bluuebunny/crossref_metadata_2025 huggingface dataset:
Self-administered Behavioural Treatment
Authors: Marks Isaac
Published: June 2009

The growing sophistication of behavioural psychotherapy is indicated by the progressive easing of service delivery for anxiety disorders. This is attained by emphasis on the patient doing systematic self-exposure and recording details of tasks completed in daily exposure homework diary sheets. Therapist-accompanied exposure is now known to be largely redundant. The clinician's chief role is to assess, guide and monitor progress and teach relapse prevention, rather than to be with the patient during exposure. A similar self-management model could develop for the relief of sexual, depressive and eating disorders. Further advance is needed to shorten the time and effort needed from sufferers to help themselves.
Classical Conditioning: Still Going Strong
Authors: van den Hout Marcel , Merckelbach Harald
Published: June 2009

This paper summarizes developments in the field of classical conditioning. Attention is paid to four common misconceptions of what is classical conditioning. First, classical conditioning does not ensue as a simple result of temporal pairing of conditioned and unconditioned stimuli. Rather, conditioned reacting occurs if and to the degree that the subject is able to predict the occurrence of one stimulus from the presence of another one. Second, what is learned during classical conditioning is not necessarily a response to a cue, but rather a probabilistic relationship between various stimuli. Third, classical conditioning is not only manifested in responses mediated by the autonomic nervous system, but also in immunological parameters, in motoric behaviour and in evaluative judgments. Fourth, the nature of the conditioned and the unconditioned stimulus is (often) not a matter of indifference: particular combinations of CS and US produce more powerful conditioning effects than do other combinations. In the second part of the paper, the potential relevance of these developments is illustrated. Discussions are included about anxiety, addictions and food aversions/conditioned nausea.
Substance Misuse
Authors: Hodgson Ray J.
Published: June 2009

Social learning theory has provided the field of substance misuse with a solid base from which to generate hyotheses and develop treatments. The emphasis during the last decade has been upon outcome and efficacy expectancies, relapse prevention and stages of change. Helping people to move through these stages of change (motivational interviewing) has been a particularly strong focus. The literature on alcohol dependence provides reasonable evidence to support the effectiveness of the following treatment approaches: antidepressant medication, behavioural contracting, brief interventions, behavioural marital therapy, behavioural self-control training, community reinforcement approach, covert sensitization, Disulfiram (Antabuse), social skills training and stress management training. It is also suggested that interest in cue exposure will develop in the future. During the next decade self-regulation theory will turn out to be a rich source of ideas as well as a useful conceptual framework that integrates a range of treatment approaches.
Behavioural Psychotherapy and Schizophrenia: The Past, the Present, and the Future
Authors: Tarrier Nicholas
Published: June 2009

Behavioural therapists have been involved with the management of schizophrenia since the emergence of the discipline in the 1950s. It has been stated recently that behaviour therapists have lost interest in serious mental illness. However, in the last few years great advances have been made in behavioural approaches to the management of schizophrenia. Controlled trials of family management methods have indicated that: relapse rates can be reduced, the patient's social functioning increased and family burden decreased. These approaches also have economic benefits over traditional services. Furthermore, other methods, such as early signs monitoring followed by early intervention and self-management of drug resistant residual symptoms, have also shown promise. The development of these innovative behavioural approaches is especially important in an era of community based mental health services.
Permutation Statistics in Single Case Design
Authors: Clements J. C. , Hand D. J.
Published: June 2009

This paper illustrates the use of a single case design and analysis based upon assignment rather than sampling theory in a series of case studies of young and handicapped children with sleeping difficulties. The strengths and limitations of the design are discussed.
Cognitive/Behavioural Therapy and Pharmacotherapy with Chronic, Drug-Refractory Depressed Inpatients: A Note of Optimism
Authors: Miller Ivan W. , Bishop Stephen B. , Norman William H. , Keitner Gabor I.
Published: June 2009

Several previous studies have reported that cognitive/behavioural treatments have been relatively ineffective for chronic, drug-resistant depressed patients. In the present report, six chronic, drug-resistant depressed patients were treated with an integrated program consisting of cognitive/behavioural treatment, pharmacotherapy, and short term hospitalization. The obtained improvement rates were substantially better than previous studies. Potential explanations for these findings are discussed.
Sensory Reinforcement with Autistic Children
Authors: Baker L. J. V. , Milner Yvonne
Published: June 2009

