Cognitive-Behavioral Therapy for Anxiety Disorders

Mastering Clinical Challenges

Gillian Butler, Melanie Fennell, and Ann Hackmann

HardcoverPaperbacke-bookprint + e-book
July 14, 2008
ISBN 9781593858308
Price: $84.00
224 Pages
Size: 7" x 10"
April 20, 2010
ISBN 9781606238691
Price: $34.00
224 Pages
Size: 7" x 10"
March 1, 2011
ePub ?
Price: $34.00
224 Pages
print + e-book
Paperback + e-Book (ePub) ?
Price: $68.00 $37.40
224 Pages

Helping therapists bring about enduring change when treating clients with any anxiety disorder, this invaluable book combines expert guidance, in-depth exploration, and innovative clinical strategies. The authors draw on extensive experience and research to provide a framework for constructing lucid formulations of complex cases. They identify obstacles that frequently arise during the early, middle, and later stages of treatment and present a wide range of practical solutions. The volume demonstrates clear-cut yet flexible ways to enhance client engagement, foster metacognitive awareness, facilitate emotional processing, address low self-esteem and fear of uncertainty, and much more. Reproducible handouts and forms are included.

“Therapists who have some experience using CBT in practice will find it useful in learning how to circumvent common stumbling blocks and use CBT in situations novel to them. The book does a nice job in using theory, evidence, and clinical experience to enhance practice. It is a useful work for clinicians working to hone their CBT skills.”

Bulletin of the Menninger Clinic

“Each chapter constructs a golden bridge between science and practice. The authors identify the important components of treatment at each phase, while explicating the theoretical and empirical framework within which each component of treatment is grounded. Their knowledge of the literature on the development and persistence of anxiety disorders is current and impeccable. Large bodies of findings are distilled into accurate summations that readily inform practice. The authors draw upon their collective expertise in treatment to describe a myriad of strategies the clinician can use to meet the goals of each treatment component. Well-written, concise, and centered on rich case examples, these descriptions effectively communicate how to implement CBT techniques in a truly compassionate and collaborative manner....This book empowers the clinician with the knowledge required to develop a solid case formulation and exercise good clinical judgment in the implementation of the rich variety of therapeutic techniques described. This book is an invaluable resource for the clinician, the CBT trainee, and the CBT instructor.”

Journal of Behavioural and Cognitive Psychotherapy

“Provides practical and user-friendly guidelines for clinicians in their daily work....A valuable resource for clinicians in training in advanced CBT strategies and is a notable attempt to advance a transdiagnostic approach to treating anxiety disorders that provides a snapshot of where the field is heading next.”

Journal of Psychosomatic Research

“I would love to have had [this book] available to me when I first attempted to treat people with anxiety disorders as a trainee in the 1970s, and I would urge anyone new to the field, as well as more experienced practitioners, to obtain a copy....Provides one of the best accounts I have read of how to get the most out of therapist-guided, in-session behavioral experiments, including their use to enrich the formulation, to detect subtle safety-seeking behaviors that maintain the problem and prevent patients from disconfirming their fears, and to promote experiential learning.”

Cognitive Behavioral Therapy Book Reviews

“This long-awaited book exceeds expectations. It provides a single, comprehensive guide to CBT for anxiety disorders, from assessment to termination. This is no small feat in itself, and yet, Butler et al. also offer so much more. Therapists will appreciate the sophisticated nuances of therapy depicted here. Layers of clinical creativity are embedded within illustrative case examples. As an added bonus, the authors' transdiagnostic approach offers a clear path through the sometimes confusing process of treating clients with multiple anxiety disorders. I heartily recommend this elegant book, whether it is the first or the 50th that you read on anxiety treatment.”

—Christine A. Padesky, PhD, Co-Founder, Center for Cognitive Therapy, Huntington Beach, California

Cognitive-Behavioral Therapy for Anxiety Disorders is a refreshing alternative to many of the existing manuals on this topic. It presents a highly individualized, formulation-based, cognitive approach to treating these challenging conditions. The book is well grounded in science and includes solutions to the most common treatment roadblocks. I highly recommend it to anyone who works with people who suffer from anxiety disorders.”

—Martin M. Antony, PhD, ABPP, Department of Psychology, Ryerson University, Toronto, Ontario, Canada

“This book must be read by all those who seek to help people suffering from anxiety disorders. It clearly and accessibly portrays the essence of effective CBT for anxiety while avoiding oversimplified prescriptions. The book is unique in helping clinicians to achieve the integration of clinical art and clinical science that characterizes excellent CBT. The reader will learn essential therapeutic skills for striking a balance in two key areas: between general and specific factors in anxiety disorders and their treatment, and between self-acceptance and recognizing and implementing the need for change. Read this book and use it!”

—Paul Salkovskis, PhD, CPsychol, Institute of Psychiatry, King’s College London, and Clinical Director, Centre for Anxiety Disorders and Trauma, South London and Maudsley NHS Foundation Trust

Table of Contents


I. Setting the Scene

1. Treating Anxiety Disorders: The State of the Art

II. Deepening Understanding and Securing Engagement

2. Assessment: Investigating Appraisals in Depth

3. Case Formulation: Making Sense of Complexity

4. Decentering from Thoughts: Achieving Objectivity

III. Facilitating Emotional Processing

5. Bringing About Lasting Change at the Deepest Level

6. The Role of Behavioral Experiments

IV. Overcoming Three Major Obstacles to Progress

7. Avoidance of Affect

8. Low Self-Esteem

9. Dealing with Uncertainty

V. Ending Treatment Productively

10. Creating a Therapy "Blueprint"

About the Authors

Gillian Butler, PhD, an Associate of the Oxford Cognitive Therapy Centre, is a Fellow of the British Psychological Society and a Founding Fellow of the Academy of Cognitive and Behavioral Therapies. She has conducted research on CBT for anxiety disorders and has a special clinical interest in the use of CBT during recovery from childhood trauma. Dr. Butler is the author of Overcoming Social Anxiety and Shyness, Manage Your Mind: The Mental Fitness Guide, Psychology: A Very Short Introduction, and other books. With colleagues from the Oxford Cognitive Therapy Centre (including Melanie Fennell and Ann Hackmann), she is a coeditor of the Oxford Guide to Behavioural Experiments in Cognitive Therapy.

Melanie Fennell, PhD, is Director of the University of Oxford Diploma/MSc in Advanced Cognitive Therapy Studies and is a research therapist in Oxford's Department of Psychiatry. She will also codirect a new Master of Studies in Mindfulness-Based Cognitive Therapy program. Dr. Fennell has contributed to the development of treatment protocols for depression and for a range of anxiety disorders, and has published widely on CBT for depression and low self-esteem. In 2002, she was voted "Most Influential Female UK Cognitive Therapist" by the membership of the British Association of Behavioural and Cognitive Psychotherapies.

Ann Hackmann, PhD, until her death in 2017, was a Consultant Clinical Psychologist at the Oxford Cognitive Therapy Centre and the Department of Psychiatry, University of Oxford. She has worked for over 20 years in a research group specializing in the development of cognitive therapy protocols for anxiety disorders. She was particularly interested in working with imagery in cognitive therapy, and published widely on this topic. Dr. Hackmann provided teaching and training in cognitive therapy in many national and international settings, and was a Founding Fellow of the Academy of Cognitive and Behavioral Therapies.


Practitioners and students in clinical psychology, psychiatry, counseling, social work, and related mental health fields.

Course Use

May serve as a text in graduate-level seminars and clinical practica in cognitive-behavioral therapy and anxiety disorders.