Despite cognitive behavioral therapy being one of the most widely used and successful therapies, CBT does not work in all cases. Adhering to the dictum that clients do not fail therapies but that therapists or therapies fail clients, McKay (Fordham U.) and fellow psychologists at North American universities introduce 18 perspectives on working with refractory patients. In clinical and research contexts and through case examples, they analyze why the therapeutic relationship may not be going well, the newer generation of approaches for enhancing CBT (e.g., mindfulness- based interventions), treating specific diagnostic populations and clinical problems, and future directions in the field. Annotation ©2009 Book News, Inc., Portland, OR (booknews.com)