bluuebunny/crossref_metadata_2025 huggingface dataset:
Motivational Interviewing with Problem Drinkers
Authors: Miller William R.
Published: June 2009

Motivational interviewing is an approach based upon principles of experimental social psychology, applying processes such as attribution, cognitive dissonance, and self-efficacy. Motivation is conceptualized not as a personality trait but as an interpersonal process. The model deemphasizes labeling and places heavy emphasis on individual responsibility and internal attribution of change. Cognitive dissonance is created by contrasting the ongoing problem behavior with salient awareness of the behavior's negative consequences. Empathic processes from the methods of Carl Rogers, social psychological principles of motivation, and objective assessment feedback are employed to channel this dissonance toward a behavior change solution, avoiding the “short circuits” of low self-esteem, low self-efficacy, and denial. This motivational process is understood within a larger developmental model of change in which contemplation and determination are important early steps which can be influenced by therapist interventions. A schematic diagram of the motivational process and a six-step sequence for implementing motivational interviewing are suggested.
Behavioural Psychotherapy in Natural Homesettings: an Empirical Study Applied to Conduct Disordered and Incontinent Children
Authors: Herbert Martin , Iwaniec Dorota
Published: June 2009

A therapeutic method (behavioural casework) based upon behaviour modification and self-help principles, is described with regard to incontinence and conduct problems, both being categories of social problems which loom large in the consciousness of clinical psychologists, psychiatrists and social workers. Procedures as used in the clinical agency, but more particularly in the natural home setting, are detailed and the results (which are very encouraging) tabulated.
Scaling Subjective Variables by SPC (Sequential Pair Comparisons)
Authors: Singh Avinash C. , Bilsbury Christopher D.
Published: June 2009

Shapiro (1961) devised a scaling method based on pair comparisons to overcome the problems associated with numerical rating scales. Phillips (1963, 1966, 1970, 1977, 1979) developed the theory underlying Shapiro's method and extended it to increase the precision of measurement. In this paper we present a simpler justification of the Shapiro–Phillips method and propose improvements by sequentializing the presentation of pair comparisons. In this way, the total number of comparisons can be reduced to correspond with an acceptable level of reliability. Responses are recorded graphically producing an instant score and reliability check. Some possible generalizations are discussed.
Behavioural Concepts and Treatments of Neuroses: Comments on Marks and Wilson
Authors: Robertson Ian H.
Published: June 2009

Marks (1981) recently argued that behavioural psychotherapy had few practical, theoretical or historical links with theoretical and experimental psychology. This paper attempts to elaborate some of Wilson's (1981) arguments against this view and cites some additional British evidence in support of these arguments. Wilson's consideration of the issue of service delivery appears unsatisfactory and the suggestion is made that behavioural psychotherapy be taken out of the medical arena and placed within a rationalized therapeutic service independent of the present medical–sychological–social work structures.
A Case of Separation Anxiety Treated by in vivo Systematic Desensitization
Authors: Ballard Margaret , Yule William
Published: June 2009

An 11-year-old boy who suffered panic and anxiety during separations from his mother was successfully treated by in vivo systematic desensitization in 10 sessions. His mother was actively involved in the treatment. The manifestations of separation anxiety in school had disappeared by the end of treatment. No further problems were shown at 3-month and 15-month follow-up. The case is discussed in the context of the behavioural treatment of school refusal.
Behavioural Concepts and Treatments of Neuroses
Authors: Marks Isaac
Published: June 2009

Behavioural psychotherapy has many roots, and experimental psychology is but one of many “idols of origin” which is in any case largely ignored by behavioural practitioners. The conditioning model of neurosis has shortcomings, and cognitive explanations alone are not satisfactory. It may be necessary to think in terms of failed extinction of phobias and rituals rather than of enhanced acquisition. Aetiological theories need not be related to effective treatment, nor are they necessary for clinicians to carry out successful behavioural treatment. For therapists, paradigms are more useful when derived from clinical experiments rather than from the laboratory. A critical task concerning treatments to reduce anxiety is to investigate those parameters which decide when exposure will be habituating and when it will be sensitizing. To this end, analogue research is less relevant than clinical experiments whose results can be used directly by clinicians. Ten theoretical problems with exposure are noted.

