Cognitive therapy (CT) for schizophrenia has evolved greatly over the past 20 years, and I have read a number of very good texts on its theory and practice. However, to my mind, this book manages something that none has yet achieved: it provides an authoritative, measured, clear and up-to-date overview of a huge breadth of material, whilst giving sufficient depth to leave the reader satisfied that they know enough to inform good clinical practice.

The book falls into two roughly equal parts, with theoretical issues (Chapters 1–6) followed by clinical topics (Chapters 7–14). The first chapter gives an overview of the epidemiology, genetics, neurobiology, neurocognition, treatment and outcome of schizophrenia, before moving to an overview of CT for each of the main symptoms of the disorder. This chapter alone is highly recommended to any clinician who wants a state of the art introduction to these topics. Chapter 2 on “Biological Contributions” argues convincingly that cognitive therapists should understand some of the neurobiology of schizophrenia. The clear writing style helps the reader get to grips with some of the complexities of the neuroanatomy and neurochemistry of the disorder, something that I have often found rather less transparent in other sources.

Chapters 3–6 present the authors’ cognitive models of delusions, auditory hallucinations, negative symptoms and formal thought disorder. Each chapter brings together the main findings from the theoretical literature on each of these symptoms, imposes a (usually) coherent structure upon the data, and brings the material to life with examples from the authors’ clinical work. From a UK perspective, I was a little surprised that the chapter on delusions did not include more discussion of Garety and colleagues’ model (Reference Garety, Kuipers, Fowler, Freeman and Bebbington2001), which distinguishes between anomalous experiences and patients’ interpretations of these experiences. I particularly welcomed the theoretical chapters on negative symptoms and formal thought disorder, as treatment of these has been underemphasized to date in CT manuals. These latter two chapters incorporate recent research material and provide the clinician with many useful ideas to aid formulation with these patients.

Chapters 7 and 8 give a comprehensive overview of the assessment process in CT for schizophrenia and how to engage patients. The “Assessment” chapter gives a useful summary of the main clinical interviews and rating scales currently available. Chapters 9–12 then build on the earlier theoretical chapters, presenting a thoughtful and detailed account of cognitive assessment and therapy for delusions, auditory hallucinations, negative symptoms and formal thought disorder. These chapters provide clinicians with useful checklists of areas (especially types of belief) to be covered at assessment and the treatment sections give a comprehensive overview of the main cognitive behavioural techniques that can be employed. Many of these interventions will be familiar to clinicians, but the authors also present some of their own innovations, especially for treatment of negative symptoms and formal thought disorder.

The penultimate chapter provides a detailed and clear exposition of the pharmacodynamics of anti-psychotic medications and potential issues that can arise in interactions between CT for schizophrenia and medication management. The book ends with a tour de force, a chapter in which the authors attempt to integrate current neurophysiological findings in schizophrenia with their cognitive model of the disorder. The authors refer briefly here to other research groups (mainly in the UK) who have recently attempted a similar integration; it would have been helpful to see discussion of commonalities and differences in these approaches.

Beck and colleagues’ new book is very comprehensive, but I would have liked to have seen a chapter on cognitive and behavioural approaches to family work with patients with schizophrenia. Working in a Community Mental Health Team, I often find that complex presentations benefit from cognitively and behaviourally informed family work, in addition to individual sessions of CT with the index patient. The book follows the general format of many CT texts in its focus on good outcomes. This sends out the positive, and valid, message that working with this population can be very rewarding. However, I must confess to rather variable outcomes with some of the people I have worked with using CT for psychosis, despite attempts to formulate carefully under supervision. Therefore, I would encourage the authors of the second edition of this text to include examples of less successful outcomes, with discussion of potential reasons for this.

These minor quibbles aside, I recommend this book wholeheartedly to all clinicians with an interest in the cognitive theory and/or therapy of schizophrenia. It is an invaluable summary of the current state of the art.