Health anxiety (previously referred to as hypochondriasis) is characterized by an excessive preoccupation about having a serious illness, or a significant fear of developing a serious illness, which persists despite medical reassurance.

Medical practitioners that treat physical health conditions are often untrained in addressing the anxiety that may accompany physical problems. Further, there appears to be a shortage of publications that assist the individuals providing physical treatment to understand health anxiety. This book seeks to fill that vacuum. Tackling Health Anxiety is written with the aim of assisting front-line medical professionals to recognize and treat patients with health anxiety. The author believes that the best way of successfully managing health anxiety is for multi-disciplinary medical staff to assess and treat patients for physical symptoms and health anxiety in the same location, rather than referring them to specialized anxiety clinics.

The book is well structured and divided into two parts. Part one outlines basic Cognitive Behavioural Therapy (CBT) principles and practice for Health Anxiety. It describes maintenance factors, formulation, and basic CBT session structure, including chapters on the style of CBT therapy, how to set and review homework, goal setting and relapse prevention. Clinical examples are used to illustrate theoretical points and there are frequent practical examples of how medical staff can explain concepts to patients. At the end of each chapter, there is a useful summary of main points. The book is successful in informing professionals unfamiliar with CBT principles.

Part two consists of seven chapters exploring health anxiety in specific medical contexts. Each chapter focuses on how to understand health anxiety in the context of the specific condition. Clinical case examples are provided. Chapters include neurology, respiratory medicine and genitourinary medicine. Each chapter highlights particular features of anxiety in that specific area of medicine, outlines useful CBT techniques, and discusses common problems encountered. Part two, provides more specific and detailed information about medical problems and primary physiological symptoms for various conditions. This provides a useful reference point for CBT therapists (both novice and experienced) seeking to increase their understanding of medical terminology, as well as assisting medical professionals in guiding their patients towards an alternative, less threatening, explanation of unpleasant physical sensations. For example, the chapter on cardiology outlines the medical illnesses that result in palpitations, and the medical investigations that will have taken place. This is informative and reassuring for the treating therapist. In the chapter on respiratory medicine, the author explains that breathlessness occurs as a consequence of anxiety, because rapid, shallow breathing causes hypocapnoea – a state of reduced carbon dioxide in the blood, and can cause tingling, dizziness, light-headedness, and wobbliness in the legs. Both examples provide useful information to assist therapy.

The book provides an accessible resource that will assist medical professionals to increase knowledge, awareness and skills to assess health anxiety. It is essential that psychological needs are considered in all areas of medical care. However, the rationale presented for training multi-disciplinary medical staff to deliver CBT for health anxiety necessitates a wider debate about how to best meet the patient's psychological needs. The author suggests treatment should be holistic in that physical and psychological symptoms are treated by the same practitioners, or at least in the same location. This may enable earlier intervention for health anxiety patients, which is important considering increasing therapy waiting lists, and may relieve pressures on specialist psychological services. However, multi disciplinary staff already have significant workloads and this may blur patient boundaries with on-going physical health problems. CBT requires in-depth training and supervision, as with any other type of therapy, which will incur costs. An alternative to the author's recommendations could be to have more resident CBT therapists based within hospital settings, requiring no staff re-training, and encouraging collaborative working.

Howsoever services develop an awareness of psychological health alongside physical health is a necessary and positive step forward in patient care. Consistent with its aspiration, the book is a useful resource. It is easy to read and jargon free. The tone is empathic and positive. To summarize, the book provides a comprehensive overview of the cognitive behavioural theory of health anxiety and helps the reader to better recognize, assess and formulate health anxiety problems. It provides a good overview of basic CBT skills and would be a useful reference for medical staff and CBT trainees with a particular interest in health anxiety.