The demand for behavioural psychotherapy exceeds the supply of therapists. Paraprofessionals and self-help methods can help to bridge the gap, while preventive measures may prevent the development of some pathology. Most clinical psychologists and psychiatrists are overqualified merely to deliver behavioural services; there is no evidence that such qualifications add to effectiveness, though they are invaluable for research and teaching.
Grief Therapy and Cognitive Restructuring in a Depressed Woman Acquitted of Justifiable Homicide
Authors: Cottraux Jean
Published: June 2009

A case of depression related to justifiable homicide was successfully treated with a combination of imaginal exposure and cognitive restructuring. No previous report on comparable cases has been found in the behavior therapy literature.
Behaviour Modification in Dentistry: a Review
Authors: Lindsay S. J. E. , Busch C. J.
Published: June 2009

The review evaluates the contribution which behaviour modification has made to the outstanding behavioural problems in dentistry: the treatment and management of the fear of routine conservation; the prevention of tooth and gum disease; the management of acute operative pain and chronic facial pain.

Investigations of dental fear and operative pain have been limited perhaps too much to patients, especially children, who attend for dental treatment. Behaviour modification has yet to help adequately those patients who avoid dentists and who may be the most acutely afraid and the most intolerant of dentistry. More adequate contributions here could be made if behavioural sciences were much more satisfactorily taught in dental undergraduate and postgraduate curricula than at present.

Useful contributions to preventive dentistry have already been made. The successful treatment of chronic facial pain will have to depend, at least in part, on a more adequate understanding of the psychophysiological mechanisms of the complaint. The nature of the placebo effect in treatment here also needs to be more thoroughly understood.
A Behavioural Approach to the Treatment of Epilepsy
Authors: Lavender A.
Published: June 2009

Recently a number of studies have reported successfully reducing seizure frequency by interrupting preseizure behaviour and by manipulating the consequences of a seizure. A small research project was set up to overcome some of the methodological problems of earlier studies and to evaluate such a treatment approach with four children. Treatment involved helping the children to develop means of controlling their seizures, and included a system of rewards for seizure-free periods so as to motivate the children to use their method of control. The results indicated that the treatment was successful in two out of four children. On the basis of these results some suggestions as to the mechanisms involved and the place of such an approach in the management of epilepsy are offered.
How Useful is Meta-analysis in Evaluating the Effects of Different Psychological Therapies?
Authors: Wilson G. T.
Published: June 2009

Shapiro and Shapiro (1982) argue the case that meta-analysis has made, and will increasingly make, an important contribution to the evaluation of the effects of psychological therapies. Briefly stated, they make the following claims for meta-analysis: (1) Meta-analysis provides systematic and quantitative methods for summarizing and integrating the voluminous and diverse literature on psychotherapy. (2) Meta-analysis reduces (eliminates?) the subjective bias that is said to vitiate traditional, qualitative reviews of the literature. Consistent with similar allegations by Smith et al. (1980), Shapiro and Shapiro (1982) suggest that the conclusions drawn in “some” of these traditional reviews “are a function of the assumptions, predispositions and consequent biases of the reviewer.” Meta-analysis, however, is put forward as a distinct alternative to this sorry state of affairs, since it purportedly overcomes these sources of personal and professional bias and results in more objective more accurate evaluations of the evidence. (3) Meta-analysis has “the same superiority over a traditional literature review as that enjoyed by a systematic therapy outcome study over a series of impressionistic case reports.” (4) The advent of objective, quantitative meta-analytic procedures does not abolish the need for traditional literature reviews subjective and qualitative as they might be. The latter have their limited place, just as impressionistic clinical case reports can complement well-controlled experimental outcome studies.
Assertiveness Training with Outpatients: The Effectiveness of Skill and Cognitive Procedures
Authors: Hatzenbuehler Linda C. , Schroeder Harold E.
Published: June 2009

