Lillian Nejad and Katerina Volny have produced not only a clinically effective method for addressing issues of stress and anxiety, but a method based upon empirical evidence. This is in keeping with modern psychology's cutting edge commitment to the clinical scientist model that will-”-and must characterize the work of all mental health practitioners in the future. This book is a must for every clinical bookshelf . Nejad and Volny are to be congratulated for their efforts. Countless troubled people will live happier, stress-free lives because of their work.

Nejad and Volny have approached the treatment of stress and anxiety through the eyes of a generic therapist. This book provides a simple 'off the shelf' reference guide and tool kit for practitioners from all modalities and professional backgrounds who work with clients experiencing anxiety and stress. The authors elegantly weave their way through a range of different approaches, all of which are underpinned through the empirical evidence base of cognitive behavioural therapy, and at the same time stay sufficiently generic in their language to ensure that all modalities are respected.

The evidence base presented is predominantly CBT, and the authors effectively balance referencing with what is in essence a 'how to' guide for managing stress and anxiety. Practitioners seeking a more comprehensive review of evidence base for psychological therapies may be frustrated by the lack of research critique.

In providing a comprehensive and holistic review, therapists within the wider modalities of psychotherapy and counselling, as well as nurses, doctors, and social workers, will find the approaches outlined in this book an effective adjunct to their own theoretical stance. Particularly helpful within the book is the accessible range of definitions that therapists might use to linguistically represent their service to the public, the health service or other purchasers of clinical care. The book provides a refreshing inclusion of strategies for self management of these potentially disabling and restrictive conditions, enabling an effective client/therapist partnership.



For therapists who wish to complement their work with this particular client group, the handouts, reference guides, worksheets and tips will provide a user friendly tool kit that can be used with clients, as well as a potential training resource.

In over 15 years as a practicing psychotherapist, I have seen a lot of people with anxiety disorders or mood disorders and, given the high co-morbidity of the two illnesses (Kessler et al., 1994), a lot of people with both. As debilitating as depression can be, I have often thought that anxiety, at least in its more severe forms, is the harder emotion for people to subjectively bear. Anxiety is just so distressing to feel.

Therefore, I was not entirely surprised by findings of a recent longitudinal study (Sareen et al., 2005) that the presence of any anxiety disorder, with all other mental disorders controlled, is significantly associated with increased prevalence of suicidal ideation and attempts. Further, the presence of any anxiety disorder

in combination with a mood disorder is associated with a higher likelihood of suicide attempts when compared with mood disorder alone. Add to this the facts that anxiety disorders are the most common of the mental disorders, with an early age of onset (Kessler et al., 2005), and we have strong reasons for

clinicians to be well versed in effective methods for alleviating disorders of anxiety.

An excellent resource to this end is Treating Stress and Anxiety: A Practitioner's Guide to Evidence-Based Approaches by Lillian Nejad and Katerina Volny. The authors are clinicians in Australia who specialize in cognitive-behavioral techniques for the management of stress and anxiety. I have a large number of

books on my shelves on the topic of anxiety, but I would recommend this source to seasoned as well as new clinicians. The book is distinguished by its clear, accessible language, intuitive organization, and, best of all, client handouts that are among the best I have seen. The authors present information and techniques found mostly in cognitive-behavioral approaches, with a little mindfulness thrown in, that have been found effective in clinical trials. Readers wanting a detailed review of relevant studies, however, will not find it here. Rather, the aim of the writing is to be psycho-educational, practical, and straightforward enough that clients as well as therapists can grasp the concepts presented.

Chapters initially present an overview of stress and anxiety, discuss how to clarify presenting problems and set treatment goals, briefly describe treatments for specific anxiety disorders, and focus on fundamental lifestyle behaviors that promote resilience against the stresses of life. Active interventions for symptoms of anxiety disorders are addressed in chapters focused on breathing and relaxation exercises, challenging anxiety-promoting thoughts, and breaking avoidant behavior. Chapters on relapse prevention, co-morbid problems with depression, anger and substance abuse, and group programs for reducing

anxiety round out the book. Again, the concepts are not particularly new, but they are well presented, and much is covered in this relatively slim volume.

