This book review first appeared in The Independent Practitioner (AIP Journal) Summer, 2009, pp.15-16. The BACP own the copyright and it is reprinted here with their permission.
Beck’s Cognitive Therapy: Distinctive Features
ISBN 978-0415439527 £9.99
This book sets out to provide a concise account of Beck’s work against a background of his personal and professional history. It is divided into two parts. There are 15 short chapters which examine Beck’s contribution to explaining psychopathology, and then 15 more looking at Beck’s suggestions for the best methods of treatment. Within each chapter the author also attempts to view each topic in the light of current research and of other relevant theoretical or pragmatic positions. He attempts a lot in a mere 166 pages.
I enjoyed this book. The author communicates well, and the combination of the lightness of his style, and the corset imposed by the series editor, mean that the chapters deliver substance without crushing with impenetrable weight. I found the first half of the book to be the most rewarding. Wills gives a clear account of Beck’s contribution to the evolution of CBT theory. Throughout this section there is a definite sense of an empirical pragmatist at work, slowly moving away from psychoanalysis, using patient statements to build hypotheses, then testing these hypotheses and refining theory, starting with depression and then moving into other areas of psychopathology. Amongst other things Wills explains the use of imagery, the development of the different levels and types of cognition, the role played by emotion (the ‘Royal Road to cognition’) and the interaction with behaviour.
The second part of the book outlines the classic CBT ‘treatments’ – case formulation, homework assignments, thought records, structured and goal-oriented activities to challenge and rebuild thinking and behaviour. The importance of the collaborative relationship is discussed at length. The strength of this section is that the author does provide snippets of recent research that either validate or question particular approaches, although the practical implementation of the strategies are barely touched on.
Another strength of the book is the sense that judgements are informed by the realism of a practising therapist. For example, in the chapter on formulation as a means of developing focus for therapeutic work, Wills spells out the need for great sensitivity to the client’s particular situation in order to avoid robotic implementation of theory (‘CBT by numbers’).
Although I enjoyed the book I have a few reservations about it. First, in some ways, I was surprised by the lack of the specifically distinctive material for Beck. If Aaron Beck is the gentle angel of cognitive therapy, Alert Ellis is the rough diamond. Of course, such descriptions are unhelpful caricatures, but as I read this book I found that, for me, Ellis was always lurking in the background, and I could hear attendees on training courses asking: “Apart from differences in personality, what are the theoretical and practical differences between Beck and Ellis?” We occasionally have a specific answer – in chapter 7, for example, where the differences between Beck’s ‘dysfunctional thinking’ and Ellis’s ‘irrational beliefs’ are discussed . We also learn the reasons why Beck was less profligate with time and depth than his erstwhile psychoanalytic colleagues. However, for a lot of the time Beck’s distinctiveness has to be implied. However ably Beck is described, the backcloth needs more substance for his distinctiveness (the title) to be more fully appreciated.
My second reservation concerns not the book’s execution, but its conception. I do hope I am wrong, but I found myself wondering if this was a book in search of a target audience. I could not quite work out who it was aimed at. The cover claims that it will appeal to both newcomers and experienced practitioners wanting a succinct guide. Readers generally interested in Beck will want far more on his life and background. Equally, hard core CBT therapists may be disappointed by its introductory nature. However, those undergoing initial training in CBT will need a much more developed and practical approach – the book Wills co-authored with Diana Sanders (Cognitive Therapy: Transforming the Image, Frank Wills & Diana Sanders, Sage 2004) would better suit their needs.
What the book does well is give a brief introduction to Beck’s development, his originality, his rigour, his pragmatism, and his relaxed attitude about the ownership of ‘his’ model. Therapists who have some experience of using CBT, and who wish to have their understanding of one of the founders of their espoused model strengthened, will probably find this an informative and enjoyable read. Equally therapists from other backgrounds who are not looking for a CBT manual, but who wish to be more informed about the work of one of the three most cited authors in the counselling and psychotherapy literature, will find this concise book very helpful.
James Rye is a Director of Connections Counselling Ltd (http://www.connections-c.co.uk/) and works as a psychotherapist, counsellor, supervisor, and trainer.
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