Forty-four community mental health outpatients participated in an assertiveness training program in which three treatment methods were compared. Skill training aimed at training specific assertive responses by means of instruction, modeling, behavioral rehearsal, feedback, and homework assignments. Cognitive training focused on altering the irrational cognitions which theoretically inhibit the expression of assertive responses. A third group (Cognitive–Skill) received both forms of training simultaneously, and a fourth group (Waiting List) was included as a control. A behavioral roleplaying test (B.R.P.T.) and the Social Fear Scale were administered prior to and immediately following four individual training sessions occurring at one week intervals for all three treatment groups. Analyses of covariance of assertive content ratings made by independent judges for B.R.P.T. responses revealed that all three treatment groups evidenced significantly more assertive and effective responses on both refusal and behavior change situations when compared to the Waiting List control. Analyses of paralinguistic dimensions of the B.R.P.T. revealed training generally to be more successful for the Skill group.
2081: Will We be Many or One – or None?
Authors: Franks Cyril M.
Published: June 2009

This is a series of short invited contributions from therapists and research workers who have volunteered to answer the following question: “If your fairy godmother were to wave her magic wand and give you an immediate answer to a question or questions, without having to do the relevant research, what would you most like to know?”
The Effects of Different Instructions on Smoking Cessation for Individuals with Different Degrees of Dependence
Authors: Fagerström Karl-Olov , Storm Hans-Gunnar
Published: June 2009

Therapist instructions and patient expectations appear to yield good treatment results with placebo pills. In this study the smoking cessation rate was studied after administration of a placebo smoking withdrawal chewing gum. Two groups from two factories were recruited and given instructions that they were to receive an effective chewing gum for smoking cessation. One group was told that the gum contained nicotine while the other was told that it worked through its special taste. At follow-up periods of 1, 3 and 8 weeks those given the nicotine instructions were superior to those given the taste instructions, although not significantly so. When nicotine dependence was taken into consideration it was found that the more nicotine dependent half of the subjects responded significantly better to the nicotine instructions as compared to the low dependent subjects.
Multimodal Behavioral Treatment of Recurrent Injury-Scene-Elicited Fainting (Vasodepressor Syncope)
Authors: Kozak Michael J. , Montgomery George K.
Published: June 2009

The known physiological and cognitive characteristics of vasodepressor syncope were accounted for in the development of an effective multimodal behavioral treatment for recurrent injury-scene-elicited fainting. Skeletal muscle tensing was employed as an immediate coping response to prevent fainting in situ, while cognitive–attentional retraining with graded exposure was employed to modify maladaptive cognitions.
A Comprehensive Behavioral-cognitive Treatment of Writer's Block
Authors: Rosenberg Harold , Lah Michael I.
Published: June 2009

A behavioral-cognitive intervention, including the use of a schedule, overt and covert reinforcers, and therapist monitoring of progress, was used to treat a graduate student with writer's block. Daily self-recording was used to assess baseline and intervention phases, and indicated that the intervention yielded an immediate and consistent increase in the number of hours of writing, the use of weekdays for writing, and self-rated effectiveness. Clinical considerations involved in the use of the procedure and generalization of the method to other work projects and clients are discussed.
Methodology and Cognitive—Behavioral Assessment
Authors: Kendall Philip C.
Published: June 2009

In the most recent edition of the Annual Review of Behavior Therapy (Franks et al., 1982) the point is made that behavioral assessment has moved simultaneously in two different directions. In one direction we see the heartland of assessment being entered via a more basic concern with the reliability and validity of behavioral assessment procedures. In the other direction we observe behavioral assessment to be taking a wider cut, expanding into the arena of cognitive-behavioral assessment. While the reasons for the reliability and validity studies may be apparent (i.e. to assure psychometric credibility), some have questioned the soundness and legitimacy of our excursion into the “mind”.
Promotion of Pressure-relief Exercising in a Spinal Injury Patient: A Multiple Baseline Across Settings Design
Authors: Carr Sally , Wilson Barbara
Published: June 2009