Three non-verbal, autistic boys of 9, 12 and 16 years served as subjects in two experiments and a nurse play-therapist acted as the agent. The first experiment compared the effects upon a motor coordination task of each subject's preferred sensory reinforcer with those of the sensory reinforcer preferred by the other two subjects. On-task performances were maintained by prompting and by contingent presentation of each reinforcer in a multiple-baseline design across subjects. All subjects showed higher levels of on-task performance for their preferred sensory activity. In the second experiment a multielement-baseline design compared the effects of the preferred sensory reinforcer with those of a preferred edible reinforcer. All subjects showed higher levels of on-task performance for their preferred sensory activity. Inter-observer reliability remained above 90%. A role for sensory reinforcement in training autistic children is suggested.
Comparison of Effectiveness: Behavioural and Talk-based Alcohol Education Courses for Court-referred Young Offenders
Authors: Baldwin Steve , Heathers Nick , Lawson Alan , Robertson Ian , Mooney Jimmy , Braggins Frankie
Published: June 2009

Referrals for young males with drink-related offending behaviours were obtained from local courts. Following an assessment interview, young offenders completed either a talk-based Alcohol Education Course (AEC) or a behavioural AEC. At follow-up interviews, differences in dependent variables of offending and drinking behaviour were observed. The results are discussed in the context of their possible implications for practice.
Group Treatment for Obsessive-Compulsive Disorder: An Evaluation
Authors: Enright Simon J.
Published: June 2009

This study presents the results of a preliminary investigation into the effectiveness of treating people with obsessive compulsive disorder (OCD) in group. Twenty-four clients in four groups run consecutively participated in the study. Outcome measures of statistical and clinical significance suggest that specific effects on the reduction of OCD symptoms were small. However, important positive non-specific effects were achieved relating to enhanced mood, reduction of the disabling effects of the symptoms, and clients self reported increased sense of hope, understanding and control. Initial improvements were maintained at six month follow-up. Clients' rating of helpfulness for the different contents of the group programme were highest for non-specific aspects. The author suggests that the presented group programme may have an important pre-treatment role in helping OCD clients prior to individual therapy.
Behavioural Psychotherapy: A National, European and International Perspective
Authors: Holland Rod
Published: June 2009

I remember quite well my first exposure to an international conference of behaviour therapists, albeit through a haze of Irish hospitality. As a trainee clinical psychologist in the early 1970s, at a time when training budgets could stretch to the occasional foreign conference, I was fortunate enough to attend one of the early, and now infamous, Wexford Congresses on Behaviour Modification, organized by the now defunct Behavioural Engineering Association of Ireland.
The Development of the BABP
Authors: Lomas Howard
Published: June 2009

On a cold and dull Autumn Friday in 1972, I was among hordes of Behaviour Changers/Modifiers/Engineers/Therapists (all to become Psychotherapists) making their way from the four corners of Britain to the Middlesex Hospital in London. We were all going to a meeting to discuss the setting up of a National Association for those interested in Behavioural … whatever. When I arrived, I was refused entry unless I paid £3 annual membership fee to the very smartly dressed bouncer on the door who claimed to be the Treasurer. “But I thought the meeting was to decide if we are going to form an Association and, if so, to elect the officers!” My protests were in vain, as would have been my 460 mile day trip if I had not parted with my £3 — I have never really mastered contingency management!
The Origins of Behavioural Psychotherapy
Authors: Lillie Francis
Published: June 2009

The co-editor of the first BABP Newsletter in 1973 reminisces on the excitement of early behavioural therapy in the UK but is disappointed at the pace of change at service delivery level.
Fear Reduction Processes in Imaginal and In Vivo Flooding: A Comment on James' Review
Authors: Hecker Jeffrey E. , Thorpe Geoffrey L.
Published: June 2009

The research comparing imaginal and in vivo exposure in the treatment of clinically significant fear, recently reviewed by James (1986), is reexamined from the perspective of bioinformational theory and the concept of emotional processing. Fear is assumed to be stored in long term memory as a network of propositionally-coded information, which has to be processed if treatment is to be successful. Emotional processing is indicated by activation of fear responses and their habituation within and across treatment sessions. Consistent with the theory, our review indicates that successful treatment via imaginal and in vivo exposure is indeed related to activation and habituation of fear responses; interference with processing has a negative impact upon fear reduction, regardless of the specific treatment techniques employed. Furthermore, some apparently discrepant findings in the available research literature can be understood in terms of the theories cited. These ideas provide a useful perspective from which to plan future research efforts and to advance our understanding of the processes underlying reduction of pathological fear.
Clinical Aspects and Treatment of the Hyperventilation Syndrome
Authors: Garssen Bert , Rijken Hanneke
Published: June 2009

The Hyperventilation Syndrome is a common disorder and clinical psychologists will be regularly confronted with it, because the syndrome is closely interwoven with psychological problems. The literature is reviewed with respect to pathophysiology of the complaints, aetiology of the syndrome and treatment. A new developmental model is presented and directions for future research are proposed.
Three-year Post-treatment Follow-up of “A Comprehensive Behavioral—Cognitive Treatment of Writer's Block”
Authors: Lah Michael I. , Rosenberg Harold
Published: June 2009

