Book Reviews |
CBT for Occupational Stress in Health Professionals. Introducing a Schema-Based Approach
Martin R. Bamber. Published by Routledge, 2006. ISBN 1-58391-852-3. Price: £24.99 (paperback). 280 pp.
The author is a chartered consultant clinical psychologist in a National Health Service (NHS) Trust as well as being a teaching fellow at the University of York. He has experience of occupational health psychology services in the NHS and has a research interest in occupational stress.
The intended target audience for the book is all those who deal with occupational stress including health care professionals, human resource workers and even sufferers themselves.
The National Institute of Clinical Excellence (NICE) has produced guidelines recommending that cognitive behavioural therapy (CBT)—an evidenced-based talking therapy for people with depression and anxiety disorders—should be available as an option for all but the mildest or most recent forms of depression and anxiety. CBT has been shown to be as effective as drugs when treating depression and anxiety in the short term, and tends to have more durable effects. Despite this, it remains difficult to meet the need to implement the NICE guidelines because the therapists are not available. If the NICE guidelines were implemented, many more people would receive help and massive suffering would be avoided. It has been estimated that savings to the government on Incapacity Benefits would largely offset the cost of implementing the guidelines. The publication of the Layard report in 2004 identified that there were more people on Incapacity Benefit with mental health problems than there were people in receipt of Job Seekers Allowance. The vast majority of these people were not in contact with specialist Mental Health Trusts and suffered from ‘mild or moderate’ mental illness. In fact, the disability suffered by this group was just as severe as for those with a ‘severe’ mental illness. The Layard report outlined how effective CBT is and particularly recommends increasing access to psychological therapies, especially CBT in order to help alleviate the suffering of people with mental health problems. The report and recommendations were included in the Labour Party Manifesto for the May 2005 General Election campaign. So there is probably an identifiable need in the occupational health setting given the numbers of people seen with mental health problems arising from occupational or other stress. In most areas, there is probably an unmet need with lengthy waiting lists and a lack of appropriately trained therapists. So it is likely that individuals with such conditions have more prolonged absence and it becomes ever more difficult to support people back into the workplace.
The book is divided into three sections with the first part introducing the author to occupational stress concepts, causes and consequences. The second part outlines the CBT approaches towards assessment and management of the standard interventions both from individual and organizational perspectives. This section is supported by interesting and common case studies. The final part of the book is probably aimed at a more specialist readership as it advances a new approach towards the treatment of occupational stress and work dysfunction.
This is an eminently readable book with a comprehensive and detailed approach, which demonstrates the value that CBT can bring to improving the mental health of individuals within a workplace setting. It is therefore useful not only for occupational physicians wanting to expand their skills within a consultation setting but also to allow more meaningful and engaging dialogue with counsellor colleagues prior to or subsequently after referring an individual.
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