This text is based on Professor Chris Williams' jargon free cognitive behavioural therapy (CBT) model integrating complex elements of cognitive behavioural theory into workable self-help techniques. Williams is the Director of Glasgow Institute of Psychosocial Interventions (GIPSI), which has a focus on training and research in evidence-based psychosocial interventions. The “five areas approach” explores links between “altered thinking, behaviour, feelings, physical symptoms and people and events around us”. This book has been integrated in primary and secondary care in three health board areas of Scotland and has resulted in a significant evidence base for its effectiveness.

As such, it should come as no surprise that this is an excellent interactive workbook that I would highly recommend to clients who do not meet the threshold for specialist CBT services. As described in the title, it explores stress, anxiety and panic. To put this into diagnostic terms, it refers to low levels of anxiety in the form of worry and stress, with chapters of the book directed towards symptoms commonly associated with panic disorder and social phobia. However, many of the techniques used are generalizable to features of other anxiety disorders.

The book is structured into two sections. The first assists the client in understanding the nature and development of their problems. There is careful introduction of the nature of the text to the reader with exploration of terms, relevance to the individual including symptom checklists, assistance in thinking about how to best use the text, promoting commitment, encouraging realistic expectations, and an understanding of the need for additional support and signposts to services if required. There is in depth explanation of the nature of worry, stress, panic and phobias, in a clear and easy to understand manner. This is built on with checklists and case examples to assist the reader in understanding the development of their difficulties. From this understanding, the interplay of triggers and appraisal are linked to physical symptoms, behaviour and emotions to form the “five areas assessment”.

Integral to part one of the book are 10-point scale ratings of difficulties that direct readers to relevant chapters in the second part of the book. This allows readers to direct their self-therapy towards specific problem areas and goal setting. The second section of the book is further subdivided into two subsections: first, changes relating to external causes, others and events, and second, changes that are more directly under the control of the reader.

The first subsection explores practical problem solving, assertiveness and anger management techniques. The second subsection explores sleep difficulties, the use of exercise, safety behaviours, avoidance, social phobia, thinking errors, depersonalization and hyperventilation. A common theme of the second section is a focused review of theory related to the specific difficulty, examining it from the patient's perspective with the use of individualized checklists. It then encourages the client to identify their difficulties relating to cognition and/or behaviour within the context of the model and then breaking these down with the assistance of a case example in step by step manner to specific interventions. These interventions include practical methods including exercise, problem solving, monitoring behaviour and thoughts, examining cost and benefits and setting goals involving changing behaviour and challenging thoughts. The chapter on cognition provides a checklist to assist in identifying thinking errors and uses extensive examples to illustrate functional analysis leading to the intervention of not acting on the thought, thought challenging, and a “worry box” for ruminations.

The workbook is well laid out, with clear formatting of text and space for clients’ contributions. Illustrations, by Keith Chan, are used effectively to capture the essence of the text. Individual chapters often use case examples for the reader to make short, medium and longer term goals, with encouragement of reflections on achievement and developing an anticipation of potential difficulties that may occur. Where relevant, chapters are completed with formal summaries from the author, with space for clients to provide their own summary. Planning is further operationalized into intended changes, methods and potential problems. Frequently a checklist then assists in forming specific SMART goals, to encourage ongoing interventions and review of improvement with a move to longer term goals and maintenance of gains.

Sources of extra help are highlighted throughout the text to assist those who may require more support than self-help can provide. There are links to free self-help material on the author's website to compliment the text with short talks and a moderated support group (www.livinglifetothefull.com). The author also offers a further website that features free Mp3 downloads, diaries, worksheets, along with paid content (www.fiveareas.com).

Overcoming Anxiety, Stress and Panic is a valuable addition to self-help books for those experiencing mild anxiety symptoms. It is useful both as a public health intervention for those who do not come into contact with health practitioners and for those whose care is managed by their General Practitioner. It may also benefit clients in mental health services who are not receiving CBT.