Three years following the initial behavioral—cognitive treatment for a case of writer's block with his Master's thesis, the subject was faced with writing his doctoral dissertation. Without the prompt or assistance of the original therapist, the subject used the task analysis, chaining, distraction control, and reinforcement procedures to successfully complete the writing project, although without using a formal work schedule. The subject's perceptions of these techniques and their effectiveness during the writing of the dissertation are presented and discussed.
The Generalization of Treatment Effects in Parent Training with Multidistressed Parents
Authors: Dadds Mark R. , Sanders Matthew R. , James Jack E.
Published: June 2009

This paper presents two studies which attempt to clarify the processes by which families who have multiple problems respond to behavioural parent training procedures. Study 1 assessed a range of parent and child behaviours in diverse home and community childcare settings during baseline, child management training and 3-month follow-up. Results show that while treatment gains occurred in the home training setting with the therapist present, little generalization of therapeutic effects to other settings was found. At follow-up, the gains made in the training setting had largely reverted to baseline levels. Study 2 assessed the same parent and child behaviours across settings for another group of multidistressed families during baseline, child management training, generalization training (consisting of planned activities and a social-marital support intervention) and at follow-up. Results indicated that the generalization training was associated with further improvements in non-training settings for parent and child behaviour, and that these results had maintained or further improved at follow-up. The results are interpreted and discussed with reference to future research and clinical work with conduct disordered children and their families.
Insight Versus Rehearsal in Cognitive-Behaviour Therapy: A Crossover Study with Sixteen Phobics
Authors: Thorpe Geoffrey L. , Hecker Jeffrey E. , Cavallaro Lorraine A. , Kulberg Gordon E.
Published: June 2009

Although cognitive restructuring (CR) procedures have not proven very helpful for phobics in recent studies, insight and rehearsal components of CR have often been confounded. To seek possible differences in effectiveness between insight and rehearsal, we treated 16 phobics (eight agoraphobics and eight others) with four sessions of each method, using a counterbalanced crossover design with 1-month follow-ups after each treatment component. Significantly fewer sessions were attended by the clients in the rehearsal/insight sequence, and benefit ratings made by project completers significantly favoured insight/rehearsal. Few other treatment group differences were seen, but those that emerged gave the advantage to insight. Rehearsal seemed unhelpful, particularly to non-agoraphobics. Conclusions are (1) that CR methods show some promise in application to phobias, provided that self-exposure homework forms the core of the treatment plan, and (2) that insight followed by rehearsal is the preferred sequence.
Managing Difficult and Disruptive Behaviour in Residential Settings: The Use of Room Management
Authors: Hill Patrick , Chamberlain Paul
Published: June 2009

The use of room management techniques to increase the levels of engagement of people with a mental handicap has been well documented. The difficulties in using constructional approaches (as opposed to eliminative procedures) to deal with difficult and disruptive behaviour in residential settings has also been well documented. This study reviews the relevant literature and describes in detail the application of a room management technique in a women's hospital villa. The six residents who took part are described as severely mentally handicapped, difficult and disruptive. During the room management sessions the levels of engagement in purposeful activity of the women increased and the problem behaviour exhibited decreased. Both changes were statistically significant. The implications of these findings for the general management of people who exhibit difficult and disruptive behaviour are discussed.
Treatment of Irritable Bowel Syndrome by Exposure in Fantasy: A Case Report
Authors: Newell R. J.
Published: June 2009

A female irritable bowel syndrome sufferer was offered several strategies sequentially for coping with the complaint. Of these, bowel retraining established desired bowel frequency and exposure in fantasy resulted in decreased frequency and intensity of pain attacks. Both of these effects were maintained to 18-month follow-up.
Giving Away the Behavioural Approach
Authors: Carr Janet
Published: June 2009

It is accepted that for reasons of economy and efficacy the behavioural approach needs to be “given away” to those in day-to-day contact with clients. These new behaviourists may need special help if they are to use their skills to best advantage but can make a valuable contribution both to their clients and to practical knowledge in the area.
Acquisition of Makaton Symbols by a Young Man with Severe Learning Difficulties
Authors: Brownjohn M. D. R.
Published: June 2009

Recognition of and discrimination between seven Makaton symbols was taught to a young man with severe mental handicap and some physical difficulties which, combined with “poor motivation”, had previously resulted in his failing to learn signing. An errorless learning approach as well as tangible and social reinforcers were used to teach the symbols, while over-learning may also have been important in promoting retention. Following the successful completion of the programme the young man was accepted for speech therapy and further communication training, for which he had previously been thought unsuitable.
A Problem of Sexual Behaviour Presenting in an Adult Training Centre
Authors: Robertson Georgiana
Published: June 2009