A multiple baseline design was used to investigate the efficacy of a verbal feedback procedure in increasing the performance of pressure relief exercises in a spinal injury patient. Results showed that the procedure resulted in substantial increases in rates of lifting, with concommittent improvements in pressure sores. At 2½ months follow-up the patient's skin was still clear, but it is unlikely that this can be attributed to continued good performance of pressure-relief exercises.
Manipulating the Explicit Demand of Paradoxical Intention Instructions
Authors: Ott Brian D. , Levine Bruce A. , Ascher L. Michael
Published: June 2009

In a previous study, Ascher and Turner (1980) accounted for differential results of two types of paradoxical intention administrations by suggesting that in one case subjects were encouraged to follow the explicit demands of the instructions which adversely effected performance. It was the purpose of the present study to determine the effect of employing a procedural component to emphasize the explicit demands of paradoxical intention instructions. Two groups received identical paradoxical intention instructions. One was required to present “objective” data along with their subjective sleep report—the other had only to present the subjective data. Two control groups were included in the design which employed sleep onset latency as a dependent variable. As hypothesized, results indicated that the paradoxical intention group submitting “objective” data reported latencies which were significantly longer than those of the no-treatment control, while the paradoxical intention group that was not required to submit “objective” data reported sleep onset latencies which were significantly shorter than those of the no-treatment control group.
A Review of the Effectiveness of Assertiveness Training in the Treatment of Alcohol Abusers
Authors: Watson Donnie W. , Maisto Stephen A.
Published: June 2009

Assertiveness skills training is frequently a component of current behavioral treatments of alcohol abuse. Although the results of several uncontrolled and controlled evaluations generally suggest the efficacy of using assertiveness training, methodological problems in this research prevent firm conclusions. Thus, before conditions under which assertive skills training with alcohol abusers are most effective can be delineated, additional evaluation correcting these problems is needed.
Cognitive–Behavioral and Psychopharmacological Treatment of Delusional Symptoms: A Preliminary Report
Authors: Hartman Lorne M. , Cashman Frank E.
Published: June 2009

Several psychopathological conditions include delusional beliefs as central symptoms. A conceptual model highlighting the importance of cognitive factors in regulating the bizarre internal contingencies which characterize delusional systems is presented. Cognitive–behavioral treatment emphasizes the direct modification of expectations and beliefs as well as the disordered behavior patterns they support. The efficacy of neuroleptics in treating delusional states has also been reported. Two patients with predominate delusional beliefs were treated in a cross-over design by the sequential use of cognitive–behavior therapy and pimozide. A third patient received cognitive–behavioral training alone. The delusions as well as the anxiety associated with them diminished and behavioral functioning improved significantly following cognitive therapy. The relationship between delusional symptoms, perceptions of self, and social functioning, as well as the optimal application of cognitive–behavioral and psychopharmacological interventions are discussed.
Supporting the Residual Memory of a Korsakoff Patient
Authors: Davies Ann D. M. , Binks Martin G.
Published: June 2009

The memory functioning of a 31-year-old Korsakoff syndrome patient was assessed in his everyday environment and in the laboratory and a programme devised to support residual memory capacity. The patient's wife was used as a monitor of input and retrieval conditions and taught how to seek situations in which her husband would be least impaired. Prompt cards and leaflets were provided for acquaintances in order to reduce the memory demands of the patient's environment.

Follow-up at 1 year showed that although tested memory functioning deteriorated, the patient's memory support system had continued. Additionally, an experiment demonstrated that retrieval could be boosted significantly by presentation of associative cues at storage and retrieval. These findings were used to guide further change in the way the patient's wife managed his memory impairments.
Treatment of an 11-year-old Obsessive-compulsive Ritualizer and Tiqueur Girl with in vivo Exposure and Response Prevention
Authors: Zikis P.
Published: June 2009

A case is described of an 11-year-old schoolgirl with both obsessive-compulsive rituals and tics of sudden onset following a traumatic event at the age of five. Treatment consisted of exposure in vivo and response prevention directed mainly towards her obsessive-compulsive rituals as they were considered the primary problem. Following the initial therapist–patient out-patient session and home treatment with her mother, the obsessive-compulsive rituals disappeared and the tics decreased. Three weeks later the tics disappeared without specific treatment and the patient has maintained her improvement at follow-up, 52 weeks later. The actual therapist–patient time was about an hour.
Nurse—Patient Interaction in a Token Economy
Authors: Rezin Valerie A. , Elliott Peter A. , Paschalis Paul
Published: June 2009