Useful specifics are included, such as the recommendation to practice relaxation exercises twice a day for one week and then once daily for four weeks. I find that clients with anxiety that they cannot control are comforted by instructions that are so well defined and laid out.

The authors capitalize on the truth that knowledge is power by including over 50 worksheets and handouts to give to clients. The handouts are up to date, such as the Harvard eating guidelines that were issued in 2007, and detailed when appropriate; the important subject of how to sleep well spans five well-organized

pages. Many of the subjects covered are pertinent to even clients without anxiety, such as dealing with stigma about mental health difficulties. All of the client material is angled toward promoting understanding and a sense of self efficacy; in my view, the handouts alone are worth the price of the book. A companion CD of client handouts is included for ease of reproduction, and recommended websites for therapists and clients are provided.

As we know, anxiety disorders involve not only the fear that something undesired may happen but also the fear that we cannot cope with those undesired possibilities of life or subjective experience. The latter fear often seems the more disruptive to the lives of our clients. The material in this book should go a long way to promoting a sense of being able to meet and manage the experience of anxiety and stress.

References
Kessler, R. C., Berglund, P., Demler, O., Jin, R., Merikangas, K. R., & Walters, E. E. (2005). Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey replication. Archives of General Psychiatry, 62, 593"602.
_ Kessler, R. C., McGonagle, K. A., Zhao, S., Nelson, C. B., Hughes, M., Eshleman, S., et al. (1994). Lifetime and 12-month prevalence of DSMIII-R psychiatric disorders in the United States: Results from the National Comorbidity Study. Archives of General Psychiatry, 51, 8"19.



_ Sareen, J., Cox, B. J., Afifi, T. O., de Graaf, R., Asmundson, G. J., Have, M., & Stein, M. B. (2005). Anxiety disorders and risk for suicidal ideation and suicide attempts: A population-based longitudinal study of adults. Archives of General Psychiatry, 62, 1249"1257.

This is a practitioners guide that is based on Cognitive Behavioural Therapy techniques to aid therapists and clinicians provide practical and effective treatments for stress and anxiety management.

It is a very direct and clear-cut manual. Every chapter deals with a specific topic, such as “maintaining emotional health' and “the impact of thoughts on stress and anxiety' amongst others. Each has very articulate and easy to read explanations, suggested treatment plans and exercises, handouts and worksheets for clients to use. IN fact the book comes with a CD containing the handouts and worksheets so you don't even have to type them out ” simply pop the CD into your PC and away you go!



There is also a brilliant audio CD containing 15 relaxation techniques and exercises with clear and uncomplicated instructions before each track. This is a great accompaniment to the book and I would recommend that you buy both the book and the CD to get the full benefits.

Treating Stress and Anxiety: A Practitioner's Guide to Evidence-Based Approaches is a guide for clinicians and therapists to evidence-based cognitive behavioral techniques that can help reduce patients' stress and anxiety, as well as enhance their overall quality of life. Chapters discuss basic emotional health maintenance (including watching one's diet, engaging in regular exercise, getting sufficient sleep, and properly managing time), relaxation and breathing exercises, confronting fears, tips for managing persistent harmful thoughts, preventing relapses, and much more. “When an individual is particularly vulnerable or experiencing severe ongoing stress, they may often be in crisis. When in a crisis state, it is very difficult to maintain work towards longer term goals and to try new and challenging tasks. It can be helpful to develop a list of simple and effective strategies to alleviate distress in times of crisis, and therefore minimise the impact of ongoing crises-¦ It is wise to consider attempting several distress management strategies when confronted with a crisis. It may also be helpful to involve supportive people and relevant agencies when planning for crisis management.” Included with the text is a CD-ROM of useful client handouts and worksheets. A superb, easy-to-follow, highly practical manual for treatment professionals.

Treating Stress and Anxiety by Lillian Nejad and Katerina Volny is a book that should be on the desk of every practitioner who works with adults experiencing stress, anxiety, phobias, or PTSD. The book provides treatment plans and goals for the practitioner, as well as a variety of educational client handouts (in PDF file format) contained on a CD. The files are ready for the practitioner to print out for each client as needed (Adobe Reader is the software you need on your computer).

