This book makes excellent use of a wide range of literature from the early work on stuttering and therapy through to 1995. In the preface, Manning sets out his aims: to generate enthusiasm; to discuss clinical decision making from the perspective of the individual client's needs; to provide clinicians with choices of treatment strategies; to explore some of the less frequently discussed issues around diagnosis and treatment and to suggest questions for clinical investigation.

In the first chapter, clinician characteristics are considered including attitude and knowledge and development arising from increased experience of stuttering and therapy. Topics discussed include: opening your focus; taking risks; challenging the client and humour in therapy.

The chapter on aetiology, onset and development gives an overview of current knowledge and provides a good background to assessing fluency disorders in children. The author identifies two basic principles that determine severity, i.e. handicap (the extent to which a person narrows his life and choices because of the stammer) and struggle ("closing down or obstructing the speech production system").

The chapter on the treatment of young children explores general issues and discusses or describes current approaches. The next chapter discusses the "direction and logic of treatment" for adolescents and adults and introduces specific treatment techniques so the therapist can facilitate the client's progress towards the goal of self-management. Counselling strategies and techniques are described in the next chapter and the author stresses again the importance of selecting an approach in response to the needs of the client. The two final chapters consider indicators of progress during and after therapy. These chapters are interesting and help to fill out some of the more subtle changes that are so easily overlooked by therapist and client, especially when progress seems slow.

Three appendices list assessment procedures, support groups and pamphlets and video tapes. The author's considerable experience and knowledge are evident throughout this excellent book which both students and therapists should find informative and thought provoking.

Reviewed by Rosemarie Hayhow, specialist speech and language therapist, United Bristol Healthcare Trust, in the Winter 1996/97 issue of 'Speaking Out'.

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