Psychotherapy: Indications and Outcomes Edited By David S. Janowsky. Washington, DC: American Psychiatric Press, 1999. 414 pp. £49.95 (hb). ISBN 0-88048-761-5

This edited collection of conference papers covers a wide range of topics within the domains of psychotherapy process, outcome and process-outcome research. It contains 17 chapters in eight sections devoted to: individual and interpersonal determinants of psychotherapeutic effects (four papers first authored by Luborsky, Blatt, Janovsky and Shea); dialectical behaviour therapy (Linehan); cognitive-behavioural therapy (Biggs, Shaw and Agras); interpersonal therapy: mechanisms and efficacy (Weissman, Markowitz and Spanier); psychotherapy with the medically ill (Spiegel); family therapies (Glick and Goldstein); methodological considerations in psychotherapy research (Hollon and Goldstein); and psychotherapy in the era of managed care (Sharfstein). ?

The broad coverage of a wealth of important research fields and the impeccable pedigree of the authorship must establish this as a potentially important source text for psychotherapy researchers. Whether it will be of more general value to clinicians who want to be updated on developments in a rapidly moving research field is less clear. The papers presented in this volume were all first given at a conference of the American Psychopathological Association in early 1996. Although the authors have clearly been given the opportunity to update their contributions, the extent to which they have done so is variable. While some (e.g. Linehan) have included reference to more recent published material, others appear to have left their papers largely untouched, with the result that their interest will rapidly become historical.

Despite this, there are several interesting and useful contributions. One such example is Luborsky et al's paper. This establishes the applicability of the Alice in Wonderland dodo's verdict (“All have won and all shall have prizes”) to comparative outcome research on the psychodynamic therapies, and examining the range of possible explanations for the equivalence paradox (i.e. that widely differing therapies often appear to yield similar results). Another is the detailed check-list offered by Donald Klein for developing and evaluating treatment in psychotherapy and pharmacotherapy. Where high-quality comparative outcome research is concerned, however, there is not much in this book that was not already available in Roth et al's What Works for Whom? (1996). Moreover, much has happened in this field since, as a cursory inspection of the relevant 1998 Special Section of the Journal of Consulting and Clinical Psychology will reveal.

In summary, had this book appeared in early 1997 it would have made an outstanding and original contribution to the research literature available at that time, offering a synthesis of key contemporary developments. Its value today is less, but still substantial. It has been estimated that clinicians wishing to adopt an evidence-based approach to their clinical practice would need to read an average of 19 papers a day, 365 days a year to keep up with the published literature in any major speciality. The enormity of this task underlines the key importance of reviews and syntheses of relevant research. This edited collection is one such; perhaps not the first I would head for if I could have only one, but still a candidate for a place on my bookshelf.