Fourteen long-stay psychiatric patients on a token economy ward were divided into two groups to assess whether the giving of tokens affects staff–patient interaction. Group one received contingent praise and tokens; Group two contingent praise and non-contingent tokens. The length of time and frequency of nurse–patient interactions was measured in both groups over a 5-month period. Several significant differences between groups were found. The giving of contingent tokens affected nurses' behaviour in the following ways.
Brief Behavioural Psychotherapy with Psychosomatic/Anxiety Patients in Primary Health Care
Authors: Kowalski Reinhard
Published: June 2009

To date clinical psychology research in primary health care has not taken sufficient account of the specific medical learning history of psychosomatic/anxiety patients and of the need to modify this learning process in therapy. In this pilot study a clinical judgement method is used to identify a group of primary care patients with physical symptoms where the general practitioner considers psychological factors highly relevant. Brief behavioural psychotherapy is defined and offered to those patients in order to provide effective approaches to their symptoms.

As a result different patient groups emerge: those who do not attend for their initial interview, those who attend only for their initial interview and those who attend for further sessions. These groups differ in general practice consultation rates prior to the intervention, and their consultation rates change differently following the intervention. The regular therapy attenders also differ from the “interview only” patients in terms of chronicity and degree of depressive symptoms. Significant symptomatic improvement was achieved for the therapy group. Further research is needed to identify the different groups of psychosomatic primary health care patients.
The Treatment of Urinary Frequency By Paradoxical Intention
Authors: Timms Michael W. H.
Published: June 2009

Paradoxical instructions were presented to a 13-year-old male client presenting with urinary frequency associated with school attendance. This resulted in sudden change in frequency behaviour which was maintained at follow-up. This case study represents the first report of the application of paradoxical intention to the problem of urinary frequency, and an explanation of the treatment success is offered.
Habit Reversal Treatment for Trichotillomania: A Case Study
Authors: Fleming Ian
Published: June 2009

Current evidence supports the effectiveness of behavioural methods in the treatment of trichotillomania (compulsive hair-pulling). In particular, the Habit Reversal Method has been demonstrated to be effective. Some discussion has centred on defining the active components of this “package” and whether it is applicable to all clients. This case study reports on the successful use of the method to treat a 19-year-old female. Treatment produced an immediate reduction in the number of hairs pulled out, although the client relapsed. Functional analysis was unable to detect any factors associated with this other than loss of client-therapist contact, and the re-introduction of treatment with an emphasis on client self-reinforcement for progress produced significant improvement. This continued upon withdrawal of treatment and was maintained at a follow-up 6 months later. In addition, the intervention resulted in the client being able to exhibit increased control over the behavioural chain which culminated in hairs being extracted. A relationship appeared to exist between these two forms of behaviour change. The findings were discussed with regard to the proposed active change agents in the treatment of trichotillomania.
Prompting Strategies for those with a Severe Mental Handicap: A Comparison of Procedures Using only Response Prompts with a Procedure Combining Stimulus and Response Prompts
Authors: Riley Gerard
Published: June 2009

Prompts are assessed in terms of their ability to convey an understanding of the task to those with a severe mental handicap. On this basis, it is suggested that the most effective strategy for teaching manipulative tasks to this group may be one which combines stimulus and response prompts. Two case studies compared this procedure with two procedures which used response prompts only. The combined procedure was more effective in both studies. The studies also demonstrated the applicability of stimulus prompts to teaching the motor, as well as the visual, components of manipulative tasks.
Friends—Who Needs Them? Two Case Studies Illustrating the Assessment and Treatment of Boys with Peer Relationship Difficulties
Authors: Conning Alison M. , Head Donna M.
Published: June 2009

