176 BOOK REVIEWS

in the face of a chronic insufficiency in staffing resources may, if viewed cynically. reflect a process of marginalisation rather than one of professional achievement and development. Let us hope that new horizons do not turn out to be boundaries of acceptability on closer examination.

DOUGLAS FRASER

P. TROWER, A. CASEY and W. DRYDEN: Cognitive-Behavioural Counselling in Action. Sage, London (1988). viii + 152 pp. f7.95.

This is the most explicit and clearest guide to the practice of cognitive-behavioural therapy (CBT) that I have yet found. Drawing upon the various CBT approaches, leaning perhaps more to Ellis than any other, the authors provide a concise, yet detailed, step-by-step introduction to how a generic therapy of this type is carried out, with a case example taken through the whole process. Followed flexibly, these instructions would be invaluable to a beginner and useful to many. I found particularly useful and clear their systematic treatment of types of emotional cognitions with appropriate interventions. Also, their discussion of common problems is well done.

For such a slim volume, their coverage of some components of therapy is necessarily brief. For example, in their description of the initial assessment phase, the gap between open, client-centered exploration of problems and cognitive- behavioural analysis of emotional incidents, seems to me to be potentially a large one that takes as read some key behavioural methodology. I think this makes the book more useful to a reader with a background in psychology than to someone completely fresh to the field. I shall recommend it without hesitation to my trainee clinical psychologists.

RUTH WILLIAMS

R. C. ROSEN and J. G. BECK: Patterns of Sexual Arousal-Psychological Processes and Clinical Applications. Guildford Press, New York (1988). xiii + 404 pp. f26.95.

This is one of those rare volumes which combines interesting reading with an authoritative reference book. The style is emminently readable and the presentation is clear with well thought out headings allowing selective reading and quick reference.

The areas reviewed range from the historical, through current views in endocrinology and psychophysiology of dysfunctions and deviations, to conclusions on future directions. The authors do not shy away from controversial or poorly understood areas, and are appropriate and constructive in their criticisms of research.

Most of the chapters contain a section considering the relevance of the psychophysiological data to treatment issues. This integration of physiology, psychology and clinical issues is the logical and essential step to our further understanding of human sexuality.

Unfortunately, despite publication in 1988, I was disappointed to find some areas were not absolutely up to date, the most notable example being erectile function and dysfunction. Major developments in diagnostic procedures and treatments have occurred during the 1980s which receive little or no attention. As long as the reader is aware of this, however, this does not greatly limit the usefulness of the book. We must all eventually refer to journals to keep fully abreast of developments, and Rosen and Beck are offering us the background reading to do this with maximum benefit.

Although researchers will find this book essential, I would also highly recommend it to clinicians, behavioural, medical and eclectic, who will find in it data and comment of direct relevance to their work.

ALAIN GKEGOIKE

S. MCOREY and S. GREER: Psychological Therapy for Patients with Cancer: A New Approach. Heinemann Medical Books, Oxford (1989). xiii + 233 pp. f 14.95.

This book presents a new brief therapy the authors call Adjuvant Psychological Treatment (APT) for cancer patients. This is in fact a how to do it manual. The authors introduce the psychological effects of cancer and the personal meanings and resources cancer patients utilise. APT is intended for use across a broad spectrum extending from people with no abnormal symptoms who want help in fighting and coping with cancer to those with definable cancer illness. The adjustment styles can be seen as cognitive schemata. The focus in APT like cognitive behaviour therapy is cognitions as well as behaviour. Ventilation of feelings, behavioural techniques and cognitive techniques are used in the therapy. The authors are involved in a trial of APT and they include the research design in the manual. We await the results with interest.

The book is concise, lucid and highly readable. The examples of the patient case histories add to the value of the book. The literature review is comprehensive and the review of the role of psychotherapy in improving quality of life particularly good. The beginning, middle and the end of therapy are described with clearly set out aims and the recommended number of sessions. The use of therapy with couples is encouraging and helpful. In times to come, APT deserves to gain wider support and the manual is one way forward.

However, one or two proof-reading mistakes become glaring and, in view of the lack of any data, Chapter 11 could have been easily left out. The advocated use of APT in other illnesses like multiple sclerosis and AIDS could have been easily expanded. This is understandable since the book focuses on therapy with cancer patients. For this reviewer, the value of the book would have increased even more had the authors included more on termination of therapy and perhaps a chapter on difficult patients. These criticisms apart, the book is excellent value and recommended for use by those who are involved in caring for cancer patients.