Clinical Handbook of Psychological Disorders: A Step-by-Step Treatment Manual

Citation

Barlow, D. H. (Ed.). (2021). Clinical Handbook of Psychological Disorders: A Step-by-Step Treatment Manual (6th ed.). The Guilford Press.

Chapter Summary

The sixth edition has 19 chapters and about 820 pages. The publisher says the chapters come from preeminent experts, and the reviewers it quotes note that many contributors developed the treatments they describe. The publisher's description gives the common plan: the disorder and the state of current knowledge, the conceptual and empirical basis of the intervention, and then the question the book is built around, "How do I do it?", answered through an extended case example. Barlow adds a concise introduction to each chapter highlighting the distinctive features of the treatment. Because the chapters share this plan, the summaries below name the disorder or approach and the authors rather than repeating the structure.

Chapter 1: Panic Disorder and Agoraphobia

Written by Michelle G. Craske, Kate Wolitzky-Taylor and Barlow. The opening chapter presents the treatment of panic disorder, with and without agoraphobia.

Chapter 2: Posttraumatic Stress Disorder

By Candice M. Monson, Philippe Shnaider and Kathleen M. Chard, on the treatment of posttraumatic stress disorder.

Chapter 3: Social Anxiety: A Process-Based Treatment Approach

By Idan M. Aderka and Stefan G. Hofmann. The publisher lists this chapter as new to the edition and calls process-based therapy a new third-wave approach for social anxiety.

Chapters 4–5: Obsessive–Compulsive Disorder; Generalized Anxiety Disorder: An Acceptance-Based Behavioral Therapy

Chapter 4 is by Martin E. Franklin and Edna B. Foa. Chapter 5, by Lizabeth Roemer, Elizabeth H. Eustis and Susan M. Orsillo, presents an acceptance-based behavioral therapy rather than a standard cognitive-behavioral protocol.

Chapter 6: Emotional Disorders: A Unified Protocol for Transdiagnostic Treatment

By Laura A. Payne, Kristen K. Ellard, Todd J. Farchione and Barlow. It describes one protocol intended for several emotional disorders instead of a separate protocol per diagnosis.

Chapters 7–9: Cognitive Therapy for Depression; Interpersonal Psychotherapy for Depression; Behavioral Activation for Depression

Three approaches to the same problem, by Jeffrey E. Young and colleagues including Aaron T. Beck; by Kathryn L. Bleiberg and John C. Markowitz; and by Sona Dimidjian, Christopher R. Martell, Ruth Herman-Dunn and Samuel Hubley. Reading them together shows how three evidence-based treatments differ in theory and technique.

Chapters 10–11: Borderline Personality Disorder; Addressing Self-Injurious Thoughts and Behaviors within the Context of Transdiagnostic Treatment for Emotional Disorders

Chapter 10 is by Andrada D. Neacsiu, Noga Zerubavel, K. Maria Nylocks and Marsha M. Linehan. Chapter 11, by Kate H. Bentley, Joseph S. Maimone and Matthew K. Nock, is listed by the publisher as a new chapter on the transdiagnostic treatment of self-injurious thoughts and behaviors.

Chapters 12–13: Bipolar Disorder; Schizophrenia and Other Psychotic Disorders

By David J. Miklowitz, and by Nicholas Tarrier and Katherine Berry, covering the severe mental illnesses.

Chapters 14–16: Alcohol Use Disorders; Substance Use Disorders; Treatment of Sleep Disturbance

Chapter 14 is by Barbara S. McCrady and Elizabeth E. Epstein, Chapter 15 by Stephen T. Higgins, Sarah H. Heil and Kelly R. Peck, and Chapter 16 by Katherine A. Kaplan and Allison G. Harvey.

Chapter 17: Cognitive-Behavioral Therapy for Chronic Pain

By John D. Otis. The publisher lists a chapter on chronic pain as new to this edition.

Chapters 18–19: Eating Disorders: A Transdiagnostic Protocol; Couple Distress

Chapter 18 is by Zafra Cooper and Rebecca Murphy; Chapter 19 by Andrew Christensen, Jennifer G. Wheeler, Brian D. Doss and the late Neil S. Jacobson. The volume ends with author and subject indexes.