This paper presents case studies of two boys who had problems forming friendships, and who participated in a group treatment designed to enhance their social skills. The intervention consisted of both behavioural techniques and cognitive problem solving strategies. The boys' improvement was reflected in some of the formal measures of change, and in reports from parents and teachers. The paper addresses issues concerning the role of assessment, and the selection of appropriate measures of change.
Modifying Bedtime Disruptions in Children using Stimulus Control and Contingency Management Techniques
Authors: Sanders Matthew R. , Bor Bill , Dadds Mark
Published: June 2009

The present study examined the effect of a bedtime management programme which incorporated both stimulus control and contingency management procedures on the level of bedtime disruption in children. Using a multiple baseline across subjects design each of four children (ranging in age from 2–5 years) were sequentially introduced to the treatment program, which was implemented by the child's parents each night. In addition the study sought to determine whether direct treatment of bedtime disruption would be associated with any negative side effects. Systematic observational data revealed that the Bedtime Management Program was effective in reducing bedtime disruptions in all subjects and the improvements sustained during a 2-month follow-up. No evidence suggests that treatment resulted in negative side effects. The implications of the results for behavioural parent training are discussed.
The Effects of Applied Relaxation and Operant Activity Training on Chronic Pain
Authors: Linton Steven J. , Melin Lennart , Stjernlöf Kristina
Published: June 2009

This investigation was designed to evaluate the utility of a behaviour therapy programme provided on an outpatient basis for the management of chronic pain. Twenty-eight chronic pain patients were randomly assigned to one of three groups. The first group served as a waiting-list control and had minimal contact with the clinic during the study, while the second group received the regular treatment regime provided by the rehabilitation clinic. The behaviour therapy group also received some of the regular treatment techniques offered by the clinic, but in addition, these patients were given: (1) training in applied relaxation (coping) to control the pain, and (2) an operant activities programme to increase relevant activities at home. Results indicated that the behaviour therapy group had significantly greater reductions in pain than the other two groups, and moreover, the behaviour therapy group had the best results for variables of sleep, activity and medication levels. These findings suggest that applied relaxation and an activities training programme may be valuable tools for the remediation of chronic pain.
Compliance with Relaxation Training: the Effect of Providing Information
Authors: Bennett Gerald , Millard Mark
Published: June 2009

In order to test its effect on compliance with recommended practice of relaxation training, patients in anxiety management training groups were provided with additional information about the procedure and its rationale. After an introductory training session all subjects were provided with audiotaped relaxation instructions to use for three weeks until the second group meeting. Additional information was provided either as an audiotaped message at the end of the relaxation instructions (“Message”) or as a printed leaflet (“Leaflet”). In a 2 × 2 factorial experiment 32 subjects were randomly assigned to one of four conditions: (1) Message, (2) Leaflet, (3) Message and Leaflet, (4) Basic Programme alone. Neither manipulation had an effect on self-reported frequency of practice during the three weeks (which was high), but both increased subjects' knowledge of the treatment and also their satisfaction with it. Subjects receiving the message were significantly less likely to drop out of treatment during the remainder of the 16-weeks group programme. Compliance was predicted by subjects' perceptions of the severity of their condition but not by their knowledge, satisfaction or state anxiety.
A Review of the In-service Training of Nurses in Behaviour Therapy
Authors: Milne Derek
Published: June 2009

This article presents an examination of 17 empirical studies of the in-service training of psychiatric and mental handicap nurses in behaviour therapy. Particular attention is given to subject characteristics, training methods, course content and evaluation. It is concluded that the integrity of both independent and dependent variables in this literature is suspect, and that it may therefore be premature to consider abandoning nurse training as a vehicle of institutional change. In contrast, what is needed are more systematic investigations, especially those which relate training interventions to institutional constraints, since both variables appear to be necessary conditions for successful innovations in patient care.
Assertiveness Training and Exposure In Vivo for Agoraphobics
Authors: Thorpe Geoffrey L. , Freedman Eric G. , Lazar Joel D.
Published: June 2009

