This is a handbook to help individuals understand and treat substance misuse difficulties using cognitive behavioural therapy (CBT) techniques. It combines a grounding in the various theories of addiction, with clear information on the structure and techniques of the appropriate CBT interventions. While it is written in a style that can be easily understood by those with more limited knowledge and experience of CBT, the information provided in the intervention sections is sufficient to provide something of note for the more experienced therapist.

Although not designed as a manual, this book offers information on the specifics of CBT treatment in that it features vignettes, questions and behavioural experiments that would be helpful for those wishing to construct a high quality CBT intervention for a client with an addiction problem. Treatment guidance is strongly placed within the context of current service delivery, mentioning current initiatives such as Improving Access to Psychological Therapies (IAPT) and International Treatment Effectiveness Programme (ITEP) and how the handbook can be used to support workers in those fields. It is also clear in providing specific guidance on individual therapist competency, both in the use of this book and in the overall treatment of addictions using CBT.

The opening chapter reads as something of a manifesto for the use of CBT with addiction clients. CBT could be said to have suffered with this population following the decision by NICE to not recommend its use to treat substance misuse difficulties directly, but for use with comorbid presentations only. The authors refer to this decision and make a forceful case for the worth of using CBT in this population. Most notably, they point to the emerging importance of long-term recovery as a government target and the benefits of CBT in achieving long-term change.

There follows a comprehensive section on the current theories of addiction and a chapter on the fundamentals of a CBT intervention, covering issues such as engagement, treatment goals and the therapeutic relationship. A chapter on Motivational Interviewing (MI) might seem out of place in a CBT guide but the authors explain how it is routinely incorporated into a CBT intervention in this population to enhance engagement in therapy. For those familiar with more lengthy tomes on MI, this chapter is an excellent practical guide to the use of this technique that will no doubt be widely photocopied for those in need of a quick guide.

The chapter on assessment provides an excellent description of assessment within the context of services where generic assessments are provided prior to the person seeing a therapist. It separates out the specific cognitive-behavioural parts of the assessment and should provide clarity for those working within such a context. The authors go on to develop the idea of formulation in the next chapter. They cleverly incorporate developmental and situational formulations into a “case-level” formulation, using Beck's cognitive model and Padesky's 5-part model within the “5-Ps” structure, from “predisposition” to “protective” factors. This is a highly practical and comprehensive cognitive-behavioural formulation that could easily be used with other disorders.

The final three chapters focus on specific cognitive-behavioural techniques. These cover the common cognitive distortions in addictions and their appropriate interventions, techniques for challenging beliefs and behavioural experiments (BE). In some sense the whole of CBT for addictions is a behavioural experiment, with the client believing that they cannot function without substances and the therapist using techniques to challenge this belief. However, some therapists do not consider BE in addictions work for fear of risking a relapse and thus it is useful to have this technique given specific attention in this book.

The last two chapters cover behavioural interventions and managing emotions. The former is dominated by a section on managing cravings but also includes stimulus control, activity scheduling and problem solving approaches. The chapter on managing emotions is extremely important given that many individuals use substances to avoid unpleasant emotions, and the recurrence of these emotions during abstinence is a major cause of relapse and disengagement with treatment.

A minor drawback of this publication is the sole focus on substance disorders in a book on “addiction”. The forthcoming inclusion of pathological gambling with substance related disorders in DSM-V reveals the increase in focus on behavioural addictions as an issue for treatment providers. It is also notable that although discussing learning theory in addictions and the potential for using contingency management in a CBT programme, it is not included in the behavioural interventions chapter.

In conclusion, this is a ground-breaking book that provides a comprehensive overview of the use of CBT with clients with addiction difficulties. It would be a useful guide for clinicians of varied experience looking to provide a first-rate CBT treatment for clients with addiction difficulties.