Routledge has commissioned a series on “Counseling and Psychotherapy with Boys and Men” and this book is volume 8 in that series. It is aimed at those already familiar with psychotherapy (it assumes a knowledge of psychotherapeutic fundamentals) and correctly focuses on building a deeper consideration of the older man.

The initial chapters address social theories and discourse on masculinity and aging. Initially this seems removed from routine psychiatric practice but the writers are quick to ground their words in day-to-day practice, making it pertinent for the jobbing clinician. Stress is put on what it is to be a man, the sociological scripts of masculinity and how adherence to these may explain particular behaviors. The healthy aging movement, which promotes youthful virtues such as strength, activity and virility, is critiqued with a warning that, for many, old age means being frail, dependent and helpless – a reminder of the wide range of possibilities that old age brings.

The practical work with older men is always stressed, but some of the advice is trite: for example, speaking up with the hearing impaired. However, other advice such as avoiding the use of modern street language – such as “hanging out” and “awesome” – is more helpful. Emphasis is placed on understanding a man's evolving history and, in particular, the transitions of later life such as retirement, changes in accommodation and end-of-life issues. The nature of relationships and how these can change with diagnoses such as cancer or dementia is explored, and how aging affects family relationships with spouse and children is addressed.

Later chapters deal with specific disorders such as depression, anxiety, chronic illness and disability, substance misuse and cognitive impairment. The role of the psychotherapies is encouraged and the helpfulness of pharmacology is pointed out, giving the book a well-balanced approach.

I was curious to know about the three authors, a little about their professional biographies and interests. Other than their job titles and where they work, nothing more is mentioned. This is a shame as it may well add authority to their collective voice.

Although Psychotherapy with Older Men is written for the American audience, much in it is helpful to anyone working within this field. The style is readable with many clinical examples used to illustrate material that could otherwise seem dry and hypothetical. The book does not stress any particular psychotherapeutic model but encourages a pragmatic approach to the individual. In short, it is an intellectually thought-provoking but also very helpful book, full of practical advice for clinicians working in this field.