The effectiveness of brief treatment via assertiveness training and exposure in vivo was evaluated in a crossover study of eight agoraphobics. Exposure treatment brought short-term benefit as assessed by phobia questionnaires and a depression inventory, but assertiveness training did not. Conversely, assertiveness training produced short-term improvements as measured by an assertiveness inventory, while exposure treatment did not. Both treatments were relevant to the problems of our client sample, but they had specific effects on measures closely related to each treatment's target, consistent with the results of a similar recent study by Emmelkamp et al. (1983). At six-month follow-up assessment, phobia questionnaire scores were unchanged from post-treatment assessment, but assertion scores had reverted to pre-treatment levels. In addition, five untreated agoraphobics completed phobia questionnaires on two occasions, six months apart. In a quasi-experiment, their scores on the two occasions were compared with treated clients' pre- and post-treatment scores. Treated clients showed significantly greater improvement, demonstrating the sensitivity of the questionnaires to treatment effects.
Increasing the Attention Span of Five Mentally Handicapped Children Using their Parents as Agents of Change
Authors: Chamberlain Paul
Published: June 2009

A child's ability to attend selectively to stimuli is central to the learning process. The length of time for which a child will attend (the child's attention span) is of equal importance. In general, mentally handicapped children have exteremly short attention spans. This study reviews the relevant literature and describes in detail an operant procedure designed to increase the attention spans of five mentally handicapped children, using parents as agents of change.

All parents were successful and the resulting increase was statistically significant. Short term follow up indicated that any increase in attention span may well be reduced if the procedure is discontinued, thought subsequent attendances at a nursery school appeared to maintain the gains achieved by the intervention process.
Coping Techniques in the Treatment of Anxiety Disorders: Two Controlled Case Studies
Authors: Öst Lars-Göran
Published: June 2009

The effects of applied relaxation and stress-inoculation respectively were tested in an A–B design for one patient with panic disorder and one with generalized anxiety disorder. The treatments took 13 and 12 sessions respectively, and both patients were improved to a large extent as assessed by self-report, self-observation and physiological measures. The improvements were sustained or furthered at the one-year follow-up.
Are Disruptive Behaviours Reduced When Levels of On-task Behaviours Increase? An Across Settings Study of a Class of 12- and 13-Year-Old Pupils—II
Authors: McNamara E. , Jolly M.
Published: June 2009

In recent years an impressive body of research has accumulated indicating that behavioural management strategies can promote the levels of on-task behaviour of classes of disruptive secondary school pupils. These successes have led to the explicit, self-evident claim that levels of off-task behaviour have concomitantly been reduced—and the implicit claim that levels of disruptive behaviour have also been reduced: for disruptive behaviour constitutes a subset of off-task behaviour. However the promotion of on-task behaviour with a corresponding reduction in off-task behaviour is a necessary but not sufficient outcome to claim that disruptive behaviour has diminished. It may be the case that innocuous off-task behaviours have been reduced but disruptive off-task behaviours remain. From a further data analysis of a previous study (McNamara and Jolly, 1990) it is claimed that when disruptive classroom behaviour is dealt with by the promotion of on-task behaviours the total amount of all types of off-task behaviours, from innocuous to grossly disruptive, is reduced. Analysis of data for individual pupils reveals that the whole class aggregated data conceal considerable inter-pupil variability for low incidence off-task behaviours.
Coping Strategy Enhancement (CSE): A Method of Treating Residual Schizophrenic Symptoms
Authors: Tarrier Nicholas , Harwood Susan , Yusopoff Lawrence , Beckett Richard , Baker Amanda
Published: June 2009

A method of teaching coping skills to patients with schizophrenia who experience unremitting psychotic symptoms is described. This method (Coping Strategy Enhancement CSE) is based on a thorough behaviour analysis of each symptom and the assessment of any coping strategy the subject may already employ. The subject is then systematically trained in the use of appropriate coping strategies in response to the occurrence of their psychotic symptoms. Two case studies are described in which CSE was used. Both patients showed considerable improvements over treatment. In one patient improvement continued at 6 month follow-up, in the other there was some deterioration at follow-up. Possible reasons for these results were discussed.
Treatment of Compulsive Over-exercising in Anorexia Nervosa: A Case Study
Authors: Long Clive , Smith Jennifer
Published: June 2009

Despite being a long recognized feature of Anorexia Nervosa, exercising has been largely neglected as a topic for research and treatment. An increasing cultural emphasis on fitness has highlighted the dangers of becoming addicted to exercise and its role in the development and maintenance of Anorexia Nervosa. Most estimates of the incidence of exercise addiction in the anorexic population are high, and the behaviour would appear to pre- and post-date the eating disorder.