A young man's serious sexual misbehaviour, which resulted in his being banned from his ATC, was tackled using a behavioural approach (reinforcement of appropriate behaviours) and counselling. This combined programme had an immediate effect in reducing his overt sexual activities at the Centre and promoting his acceptability there which has been maintained in the succeeding three years. The token system used helped not only to structure the young man's response but also, as concrete evidence of his success, to change attitudes towards him of Centre staff.
Overcoming Nocturnal Enuresis in a 16-year-old with Mental Handicap: An Alternative to the Dry Bed Approach
Authors: Robson Irene
Published: June 2009

The dry bed approach, described by Azrinet al.(1973) as a highly successful way of bringing about night toilet-training in people with mental handicaps, is not always feasible. An alternative method, progressive lifting, was undertaken in a small group home to train a young man. Although very lengthy (lasting two years), the programme was successfully carried out by sleep-in staff who worked normal daytime shifts throughout.
Teaching a Mother to Attend Differentially to Her Mentally Handicapped Child's Behaviour
Authors: Rix Karen
Published: June 2009

A mother was taught to modify her interactional style with her language-delayed son, using direct feedback via a bug-in-the-ear and video recordings. Results showed that attending to and praising the child's behaviours and imitating vocalisations increased, while commands, questions and reprimands decreased. Methods of dealing with tantrums were taught but no occasion arose during the teaching for putting them into practice. Follow-up two years later showed Stephen making good progress, while neither his mother nor his school had needed any further outside help for him.
Teaching Hand-Laundering to a Woman with Mental Handicap
Authors: Williams Yvonne
Published: June 2009

Hand-laundering of tights and knickers was taught to a woman with moderate mental handicap. The 14-stage programme was taught over five sessions in a total of 90 minutes. At follow-up she was shown to have both maintained and generalised the skills.
Cognitive and Secondary Symptom Variables as Predictive Factors in the Treatment of Agoraphobic In-Patients
Authors: Hoffart Asle , Martinsen Egil W.
Published: June 2009

The ability of health locus of control, causal attributional, and secondary symptom variables to predict response to an integrated behavioural and psychodynamic treatment of agoraphobic in-patients, both immediately and one year after treatment, was investigated (N = 36). It was hypothesized that patients who retained an external locus of control during treatment would be likely to relapse after treatment. Further, it was hypothesized that tendencies to externalize locus of control, to attribute bad events to internal, stable, and global causes, and to attribute good events to external, unstable, and specific causes, would influence the treatment process in a negative way. It was also hypothesized that high levels of secondary symptoms, that is depression and general anxiety, would inhibit progress. None of these hypotheses were consistently supported by the results. This indicates that more precise and sophisticated models of agoraphobia development and treatment process are needed.
Adjuvant Psychological Therapy with a Terminally III Patient: A Case Report
Authors: Santos Maria J. H. , Greer Steven
Published: June 2009

Adjuvant Psychological Therapy (APT), a cognitive behavioural treatment, has been developed to alleviate cancer-related anxiety and depression. It is being evaluated in a controlled study of patients with early cancer, but has not been used previously in patients with terminal cancer. This case report describes the use of APT in a severely anxious and depressed male patient with terminal carcinoma of the colon. His psychological progress until death is reported. Although no firm conclusions can be drawn from a single case, the results obtained were sufficiently encouraging to warrant a systematic study of APT in emotionally distressed patients with terminal illness.
Successful Cognitive Manipulation of a Stereotypic Nightmare in a 40 Year Old Male with Down's Syndrome
Authors: Bradshaw Stephen J.
Published: June 2009

Substitution of a happy ending to a recurrent stereotypic nightmare and subsequent assisted rehearsal produced immediate cessation of a previously frequent nightmare and consequent removal of associated fear and distress.
Organizational Behaviour Management in a Psychiatric Day Hospital
Authors: Milne Derek
Published: June 2009

If behaviour therapy is to remain viable and relevant, it needs to address key problems in the settings in which they arise. One major problem facing behaviour therapists is that of procuring institutional innovation. This study illustrates the successful application of an “organizational behaviour management” (OBM) approach within a psychiatric day hospital. The central issues of measuring and manipulating important system variables, and of relating these to clinical outcomes, are addressed by concurrent process and outcome evaluations with nurses and patients. It is concluded that OBM represents a promising and effective extension of the behaviour therapists' skills.
The Self-Management of School Phobia: A Case Study
Authors: McNamara E.
Published: June 2009

