Book review

Psychology in Diabetes CareChichester: WileyISBN 0471977039. pp 279, £45.00

This book aims to address the needs of staff who are

involved in the delivery of diabetes care, by summarizing

applicable psychological knowledge. The editors have

collated the work of 24 known authors into nine chapters,

each on average having over 100 references. Each chapter,

in its own way, has attempted to provide practical

guidelines for staff. However, most also contain references

to the most relevant psychological models and to the

available empirical evidence.

The ®rst chapter separates childhood issues (Anderson,

Bracket) into infants, toddlers and school-aged children.

Developmental, family and school issues are discussed.

Adolescence is also considered by reviewing the psycholo-

gical characteristics and needs of this age group, and the

relevance of peer pressure and the social environment is

included (Skinner, Channon, Howells, McEvilly). A brief

review of pregnancy (Snoek) emphasizes the need for more

preconception counselling and joint working with obste-

tric teams.

Issues of patient empowerment (Anderson, Funnell,

Carlson, Saleh-Statin, Craddock, Skinner) are then ex-

plored from an American, Swedish and UK perspective.

Self-management is further developed by a chapter on

Stage of Change Counselling (Doherty, James, Roberts),

with a detailed exposition of psychological principles that

staff might use to help patients. The routine application of

behavioural principles in of®ce-based interventions

(Glasgow and Eakin) is reviewed, both in diabetes and in

other applications. Examples of protocol for clinic use are

given.

The chapter on Blood Glucose Awareness (Gonder-

Frederick, Cox, Clarke, Julian) presents empirical evidence

about the impact of training. A different therapeutic

approach is taken with Cognitive Behavioural Group

Training (van der Ven, Chatrou, Snoek), where a brief

rationale is followed with a session-by-session summary of

the programme. Detailed data are presented on three

cohorts, totalling 16, who have been through the pro-

gramme.

The last chapter overlaps slightly, but considers

Psychotherapy and Counselling more generally (Rubin),

in the form of different coping skills that can be

encouraged. Curiously, this chapter ends by considering

the prevalence of anxiety, depression and eating disorders

under the subheading of Psychopathology.

The editor's blend of practical ideas and empirical

evidence works in most chapters. It should prove a

motivating stimulus to introduce more psychosocial issues

into everyday care.

All clinicians should be able to take something useful

from the different chapters and I would recommend this

book on reading lists for doctors, nurses, dieticians,

chiropodists and psychologists who are training in

diabetes. This will rapidly become a routinely used and

useful text for reference and ideas to all professionals with

particular psychosocial issues. All departments of diabetes

will want one copy, providing a resource for clinical and

research projects. It is only the relatively high cost that will

limit individuals from obtaining their own copy as a handy

reference. It would be an excellent text for libraries, given

the leads it provides to other work.

I would have liked to have seen chapters that explore the

routine use of psychometric tools into diabetes care, such as

those that identify problems of adjustment or those

monitoring quality of life. Furthermore, a more psycholo-

gically minded approach to emotional problems that can

occur, such as anxiety, depression, phobias and eating

disorders, would have been useful. It might also have been

helpful to explore communication skills and adult educa-

tion principles that might guide services. There are also

important psychological principles to guide services as they

develop teams and manage change, that could have been

considered in a chapter on Organizational Issues.

My overall impression is that this book has ®lled a gap in

the texts available. More importantly, it has set an example

of how to turn theory into practice. It accurately re¯ects

contemporary thinking and hopefully will stimulate new

work.

P. James

ã 2001 Diabetes UK. Diabetic Medicine, 18, 339 339