The authors of Mastery of Your Anxiety and Panic: Workbook for Primary Care Settings are distinguished researchers in the field of anxiety disorders, so one might be forgiven for having high expectations for its content. This book represents their attempt to extrapolate a cognitive behavioural self-help treatment approach, based on their extensive research. The book is designed for use in primary care settings and represents a distilled version of their treatment programme.

The Client Workbook is divided into six chapters, which correspond to the six sessions of the authors' modified Panic Control Treatment (PCT). These chapters are: The nature of panic disorder and agoraphobia; Learning breathing skills and understanding your negative thinking; Learning more breathing and thinking skills; Facing fear; Facing fear out there; and Planning for the future.

The first chapter begins with three useful case studies (although unfortunately these are not referred to again in the rest of the book). Also in this chapter is information about the diagnoses of panic and agoraphobia, unhelpful coping (such as avoidance and use of “safety signals” and a description of the “panic cycle” and “agoraphobia cycle”. The chapter then goes into a relatively large amount of detail about medication and the physiology of fear, which I feel might not be useful for all clients. The chapter ends with information about record keeping and has helpful demonstrations of this.

Chapters two and three cover negative thinking and controlling breathing. There is a relatively large emphasis on controlling breathing, which some therapists of a predominantly cognitive ilk might find off-putting. The information on negative thinking reads as being fairly dictatorial rather than Socratic. However, the worksheet pages do look very helpful for evaluating thinking.

Chapters four and five look at testing out fears, which in other language might be called behavioural experiments. The emphasis appears to be slightly more on exposure than testing predictions. The final chapter looks at bringing together the learning in the preceding chapters in order to come up with a plan for the future and is very practical in helping the reader to do this.

Overall this book has good and bad features. On the plus side, the size of the book (A4) is an advantage as a self-help workbook, since it is easier to imagine actually using the record sheets and other pages that the client can fill in. The repetition of several key concepts is useful and I think necessary in a book of this type. The chapters build on each other in a step-wise fashion and the homework suggestions are practical and achievable. I can imagine using parts of this book with clients to good effect.

However, on the negative side, the language used throughout the book is too technical and jargon-filled (clients do not, for example generally want to understand concepts such as “interoceptive conditioning”, p. 37). There is less emphasis on guided discovery in this book and larger focus on what could appear to be informing the client of the errors of their ways. To be fair, it is difficult to have a self-help approach to Socratic questioning (something that inherently needs a “questioner”), but at worst this could come across as being overly authoritative.

The fact the chapters build on each other could also be a negative aspect as it relies on the client reading the book from start to finish. Using this book in UK primary care settings might present the problem of the (understandable) American focus of the book (given the authors). This is primarily only a minor difficultly of language and the occasional reference to US-specific procedures and institutions, but it might be alienating for some readers.

As a self-help book it is also limited by the fact that the language used is fairly sophisticated. Given that the reading age of many clients may be well below average, I would predict many would struggle with this book. This is a general issue concerning self-help materials highlighted earlier this year in a paper in this journal (Martinez, Whitfield, Dafters and Williams, Reference Martinez, Whitfield, Dafters and Williams2008) which concluded that the reading age of many of the most popular self-help books is too high for much of the UK population.

Overall, I would use this book with high functioning clients who are motivated to change, can read the entire book from start to finish and for whom reading is not a problem. For these clients I think it would constitute an effective self-help programme, with or without therapist support. The book may also be a useful reference to use with clients in therapy, without expecting them to read it for themselves. For many clients, I think this book would be too dense, wordy and difficult to utilise.

The Therapist Guide, which accompanies the self-help book, has several chapters that correspond to the workbook and several additional chapters at the beginning and end that outline procedures and the model of agoraphobia. The guide has many case examples of discussions between therapist and client, which aim to problem-solve obstacles and generally enhance the therapist's approach to supporting the self-help programme. I found this book a useful addition to the self-help workbook and would recommend it if one was using the workbook with clients, as it would be a useful resource in this instance.