In addition, the authors have produced an audio CD Relaxation Techniques, which can be purchased separately. The audio CD contains the voices of the authors, taking the listener through a series of relaxation exercises that reduce stress and anxiety. The authors recommend that listeners practice their favorite exercises daily. Each exercise is accompanied by a brief explanation and the exercises range from approximately 2 to 19 minutes. Most of the exercises require that the listener is seated or reclining, although one is a “walking relaxation” exercise. The background music and the voices of Nejad and Volny are soothing and the scripting is well-done. Anyone could benefit from listening to the CD whether they read the book or not. Therapists may want to recommend the CD to their clients.

The book's approach is mainly Cognitive Behavioral Therapy, with passing references to additional modalities such as psychodynamics, NLP, and hypnosis.  The text contains assessment and treatment guidelines for practitioners with the added benefit of handouts and worksheets for clients. The book begins with an overview of stress and anxiety disorders, including diagnostic criteria and statistics on the prevalence of such disorders in the general population. The second chapter covers risk factors, predisposing factors, and precipitating factors, with advice on how to assess the client's readiness for treatment, as well as possible barriers to treatment, such as social stigma.

Nejad and Volny go on to cover various treatment modalities and self-help strategies. I think every therapist could make use of the handouts in this section, which include information about proper nutrition, exercise, sleep, time management, and problem solving.

The authors devote a chapter each to relaxation and breathing exercises, managing negative and obsessive thoughts, facing fear, and preventing relapse. The chapter on preventing relapse includes a relapse prevention plan; something often ignored in clinical settings. There is also information on assessing and treating depression, substance abuse, and anger management, as frequently encountered components of anxiety. The book ends with a chapter on group therapy for stress and anxiety disorders.

The evidence-based component of the author's model shows mental health practitioners how to assess a client's presenting issues (with checklists for behavioral, physical, cognitive and emotional symptoms), set specific treatment outcomes, involve the client in the treatment process, monitor progress, and assess the result of treatment. This model is especially valuable in clinical settings that rely on external funding and in research settings that test the efficacy of various treatment approaches. With evidence-based approaches, the results are measurable, and the practitioner can answer the question, “Did therapy work for this client?”



With anxiety disorders on the increase, this book is much needed and will be much appreciated by practitioners working in a wide range of settings. I recommend it highly and I expect my copy will be quite dog-eared in a matter of months.

This is a wonderfully practical book that the authors have provided on a subject that we, as therapists, encounter frequently. As such, it is not a book of hypnotherapeutic techniques but is a book of useful techniques that we all need to know and can incorporate into our 'grab bag of skills'.

The CD accompanying the book enables the printing of the handouts to be simple and accurate.

The initial overview covers the discussion of confidentiality with the client, the assessment and setting of realistic treatment goals and risk assessment regarding suicidal thoughts, mood disorders and coping mechanisms. Extensive handouts and worksheets are excellent.

The chapters covering the treatment for anxiety disorders provide a wealth of useful information and strategies for maintaining emotional health, the impact of thoughts on stress and anxiety and a range of relaxation exercises including using the breath to ease away the discomfort. Communication styles are discussed, substance abuse and much more.



A group programme over eight weeks, complete with the handouts and worksheets, is set out clearly and there are helpful tips regarding the group structure that a therapist would find most useful.

I started reading this book a little stressed as the review was just a number of things I had to get done before I left on holiday but I am glad I tackled the task when I did.

Accompanying the book are two CDs and the first one I listened to (more than once, I may add) resulted in me feeling totally relaxed having participated in two, ten minute long breathing and muscle control exercises designed to illustrate how stress and anxiety can be dealt with on a personal level. Hence, the book review was delivered on time and I jetted of a different person, well for a few minutes anyway!

The CDs are nothing short of amazing and if, for no other reason, I would have bought this book on the strength of these toots but in order to be a little more objective, please be assured that I also read the book!

For a piece of work I thought might overwhelm me with psycho babble, this tome was a pleasant surprise in some respects and a little disappointing in others.

-˜Treating stress and anxiety' is maybe not the wisest choice of words to put on a dust cover as it does not exactly shout out -˜buy me' but then again with a growing awareness of how the issues can affect people, the title might just be construed as being highly practical.