The successful resolution of a problem of school phobia using self-management strategies is reported. The clinical report is prefaced by the observation that differences of emphasis are apparent when authorative reviews of the field of self-management are considered—and the conclusion drawn is that the successful outcome could be used to lend support to Kanfer's two-stage model of self-regulation. The client, Anne, was a pupil in the first year of comprehensive schooling. She attended school on only four days during the first term. Problem analyses in terms of operant and classical learning theories are described, and intervention strategies were generated which were accommodated within Kanfer's two-stage model of self regulation.
Anne self-recorded school attendance, lesson attendance and self-confidence. School attendance was immediately achieved and progress towards full lesson attendance was made over a seven-week period. Affective state (self-confidence) as assessed by self-report was observed to increase as lesson attendance improved but a temporal lag was observed. The report concludes with some observations of a theoretical nature and justification for the intervention to warrant the descriptor “self-management”.
A Single Case Study Illustrating the Reduction in Subvocalisation with Electromyography
Authors: Dooley Catherine , George R. E.
Published: June 2009

The effect of subvocalisation on reading speed and comprehension is briefly reviewed. Reading speed is slowed by subvocalisation but comprehension and retention of complex material is improved. In this single case study the activities of the laryngeal and mylohyoid muscles were recorded during reading and other activities. Through electromyographic biofeedback the patient learnt to reduce muscle tension and to discontinue the long term habit of subvocalisation.
Is It Ever Too Late to Learn? Information Provision to Relatives of Long-term Schizophrenia Sufferers
Authors: Sidley Gary L. , Smith Jo , Howells Kevin
Published: June 2009

This pilot study describes the provision of information tailored to meet the needs of families caring for a chronic schizophrenic member. An existing education package (Smith and Birchwood, 1987) was adapted to give greater emphasis to negative symptoms, myths/stereotypes and “quality of life” issues. A range of outcome measures revealed that the “original” education package promoted a greater reduction in the level of family burden whereas the “modified” package tended to promote greater belief in the efficacy of medication. Both educational programmes were associated with significant gains in knowledge per se (but not in “functional knowledge”) and significant positive changes in families' beliefs about their own role in the treatment process. The implications of these findings are discussed.
A Pilot Study of the Cognitive Treatment of Dysthymic Disorder
Authors: Stravynski Ariel , Shahar Anton , Verreault Richard
Published: June 2009

Six patients meeting DSM-III criteria for dysthymic disorder completed fifteen weekly sessions of one hour of individual cognitive therapy. Pre-, post- and six months follow-up assessments were carried out by an independent assessor. A significant improvement in depression was observed after treatment and maintained at six months follow-up. Clinically, improvements were meaningful and wide ranging and four of the patients no longer met DSM-III criteria for dysthymic disorders. Cognitive treatment acted specifically as it reduced significantly the frequency of negative automatic thoughts during treatment and follow-up.
Training in Cognitive-behaviour Therapy: Pilot Evaluation of a Training Course Using the Cognitive Therapy Scale
Authors: Williams Ruth M. , Moorey Stirling , Cobb John
Published: June 2009

Preliminary work in assessing the competency of trainees attending a cognitive behaviour therapy course is presented. Inter-rater reliability of the Cognitive Therapy Scale to assess competency in therapy is considered satisfactory at the overall competency level. Item reliabilities are promising. Although the power of this pilot design is weak, the competency scale showed a trend towards improvement over the course of training.
Can Therapists Predict Length of Treatment from Referral Letters? A Pilot Study
Authors: Westbrook David
Published: June 2009

Seven experienced clinicians were asked to judge how many sessions patients in a clinical psychology out-patient clinic would take to complete treatment, using patient referral letters as their only data. Results showed the clinicians were very poor at making this judgement and generally did no better than chance. Their clinical predictions were compared with statistical data using a regression analysis of initial questionnaire measures. The regression equation did a little better on some judgements, but still failed to predict long-term treatment.
Motivational Interviewing with Problem Drinkers: II. The Drinker's Check-up as a Preventive Intervention
Authors: Miller William R. , Sovereign R. Gayle , Krege Barbara
Published: June 2009

Miller's (1983) system of ‘motivational interviewing’ is elaborated by providing a theoretical context for understanding its impact, with a summary of research on motivational interventions. An extension of this approach, the Drinker's Check-up (DCU), is described as a potential intervention for health screening, treatment selection and matching, cleint self-assessment, and research. Initial data from a sample of 42 problem drinkers receiving the DCU suggest that this intervention may increase help-seeking and modestly suppress alcohol consumption. This approach is interpreted within the broader context of research on minimal interventions for problem drinkers.
A Pilot Study of the Therapeutic Usefulness of Videofeedback for Weight Loss and Improvement of Body Image in the Treatment of Obesity
Authors: McCrea Celia , Summerfield Angela B.
Published: June 2009

