I wondered why we need another treatment manual for cognitive behavioural therapy for bulimia nervosa (BN) when there are already so many excellent ones (e.g. Waller et al., 2007; Fairburn, 2008; Schmidt and Treasure, 1993; Treasure and Schmidt, 1997; Cooper, 1993; Cooper et al., 2000). What more could there be to add? Indeed, in some ways I still do wonder. However, Cooper, Todd and Wells's clinician's guide to treating BN and binge eating disorders is a remarkably useful, well written, clear and easy read.

The first four chapters give an overview of BN, binge eating and their treatment, diagnosis and assessment and an overview of the theory to date. Chapter 5 details the authors' metacognitive model. Chapters 6 to 10 – the treatment manual itself – are sequentially presented in the order in which treatment is usually administered; engagement and motivation, formulation, negative and positive beliefs about eating, and negative self-beliefs. Finally, chapter 11 discusses the ending of therapy.

The model offers an explanation for both the development and the maintenance of BN. Indeed it differentiates between the types of beliefs that are involved in susceptibility to and the development of BN, and those present in its maintenance. In terms of maintenance, it proposes that three of both positive and negative beliefs exist, two of which, in each case, are metacognitive (e.g. that the thoughts and emotions associated with BN are dangerous). Significant in maintenance is the conflict between the positive and negative beliefs about eating. This is particularly useful as all patients who come to outpatient treatment hold both positive and negative beliefs and aiding change is difficult unless this conflict is addressed.

Littered with case examples, behavioural experiments and detailed guidance on particular therapeutic techniques, this treatment manual is an excellent practical, step-by-step guide to treating patients with these conditions. The authors acknowledge that treatment often encounters setbacks and hurdles, and they reassure that this is common and offer strategies for dealing with such setbacks. Particularly useful are the sections on detached mindfulness, permissive thoughts, “yes-but” statements, and negative outcomes to behavioural experiments.

The chapters are relatively short with a very useful summary giving the key bullet points at the end of each chapter. Tables and text boxes are provided throughout with examples of questions to ask patients, sample dialogues, techniques to use in certain circumstances and possible explanations to give to patients when explaining particular elements of treatment.

The appendix is invaluable, offering a large range of “therapist resources”. Included are a sample assessment letter, information on the consequences and dangers of BN, myths about BN and cognitive therapy, numerous worksheets and assessment and treatment questionnaires. There is a worksheet or piece of guidance for numerous scenarios that arise during treatment.

Despite there being other recent cognitive therapy textbooks and manuals for the treatment of eating disorders and BN, Cooper, Todd and Wells have produced an excellent, highly accessible and practical treatment guide. All clinicians working with BN will benefit from using this book.