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Treating anxiety disorders—A guide for human service professionals
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BOOK REVIEWS
Schneider J. (1984) Stress, Loss. and Griefi lhderstanding Their Origins and Growth Porenrial. University Park Press. Baltimore. Worden J. W. (1982) Grief Counseling and Grief Therapy: A Handbook. Springer, New York. FRANCES CLEGG
D. ROWANand C. EAYRS: Fears and Anxieties. Longman, London (1987). pp. xii + 106. f3.95, B. A. THYER: Trearing Anxiety Disorders-A Guide for Human Service Professionals. Sage, Newbury Park (1987). 144 pp. 58.95. These two paperbacks share a similar outline but differ greatly in depth of presentation. Both are concerned with the nature, assessment and treatment of the anxiety disorders, viz. simple and social phobias, agoraphobia. panic disorder, generalised anxiety and obsessive-compulsive disorder. The book by Rowan and Eayrs is the latest in the Longman Applied Psychology series and, in the promotional literature, claims to “go into sufficient depth to meet the needs of students at all levels and professionals, yet remain within the gasp of the interested general reader.” What Rowan and Eayrs in fact achieve is a tightly presented introductory reader for the undergraduate student or layman which unfortunately omits to examine some new developments in the understanding and treatment of panic disorder (the work of Clark and Salkovskis among others) and in the classification of the anxiety disorders (Spitzers and Williams, 1983). Thyer’s book, on the other hand, is specifically targeted at the “human service professional” market and, in my opinion, appropriately so. It was both pleasant and instructive to find such a short book to be packed with empirical studies, illustrated with case histories and written in a lively, engaging style which permits excursions into Greek mythology, the history of psychiatry and English literature. There are few areas in which I would feel inclined to disagree with Thyer’s interpretation of the research literature (to which he has, by the way, contributed substantially). One minor quibble concerns his advice on the management of simple and social phobias: “First, long sessions are better than short ones. By long I mean sessions on the order of two or more hours. It has been experimentally shown that two consecutive hours of therapeutic exposure produce significantly greater clinical benefits than four half-hour separated sessions (Stern and Marks, 1973)” @. 46). The study to which he refers examines the use of flooding with agoraphobic patients and the results cannot simply be extrapolated to other types of phobia. Indeed the earlier work by Marks, Boulougouris and Marset (1971) clearly suggests that desensitisation is more effective than flooding in “focal phobias” and that flooding is superior only in the treatment of agoraphobia. A second conclusion which I would dispute is that the hyperventilatory syndrome can be differentially diagnosed by asking the patient to hyperventilate intentionally. “If the symptoms produced are identical in type and magnitude to those they associate with their self-reported panic attacks then treatment should be directed towards the H.V.S. itself and usually involves directive training in proper breathing. _” (p. 70).
BOOK REVIEWS
Schneider J. (1984) Stress, Loss. and Griefi lhderstanding Their Origins and Growth Porenrial. University Park Press. Baltimore. Worden J. W. (1982) Grief Counseling and Grief Therapy: A Handbook. Springer, New York. FRANCES CLEGG
D. ROWANand C. EAYRS: Fears and Anxieties. Longman, London (1987). pp. xii + 106. f3.95, B. A. THYER: Trearing Anxiety Disorders-A Guide for Human Service Professionals. Sage, Newbury Park (1987). 144 pp. 58.95. These two paperbacks share a similar outline but differ greatly in depth of presentation. Both are concerned with the nature, assessment and treatment of the anxiety disorders, viz. simple and social phobias, agoraphobia. panic disorder, generalised anxiety and obsessive-compulsive disorder. The book by Rowan and Eayrs is the latest in the Longman Applied Psychology series and, in the promotional literature, claims to “go into sufficient depth to meet the needs of students at all levels and professionals, yet remain within the gasp of the interested general reader.” What Rowan and Eayrs in fact achieve is a tightly presented introductory reader for the undergraduate student or layman which unfortunately omits to examine some new developments in the understanding and treatment of panic disorder (the work of Clark and Salkovskis among others) and in the classification of the anxiety disorders (Spitzers and Williams, 1983). Thyer’s book, on the other hand, is specifically targeted at the “human service professional” market and, in my opinion, appropriately so. It was both pleasant and instructive to find such a short book to be packed with empirical studies, illustrated with case histories and written in a lively, engaging style which permits excursions into Greek mythology, the history of psychiatry and English literature. There are few areas in which I would feel inclined to disagree with Thyer’s interpretation of the research literature (to which he has, by the way, contributed substantially). One minor quibble concerns his advice on the management of simple and social phobias: “First, long sessions are better than short ones. By long I mean sessions on the order of two or more hours. It has been experimentally shown that two consecutive hours of therapeutic exposure produce significantly greater clinical benefits than four half-hour separated sessions (Stern and Marks, 1973)” @. 46). The study to which he refers examines the use of flooding with agoraphobic patients and the results cannot simply be extrapolated to other types of phobia. Indeed the earlier work by Marks, Boulougouris and Marset (1971) clearly suggests that desensitisation is more effective than flooding in “focal phobias” and that flooding is superior only in the treatment of agoraphobia. A second conclusion which I would dispute is that the hyperventilatory syndrome can be differentially diagnosed by asking the patient to hyperventilate intentionally. “If the symptoms produced are identical in type and magnitude to those they associate with their self-reported panic attacks then treatment should be directed towards the H.V.S. itself and usually involves directive training in proper breathing. _” (p. 70).