The majority of investigations in the literature have concluded that body image is a relatively fixed phenomenon, the juvenile onset of obesity often being associated with a body image distortion which is presumed to be especially impervious to change (Stunkard and Burt, 1967; Hirsch, 1972). Nevertheless, the evidence for this suggestion is not conclusive (Collins et al., 1983), and is challenged by the findings of the present study. When subjected to regular videofeedback over a period of approximately four months, one group of obese subjects successfully lost weight, and appeared to improve the accuracy of their body image estimates. Another group of obese subjects who underwent a behaviour modification programme over the same period also lost weight and showed a lessening of body image distortion at the end of this intervention, but the changes observed between assessments were much greater for the video group. Some individuals in both treatment conditions had experienced juvenile-onset obesity. The fact that those who received videofeedback also showed improvement in terms of body image assessment and weight loss lends added support to the suggestion that the experience of videofeedback is therapeutic for the obese.
A Comparative Observational Study of the care provided in Hospital with the care provided at Home for Profoundly Multiply Handicapped Children
Authors: Beail Nigel
Published: June 2009

Considerable concern has been expressed about the quality of care provided for mentally handicapped children living in hospitals. Current policies aim to relocate these children in community settings, giving them a lifestyle as near as possible to that in an ordinary home. Studies of mentally handicapped children living in hospital have all shown that the quality of care is poor, but comparative studies of the quality of care provided for mentally handicapped children living at home have not been carried out. This paper reports a comparative observational study of the quality of care provided for profoundly mentally handicapped children living in a long-stay hospital with a match group who live at home. The rate and content of naturally occurring interaction patterns between nursing staff or family members and the children were observed during the hour after arrival home from school. The results show major differences between the two settings in terms of the types of behaviour exhibited by the children, the frequency and nature of attention given to the children and the quality of the interactions between the children and their carers. In all areas the children living at home fair better. The implications of these findings are discussed.
A Follow-up Study of a Comprehensive Behavioural Treatment Programme for Chronic Pain Patients
Authors: Melin Lennart , Linton Steven J.
Published: June 2009

The 28 patients in the Linton et al. (1985) outcome study were contacted for a 20-month follow-up. The follow-up was superimposed on a three-group design consisting of a waiting-list control, a regular treatment group, and a “behavioural” group receiving the regular treatment plus applied relaxation and operant-activities training. Measures similar to the ones used in the original study were employed, in addition to a follow-up questionnaire concerning work, health status, activity level, pain ratings, medicine use, and sleep. Ninety-three per cent of the original patients participated in the follow-up. In general, improvements were maintained by the behavioural group. Specifically, results indicated that the group receiving applied relaxation and operant-activities training had significantly larger improvements with regard to pain and activity at follow-up than the control groups. Moreover, an overall analysis of variance showed that the behavioural group differed significantly from the other two groups. The results definitely suggest that the positive effects of the behavioural programme were maintained at follow-up.
The Behavioural Treatment of Faeces Retention: An Expanded Case Study
Authors: Phillips Grania T. , Smith Jane E.
Published: June 2009

The successful treatment of faeces retention in a 6-year-old boy is discussed in the light of recent findings in the literature which suggest the need to take both family and therapist variables into account when training parents in child management skills. Details are given of the family variables considered relevant to the presenting problem in this case: lack of paternal motivation to co-operate in treatment, maternal depression and social isolation, and problem behaviour in a sibling. The treatment plan designed to take account of these variables is described, as well as the problems (and their resolution) encountered in implementing it. Successful outcome was maintained at three and six month follow-up. It is argued that wider use of this model of an expanded case study would provide useful hypotheses for future research, as well as clinical relevance for other practitioners.
Individual Change in a Social Skills Group: A Case Study
Authors: Newton Annette
Published: June 2009

This study looks at the use of individual scaling techniques, namely the Personal Questionnaire Rapid Scaling Technique (PQRST) to monitor symptom change during a social skills group. This augments the more familiar observational measures and self report questionnaires. The results suggest that these individual questionnaires may be useful to clarify social interaction difficulties and the process of change in social skills training.
Treatment of a 7-Year-Old Hyperactive Boy with Educational Problems
Authors: Hogg Caroline , Callias Maria , Pellegrini David
Published: June 2009

A 7-year-old hyperactive boy with multiple problems was treated using a combination of interventions, applied sequentially over 14 months. The first phase of treatment was participation in a drug trial (placebo, then drug) and this was followed by cognitive-behavioural training designed to teach strategies with which to approach academic work. Teacher and parent behaviour ratings showed improvement over the drug trial period and educational gains were made during the cognitive-behavioural training, both in the area specifically taught and other academic subjects. The problems choosing appropriate targets and of disentangling the effects of different treatment components are discussed.
Review of the Relative Efficacy of Imaginal andIn VivoFlooding in the Treatment of Clinical Fear
Authors: James Jack E.
Published: June 2009

