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Back to Life, Back to Normality: Cognitive Therapy, Recovery, and Psychosis

by TurkingtonDouglas, KingdonDavid, RathodShanaya, WilcockSarah K.J., BrabbanAlison, CromartyPaul, DudleyRobert, GrayRichard, PeltonJeremy, SiddleRon, and WeidenPeter. Foreword by BeckAaron T.. New York, Cambridge University Press, 2009, 198 pp., $28

Self-help books have proliferated to take over entire sections of consumer bookstores. Notably absent on these shelves have been titles addressed to persons seeking relief from psychosis. Now 11 authors have teamed up to offer an optimistic and empowering guide to cognitive-behavioral therapy (CBT) written specifically for these individuals and secondarily for others involved in their care. Aaron T. Beck, the progenitor of CBT, provides a foreword with his endorsement.

An introduction by Douglas Turkington and Peter Weiden makes the point that the benefits of CBT for psychosis "usually develop slowly following a period of joint work" (p. 5). As such, the text is not recommended for use by the consumer alone (or "service user," as the book notes in its consistently British usage). It is meant to be a complement to modalities including medication, therapy, rehabilitation, and employment.

Turkington and Weiden assert that for schizophrenia and other disorders involving psychosis, CBT is the psychotherapy supported by the most extensive scientific research base. Indeed, Turkington in particular has contributed substantially to this literature. Readers should appreciate, however, that few citations are provided, in keeping with the book’s consumer-oriented nature.

Through the book, readers can explore the nature of normality, paranoia and unusual beliefs, voices, negative symptoms, medication, vulnerability to psychosis, and ways to stay well and manage setbacks. Turkington’s chapter on voices contains material from the Hearing Voices Network, a recently developed organization that works to destigmatize and normalize psychotic experiences. Sarah K.J. Wilcock contributes a chapter explaining how CBT can help friends and family members of a psychotic person to cope better and become active participants in the loved one’s recovery.

The chapters contain a rich mix of intellectual exploration and simple exercises designed to get or keep one’s life on track. These variable approaches are to be expected in a compiled volume but may not be ideal for a disoriented person needing consistently realistic, practical instruction. The chapter on tablets and injections contains detailed pharmaceutical information (some of the drugs cited are appropriate for a British audience).

The cheerful tone and generously positive advice make this guidebook an especially helpful contribution to the clinician’s collection. As the introduction notes, CBT is safe and easy to learn. It should be more widely used with psychotic individuals. Patients, their family members, and clinicians could greatly benefit from this book as it covers these topics in a friendly workbook style with exercises. We have already recommended it in our clinic.

Augusta, Ga.

The author reports no financial relationships with commercial interests.

Book review accepted for publication June 2009.