Key Concepts

Anxiety, trauma and obsessions (Chapters 1–6)

• Process-based therapy: the publisher's term for the new third-wave approach to social anxiety presented in Chapter 3.
• Acceptance-based behavioral therapy: the treatment model used for generalized anxiety disorder in Chapter 5.
• Transdiagnostic treatment: a single protocol (the Unified Protocol) applied across several emotional disorders.

Mood, personality and severe mental illness (Chapters 7–13)

• Three treatments for depression: cognitive therapy, interpersonal psychotherapy and behavioral activation.
• Self-injurious thoughts and behaviors: handled in the book as a topic within transdiagnostic treatment of emotional disorders.
• Treatment for borderline personality disorder: the chapter is by Linehan and colleagues.

Substance use, sleep, pain, eating and relationships (Chapters 14–19)

• Treatment of alcohol and other substance use disorders, in separate chapters.
• Treatment of sleep disturbance, and cognitive-behavioral therapy for chronic pain.
• Couple distress, the only chapter focused on a relationship rather than on one individual's disorder.

Critical Analysis

Strengths

• Treatments described by their developers. The publisher says that Barlow assembled "preeminent experts"; Steven Hollon, quoted on the publisher's page, notes that the authors include many of those who developed the interventions, and the chapter list shows names such as Beck, Linehan, Foa and Barlow himself.
• The step-by-step design. Every chapter pairs a review of the evidence with an account of how the treatment is delivered and an extended case example. The Journal of Clinical Psychiatry review of the fifth edition, quoted by the publisher, praises the clinical vignettes and transcripts for showing how techniques are individualised rather than applied rigidly, and compares the book to "a favorite cookbook" that clinicians return to.
• Teaching use. Instructors quoted by the publisher, including Richard McNally of Harvard and André Ivanoff of Columbia, describe using it as a primary text in graduate clinical courses; Barlow's chapter introductions are intended to help training.
• Several treatments for one condition. Depression receives three chapters, which lets a student compare approaches within one book.

Limitations

• Selective coverage. The 19 chapters cover frequently encountered adult problems; the chapter list has no chapters on child and adolescent disorders, or on neurocognitive or neurodevelopmental conditions. It is a treatment manual, not a survey of psychopathology.
• Prior training assumed. The book teaches how to carry out treatments, not how to diagnose or what the disorders are; readers need a base in psychopathology and the principles of cognitive-behavioral therapy.
• Edited volume. Chapters are written by different teams, so depth and style differ; the shared outline reduces but does not remove this.
• Currency. The publisher states that a new edition is scheduled for December 2026, so this edition will date.
• Reading is not training. The case material and transcripts illustrate the treatments, but delivering them competently requires supervised practice.

Where It Fits in the Course

This is the practitioner-oriented end of the course list. The introductory books come first. Llewelyn and Aafjes-van Doorn's Clinical Psychology: A Very Short Introduction and Burns's Psychiatry: A Very Short Introduction are short overviews of the professions; Pomerantz's Clinical Psychology: Science, Practice, and Diversity is an undergraduate introduction to what clinical psychologists do, including assessment and psychotherapy.

For the disorders themselves, Comer and Comer's Psychopathology: Science and Practice surveys the major categories, explanatory models and treatment evidence, and Maddux and Winstead's Psychopathology: Foundations for a Contemporary Understanding is an edited graduate text on causes and treatment with an emphasis on how disorders are defined and classified. Barlow's handbook is the natural follow-up to either: once a reader knows what a disorder is and what treatments exist, it shows in session-level detail how a specific treatment is conducted.

How to Use This Book

The book is aimed at graduate students and practitioners in clinical psychology, counselling and related fields; the reviewers quoted by the publisher also place it in graduate psychotherapy courses and as a reference for experienced clinicians. Readers should already know the diagnostic categories and the basics of cognitive-behavioral therapy.

A practical plan:

• Read by disorder, not cover to cover. Pick the chapter that matches a case or a course topic, and read Barlow's introduction first for the treatment's distinctive features.
• Core for a first treatment course: Chapters 1, 2, 4 and 7, on panic, trauma, obsessive-compulsive disorder and cognitive therapy for depression.
• Compare treatments: read Chapters 7–9 together, and Chapters 5 and 6 together, asking how each defines the problem and what each asks the client to do.
• Use the case material: follow the case example through assessment, formulation and sessions, and try to explain each therapist decision in terms of the chapter's rationale.
• After the book: supervised practice and the treatment protocols or manuals referenced in each chapter.