The present review concerns the relative efficacy of imaginal andin vivoflooding in the treatment of debilitating fear. It has generally been concluded thatin vivoflooding is superior to flooding in imagery. However, in the present review, serious methodological weaknesses were found to exist in a number of studies which have been frequently cited as demonstrating the superiority ofin vivoflooding. In addition, recent empirical studies are reviewed which cast doubt on the belief thatin vivoflooding is superior to imaginal flooding. Overall, little support was found for recent recommendations advocating the abandonment of methods of imaginal exposure in the treatment of clinical fear.
Training Direct Care Staff in Goal Planning with Elderly People
Authors: Barrowclough Christine , Fleming Ian
Published: June 2009

Although there have been a vast number of reports on training direct care staff in behavioural techniques, little work has been reported pertaining to elderly individuals. This paper describes how a method of constructing, implementing and evaluating individual plans – goal planning – was adapted for use with elderly clients. Direct care staff in a number of different establishments were trained in goal planning techniques with elderly clients and evaluations of their goal planning skills were made after training. Most trainees acquired the skills to an acceptable level and in the small sample studied, this was maintained at four month follow-up. Some measures of the effectiveness of the implementation of the goal planning and its maintenance after training are reported, and limitations of the training programme are discussed.
An Experimental Test of Cautela's Operant Explanation of Covert Conditioning Procedures
Authors: Dougher Michael J. , Crossen John R. , Garland R. J.
Published: June 2009

Although covert conditioning procedures are widely employed by behavior therapists, the literature is marked by considerable procedural variability and inconsistent results. Part of the problem is attributable to the lack of a generally agreed upon and experimentally supported theoretical account of covert conditioning procedures. Inasmuch as the procedural arrangements of covert conditioning techniques depend upon the underlying theoretical framework, it is important that the framework be experimentally supported. One prominent theoretical account of covert conditioning is the operant account proposed by the main proponent of covert conditioning, Joseph Cautela. As an explanation of the clinical effects of covert conditioning, however, Cautela's account has not been adequately tested. Two experiments were conducted, the purpose of which were to conduct laboratory analogue tests of Cautela's account of covert conditioning by examining the effects of covert reinforcement and covert punishment procedures on the subsequent free-operant rate of selected target responses of college students. The results failed to support Cautela's operant explanation of covert conditioning.
The Cognitive Revolution: An Ongoing Evolution
Authors: Blackburn I. M.
Published: June 2009

The five papers which make up this special issue all reflect a feeling of guarded optimism about future applications of cognitive therapy in our clinical practice. A long way has been covered since the theoretical formulations of the early 60's, which led to the term “cognitive revolution” after Kuhn's (1962) exposé of how paradigm shifts occur in science. If there has been a revolution, it has been, on the whole, non-violent in spite of the sometimes shrill protests from the old guard. As Paul Salkovskis points out in the introductory paper, behaviour therapists have, perhaps paradoxically, been the most enthusiastic in coming to terms with the new paradigm. This coming to terms has involved experimental, theoretical and treatment studies. The areas covered have expanded steadily from depression and anxiety, to the obsessional disorders, the eating disorders, the phobias, adolescent problems and, as seen in this volume, to pain and marital conflict. Articles, books and new journals proliferate. Why should that be so?
Cognitive Processing in Phobias
Authors: Watts Fraser N.
Published: June 2009

A programme of research is described which investigates the cognitive processing of phobic stimuli. Phobics show good perceptual “pick-up” of phobic words on a version of the Stroop test. However, their encoding appears to be poor, as indexed by recognition memory for phobic stimuli. Consistent with this, cognitive representations of phobic stimuli are poorly elaborated and differentiated. Brief desensitization was found to have stronger effects on perceptual and encoding phenomena than on cognitive representations. Finally, spider phobics were found to have poor recall of phobic words. This contrasts with the opposite phenomenon that has been reported for agrophobics and depressives.
A Controlled Comparison of Cognitive—Behaviour Therapy, Diazepam and Placebo in the Management of Generalized Anxiety
Authors: Power K. G. , Jerrom D. W. A. , Simpson R. J. , Mitchell M. J. , Swanson V.
Published: June 2009

Generalized anxiety patients were randomly allocated to Cognitive-Behaviour Therapy, Diazepam or Placebo and managed in a primary care setting. Treatments were balanced for degree of psychologist/patient contact. A range of outcome measures, including patient self report, psychologist assessor and general practitioner ratings were used. Large variations within group response to treatment emerged. At the end of active treatment the superiority of Cognitive-Behaviour Therapy was suggested. Post-study psychotropic prescription and psychological treatment was assessed at a 12-month follow-up. The Cognitive-Behaviour group revealed the lowest incidence of subsequent treatment interventions.
Attentional Strategies and Agoraphobic Anxiety
Authors: Watts Fraser N.
Published: June 2009