The book is a thoroughly comprehensive guide to providing the ins and outs of what constitutes stress and anxiety, its causes and possible solutions and although a fairly expensive resource, it could appeal to a wide a audience

Whether a counsellor trying to grasp an idea that might just help a jitttery patient, an HR practitioner seeking an aid to deal with an employee exhibiting the signs or even a medical professional seeking solace and confirmation of their diagnosis, the book provides a wealth of helpful material.

One of the few off putting elements however is that, at times, the content can border on the clinical with a large number of charts and diagrams referred to throughout that tends to cloud the issue slightly.

In many respects it could be referred to as a type of workbook because in essence it is a series of exercises through which someone could work in order to more fully understand the concept of stress and anxiety and what a suitable solution might be depending on the circumstances.

The content is a little repetitive with lists of issues being repeated at times in prose but in a way this may actually be a good thing providing comfort to those looking for explanations of why a certain characteristic might cause a bout of stress or- anxiety.

One of the things I took from reading the book was the wealth of issues that can affect people' stress and anxiety Levels and what can be done about them. Detailing issues such as being aware of diet casts a whole new light on the reasons why stress and anxiety play an ever increasing role in the workplace and society which makes for lighter reading in a book that is, at times, beyond the layman.

The authors, both of whom are psychologists, have focused on evidence based approaches and techniques that are supposed to help enhance quality of life which the sales blurb touts as being in straightforward, uncomplicated Language. However, as someone working in HR, I would find it hard to turn to this aide for help without having to spend a good deal of time beforehand researching the issue which, as any seasoned HR practitioner will know, is not a luxury that often comes their way.

That said though there are easy reading sections such as these focusing on issues as diverse as steep patterns mood swings and drug taking and how these various elements can contribute to stress and anxiety. One particularly helpful section of the book are the lists of resources providing support and guidance on the subject of stress and anxiety ranging from further reading matter to websites to be visited.

I would describe this particular book as stimulating and invigorating but one which must be picked up with some fore thought rather than just trying to find a solution to an age old problem that now has a label.



Now for those that want to join me in participating in relaxation techniques, take a deep breath and begin-¦

Nejad and Volny are psychologists who work in public mental health, community health and private practice in Melbourne. They are to be congratulated for creating a very useful book for practitioners assisting adults with stress, anxiety and emotional resilience. The chapters and exercises are presented in a format that is easy to follow, with detailed references and Index. The Appendices provide recommended reading and websites for both clinicians and for clients. The chapter headings show the breadth covered:

• A brief overview of anxiety and stress


• Identifying presenting problems and treatment goals


• Treatment for anxiety disorders


• Maintaining emotional health


• Relaxation and breathing exercises


• The impact of thoughts


• Facing fears


• Relapse prevention


• Other issues related to stress and anxiety


• Group programmes to reduce anxiety


• and enhance well-being

The approaches described are primarily from Cognitive Behavioural Therapy (CBT), supplemented with techniques from relaxation training, exposure-based methods and relapse prevention. There is also useful material on depression, substance abuse, self-acceptance, anger, communication skills, and healthy lifestyles (e.g. diet, exercise, sleep, social support and time management). All this advice for clinicians is supported by a CD with over 150 pages of handouts and worksheets that you can print for clients - the kind of resource it took me years to develop for my own practice.

These resources alone make this a valuable book for experienced CBT practitioners, and yet it is presented simply enough to be accessible for those new to CBT and the challenges of working with anxiety. Detailed strategies and worksheets are provided for the following generic treatment plan:
Nejad and Volny expect this to occur over seven to twenty hour-long sessions held a week or two apart. Of course this will depend on the clients capabilities and they do note that those with co-morbid Axis I and/or Axis II disorders may take considerably longer.

