather than a weary, rousing trek to the toilet or a programme for stimulus-control or urinary retention. Altogether, this book presents a sound discussion of the psychological research literature on insomnia. Clinicians who are seeking answers to particular problems or ways of investigating them might be disappointed. The book is probably, therefore, best regarded as a valuable source book for researchers in insomnia. S.J. E. LINDSAY