It is argued that the attentional strategies of phobic patients have important consequences for how they cope with anxiety. The literature indicates that focused attention to anxiety cues is important for long-term emotional habituation but that it is made difficult by anxiety. Questionnaire studies of agoraphobics reliably identified factors concerned with attentional strategies of coping with anxiety, and showed that they were distinct from self-talk strategies. The effect of anxiety levels on the use and perceived helpfulness of these strategies was also explored. Finally, the implications of an attentional framework for exposure treatments of phobic anxiety are discussed. It is suggested that the questionnaire may be a useful way of measuring patients' attentional strategies in clinical work.
Group Relaxation Training with Adults who are Mentally Handicapped
Authors: Lindsay William R. , Baty Frances J.
Published: June 2009

This paper describes and compares two relaxation training procedures with moderately and severely mentally handicapped people. Abbreviated Progressive Relaxation is a widely used procedure while Behavioural Relaxation Training is a relatively recent development which the authors felt might be more suitable for mentally handicapped people since it does not require a conceptual awareness of internal states of anxiety. While both relaxation procedures produced improvements, Behavioural Relaxation Training was significantly better than Abbreviated Progressive Relaxation. In addition to this the results during treatment showed Abbreviated Progressive Relaxation to produce very variable effects from session to session. In contrast the effects of Behavioural Relaxation Training were quick and consistent.
Phasic Cardiac and Electrodermal Reactions to Idiographic Stimuli in Obsessional Subjects
Authors: Eves Frank , Tata Philip
Published: June 2009

This study investigated short latency cardiac and electrodermal responses in obsessional subjects with cognitive rituals. Three key phrases from anxiety provoking and from neutralizing ruminations were selected as discrete stimuli and presented through a loudspeaker. In addition, three relatively novel phrases were employed. Whereas the anxiety provoking phrases elicited cardiac acceleration, decreases in heart rate followed the novel stimuli. These data suggest that defensive and orienting responses had been elicited by anxiety provoking and novel stimuli, respectively. In contrast, only minimal cardiac reactions were evoked by phrases from the neutralizing rituals. For the electrodermal data, no reliable distinction between the three categories of stimuli was observed. The possible utility of this paradigm as a measure of treatment outcome is discussed.
Normalization and Applied Behaviour Analysis: Values and Technology in Services for People with Learning Difficulties
Authors: Emerson Eric , McGill Peter
Published: June 2009

It is argued that normalization and applied behaviour analysis represent the most significant developments of the past two decades in approaches to the design of services for people with learning difficulties. Problems in translating these approaches into practice have been compounded by an apparent conflict between them. The nature of this conflict is examined and suggestions for a rapprochement are made.
Resistance and Restraint
Authors: Linke Stuart
Published: June 2009

The functions of resistance and restraint are considered in three topographically distinct psychological disorders that are characterized by excessive behaviour. Certain similarities are observed and speculations about their common role are examined. Finally attention is drawn to the implications of this type of analysis for our understanding of such disorders and for psychological treatment.
Psychological Therapy for Premenstrual Emotional Symptoms
Authors: Slade Pauline
Published: June 2009

Four women with cyclical changes in negative emotions related to their menstrual cycle were treated individually with a combination of psychological interventions, These included problem solving, autogenic training, and anxiety and anger control strategies. Cognitive issues and attributional patterns were also considered. Analysis of symptoms using permutation statistics indicated significant improvements. The problems of open trials and extrapolation from case reports are noted. Important clinical issues which arise in psychological intervention for premenstrual emotional symptoms are also considered.
The Effect of Cue-Exposure Response Prevention on Cigarette Smoking — A Single Case
Authors: Self Roland
Published: June 2009

The procedure of cue-exposure response prevention has been successful in reducing subjective urges and overt behaviour associated with a number of compulsive disorders. Despite this it has not been systematically applied to the problem of smoking cessation. An individual case is presented which demonstrates the successful decrement of urges to smoke as a result of cue-exposure response prevention. The relevance of such a procedure to relapse prevention is discussed.
Working with People with Learning Difficulties Who Self-Injure: A Review of the Literature
Authors: Blair Alan
Published: June 2009

Self-injurious behaviour in people with learning difficulties has been found to be a common and health-threatening problem. As a consequence, there is an expanding literature addressing a variety of methods of intervention that are either designed to facilitate or to enforce the reduction or extinction of such behaviour. It is not clear, however, the extent to which such interventions are successful in achieving their avowed goal. This paper critically reviews the treatment of self-injurious behaviour, including work which takes psychodynamic, psychopharmacological, developmental, self-stimulation or learned behaviour perspectives, in order to establish the current status of interventions in this area. It is concluded that no single treatment approach has been shown to be effective in facilitating a reduction in the self-injurious behaviour of all clients. Rather, individualized programmes of intervention need to be constructed, using careful causal and functional analyses of behaviour. Moreover, such programmes, which may be multi-modal in nature, need to aim for interventions that are minimally or non-aversive.