1. Assessment and emotional health checkup.


2. Provide education about stress and anxiety.


3. Teach relaxation and breathing exercises to manage anxiety.


4. Teach cognitive strategies to manage anxiety-provoking thoughts.


5. Plan a hierarchy of anxiety- provoking tasks and plan desensitization activities.


6. Develop relapse prevention strategies for future triggers and early warning signs.

This links to my only real disappointment with the book, namely that Nejad and Volny haven't really looked beyond CBT and conservative clinical psychology. There is a paragraph where they identify hypnosis as a useful evidence-based methodology “not covered here”, but there is no mention of other approaches. Either they don't know about these, or they believe that only CBT is sufficiently “evidence-based” - whereas I believe the leading edge of treatment methods is often years ahead of such research. Indeed, the work of CBT founder Albert Ellis was not evidence-based (in the limited academic-clinical sense) for over 20 years, but people still used their -˜radical new methods'. This book would be quite familiar to Ellis as a well designed application of his 30 year old methods, and it doesn't add a lot to what I learnt as a psychology student in the 1980's. Meanwhile many of us have been using methodologies such as NLP and SFT which developed beyond the basic CBT insights, which provide quicker and deeper solutions than those Nejad
and Volny describe, and which are only recently beginning to build an academic -˜evidence-base'.



However, this doesn't detract from the book's great value as a primer and manual of CBT-based approaches to assisting adults with stress, anxiety and emotional resilience. I fully recommend it for anyone looking for such a resource.

This book focuses on a variety of -˜evidence-based Cognitive behavioural techniques' for clients with Stress/Anxiety problems. The book has an accompanying CD-Rom with handouts and worksheets. The book is laid out very much as a step-by-step program/guide for the practitioner. However, 1 would also say the book could be suitable for non- practitioners as a self-help book/CD Rom.

The reader is moved through the process of tackling a client with stress/anxiety; from assessing the client, looking at barriers to treatment, and setting treatment goals.

Various stress/anxiety disorders are summarised including amongst others; Post Traumatic Stress Disorder and Specific Phobia.

A huge portion of the book is made up of handouts and worksheets which are on the accompanying CD-Rom. 1 did question whether it is necessary for every handout to be printed up in the book and would rather the pages had been used (speaking as a Hypnotherapist) to pay more than lip service to Hypnotherapy.

There were other areas which could have been given room for expansion - 1 would guess that many therapists would agree that self-worth can be key to most client issues. With this in mind 1 found it disappointing to find self-worth issues being condensed into two brief paragraphs headed -˜Self Acceptance and Strengthening Identity'.

Potential readers may like to try the companion audio CD which is available from the same authors:-

1 am in two minds about this book. On one hand 1 can see it would be a highly effective tool, particularly for those new to therapy practise who still need more props and tools to help them, and also valuable for those practising Cognitive Behavioural Therapy. 1 did like the handouts and worksheets as a tool for the client to continue working on themselves outside therapy sessions. The book also showed a more holistic bent when the client is encouraged to look at their diet, exercise and sleep as other tools to help reduce stress and anxiety.

On the other hand 1 found the book a little too scientific with over-use of graphs and charts - which 1 guess some therapist's may warm more too.



Overall 1 think for most therapists, the book could be a useful tool for them to dip into for help with stressed or anxious clients. However, 1 feel that if followed to the letter the book could bog down a therapy session with endless paperwork, form filling, and looking at the client more as a lab rat than a sentient individual.

This is an excellent, concise and highly readable introduction to Treating Stress and Anxiety.

Despite the fact that it is written in a relatively informal style the work retains a professional focus and explores key issues in relation to evidence-based anxiety management. The emphasis upon recovery, self-efficacy and modern treatment approaches is refreshing and the worksheets and wall charts are helpful in terms of summarising the key issues.

Ultimately the book is well- balanced in terms in its consideration of cognitive-behavioural and psycho-social interventions.

Excellent - I have highlighted Chapter 2 as I think it is particularly well-written and informative summarising relevant psychological aspects of health and emotional wellbeing. I also like the fact that it does not ignore potential barriers

Positive Criticism - I think a chapter in this book relating to -˜Conflict resolution' would have been a useful addition (in terms of managing anxiety and the application of emotional intelligence). Anger is considered in Chapter 7 but I think it might have been explored further in relation to difficult situations and illuminated by case study examples. Similarly I think the basic legal and ethical issues related underlying the counselling process deserve greater attention even in an introductory text. I note that confidentiality is mentioned very briefly though.

