Greig and MacKay have written a practical guide to the Homunculi Approach: an engaging, interactive cognitive behaviour therapy (CBT) programme to help young people build emotional and social resilience. The programme is designed for young people on the autism spectrum or with emotional and behavioural difficulties, aged 8 and above. The book includes extensive resources and guidance for all who might want to run the programme, including psychologists, therapists, teachers, support workers and parents.

The Homunculi Approach is firmly rooted in CBT principles, focusing on the development of metacognitive skills to help change behavioural responses to difficult situations. Over the 10-week programme, the young person is invited to create a team of characters who live in their head, have special skills and gadgets available to them, and can be called on to help at a moment's notice. The characters and their gadgets are unique to each individual (or group, if appropriate) and relate to specific events such as being bullied or emotional outbursts in the classroom. During the 10-week programme, the young person is encouraged to use their Homunculi daily and notice how each character helps them change their behaviour. Cartoon strip templates provide a fun way to record the Homunculi in action and to reflect on progress.

Greig and MacKay start by explaining the origin and purpose of the Homunculi programme, including the theory and research that informed its design and the evidence that it works. A detailed step-by-step guide to running the programme follows, with a comprehensive set of resources, including sample templates and posters, suggested questions to ask the young person during sessions, and even information sheets to give out to parents and school staff when starting the programme. The resources that can be legally photocopied are clearly marked and most can also be downloaded. A short Frequently Asked Questions section provides help with troubleshooting when implementing the programme.

Along with the authors’ compelling enthusiasm for the innovative programme they have devised, the book's key strengths are its clarity and practicality. The theoretical basis for the programme is presented concisely and convincingly, drawing on evidence from a wide range of metacognitive, CBT and autistic spectrum research. Clear links are also made between NICE guidelines for treating autism and elements of the Homunculi programme design. Guidance notes for running the programme are suitably brief, to be read quickly before a session as a reminder, or even during a session, but sufficiently detailed to cover a range of implementation options based on available resources.

The evidence given for the effectiveness of the programme is less convincing. Greig and MacKay present some case studies and partial data from a study of 30 young people, involving two bar charts with no numerical labels and no statistical data to support them. Limited evidence for effectiveness should not be a barrier to making these high-quality, innovative resources available to practitioners, but the lack of hard data may deter those working in settings that require robust evidence-based practice. Evidence-based practice has a range of definitions, but randomization trials and replication of outcomes are important features (Weisz and Kazdin, Reference Weisz, Kazdin, Weisz and Kazdin2010). In the absence of such data, perhaps Greig and MacKay could have framed the book as an opportunity to make the Homunculi resources widely available and explicitly invited practitioners to use the resources to extend the empirical evidence base.

In conclusion, I would recommend this book to those who work with young people, particularly those on the autistic spectrum. It is a fun, innovative approach to helping building social and emotional well-being, with a strong CBT focus and clear theoretical basis. I look forward to using it with individuals as a pilot, but would hesitate to introduce it more extensively in a clinical setting until a stronger evidence base has been developed.