Level of study - suitable for level(s) 4, 5 and 6 - Health and Social Care Students

Tables and Appendices - Informative and easy to read

CDRom - The relaxation exercises complimented the book and were very easy to follow. NOTES: would have liked a script included in relation to psychiatric first aid in a -˜conflict' situation e.g. when someone is confrontational, abusive or threatening towards you.

Work sheets and handouts - a useful addition for lecturers, teachers, trainers and service users alike.

Adoption: will recommend as supplementary reading on the undergraduate/post-reg nursing programme.

Chapter 1 - A brief overview of anxiety and stress

Chapter 2 - Identifying presenting problems

Chapter 3 - Treatment of anxiety disorders

Chapter 4 - Maintaining emotional health

Chapter 5 - Relaxation and breathing exercises

Chapter 6 - The impact of thoughts on stress and anxiety

Chapter 7 - Facing Fears

Chapter 8 - Relapse Prevention

Chapter 9 - Other issues related to stress and anxiety



Chapter 10 - Group programmes to reduce anxiety and enhance wellbeing

This is one of those -˜must have' books on your shelf to be read and digested. It captures the diverse nature of stress and anxiety with descriptions, assessments, procedures and monitoring activities in abundance.

The book guides you practically through a wide selection of treatment programmes that cover the multi-facets that stress, anxiety and the human existence experience.



If you suffer from, or treat anxiety or stress, this book will give you the -˜know how' to make life easier.

In treating Stress and Anxiety, the authors provide a nearly comprehensive collection of methods for treating symptoms associated with stress and anxiety. Insight about the sources of stress and the physiological effects are presented in clear and helpful ways. This bevy of information can then be shared with the client, as an informed client becomes a better ally in the treatment process. The material in this book consists of neatly structured and precise techniques aimed at alleviating symptoms.

The methods are especially geared for empowering the client to better take charge of his or her life and promote all around wellness. Research about the efficacy of these techniques is also presented, providing the therapist as well as the client with reassurance about using these stress and anxiety reduction methods. These methods are tried and true. I believe this book provides both the beginning therapist as well as the seasoned therapist with an effective treatment plan and the necessary tools to assist their client toward greater wellbeing.

This is an intensely practical text written by clinicians for clinicians. It will be of great value on the shelves of all health professionals who are involved in treating anxiety and stress.

An excellent feature of the book is that it comes with a CD-ROM of client handouts/worksheets that can be printed. Also, a companion audio CD of relaxation therapy is available, which is a very high quality production.



The book covers all the domains that such a book would be expected to include such as variations between the treatment of different anxiety disorders, and the techniques of cognitive therapy (including mindfulness), relaxation training, exposure-based approaches and relapse prevention. It also incorporates other valuable material, however, that focuses on the psychosocial context in which anxiety and stress arise, that is, techniques designed to: promote a healthy, balanced lifestyle; increase resilience; and enhance quality of life (e.g., diet, exercise, sleep, social support, problem solving, time management, activity scheduling). In addition, the book deals with problems related to anxiety and stress such as depression, substance use, self-acceptance, anger and communication skills. In summary, a remarkably comprehensive text for treating stress and anxiety.

Lillian Nejad and Katerina Volny have produced not only a clinically effective method for addressing issues of stress and anxiety, but a method based upon empirical evidence. This is in keeping with modern psychology's cutting edge commitment to the clinical scientist model that will-”-and must characterize the work of all mental health practitioners in the future. This book is a must for every clinical bookshelf . Nejad and Volny are to be congratulated for their efforts. Countless troubled people will live happier, stress-free lives because of their work.

In this straight-forward, well-organized handbook, health professionals can have confidence that the techniques suggested are well-supported by clinical research. The book structures topics so that you can rapidly organize treatment interventions and support them by ready-made handouts and worksheets. A great teaching tool for the new clinician in this field and an efficient time-saver for the seasoned anxiety specialist.

A clear and well set out book on treating stress and anxiety. Of benefit to both mental health practitioners for themselves, as well as their patients. The accompanying CD supplements the techniques well and I would recommend it to anyone who works with individuals experiencing stress, regardless of their level of expertise.