In view of this, the development of an effective treatment method for this particular problem is needed. One such approach that employs cognitive behavioural techniques, including exposure and response prevention is described and illustrated by case example.
Minimal Intervention: A Strategy for Generalized Behaviour Change with Mentally Handicapped Individuals
Authors: Ager Alastair
Published: June 2009

Correctly construed, the concept of intervention requires that active consideration be given to the mechanisms by which any behaviour change produced by an intervention procedure may subsequently be generalized—across settings, across behaviours and, particularly, across time. Broad strategies that have been adopted with the aim of fostering generalization are reviewed. These may be seen to define a continuum along which scope for engineering behaviour change is “traded” with the probability of the contingencies required to maintain this change being assimilated within the “post-intervention” environment. Viewing strategies in this manner prompts consideration of interventions representing the extreme of this continuum, where scope for engineering change is minimal, but the probability of maintaining any change produced is very high. The implications of adopting such “minimal interventions” are examined, and these strategies shown to have some empirical support. A broad structure for implementing “minimal interventions” is proposed.
An Examination of Some Trends in Child Behavior Therapy
Authors: Forehand Rex , Middlebrook Jimmy , Steffe Marilyn , Rogers Tim
Published: June 2009

The purpose of the present study was to examine some trends in child behavior therapy over the past 12 years and to suggest some future directions. Four behavioral journals that have been in existence since at least 1970 were examined for type of behavior treated and type of treatment technique utilized. Beginning with 1970 every other year of each journal was examined and 410 articles dealing with the treatment of children were identified. There was no systematic trend across years in the number of articles published in this area. Furthermore, only a few trends across years were noted for behaviors treated or treatment technique utilized. Negative behaviors, particularly acting out ones, had been targeted for treatment most often. Consequences, particularly of a positive nature, had been utilized most often as the treatment technique of choice. The need to expand our models by treating new behaviors and utilizing new techniques was discussed.
Slow versus Rapid Exposure in vivo of Phobics
Authors: Yuksel Sahika , Marks Isaac , Ramm Elizabeth , Ghosh Anindya
Published: June 2009

Twenty-eight chronically phobic patients had therapist-aided exposure either rapidly or slowly. During therapist-aided exposure move to the next hierarchy item occurred after subjective anxiety had dropped, on a scale of 0–8 by two points (rapid) or by four points (slow). Exposure began with the lowest of eight hierarchy items. All patients had self-exposure homework between sessions. In a balanced design 12 patients were treated in London and 16 in Istanbul. Peak anxiety during sessions was comparable in both groups. Compared to slow exposure patients, rapid exposure patients completed treatment to criterion in fewer sessions and less time (4·7 vs. 5·8 sessions P< 0·01; 360 vs. 484 min P< 0·005). Criterion for termination of treatment was toleration of the highest hierarchy item with minimal discomfort, or a maximum of eight sessions. Both in London and in Istanbul rapid and slow groups improved substantially and similarly in phobias, social adjustment and mood; gains continued to 6 months follow-up. Compared to slower exposure, rapid exposure does not enhance final outcome but does shorten treatment time without increasing peak anxiety during sessions.
Evaluation of an E.D.Y. Training Course in Behavioural Techniques for Staff Working with Severely Mentally Handicapped Children
Authors: McBrien Judith A. , Edmonds Marie
Published: June 2009

Methods of evaluating training courses in behaviour modification for staff working in mental handicap are briefly reviewed. Insufficient attention seems to have been paid to changes in staff behaviour following training. A widely used training package—the E.D.Y. Course—was investigated using a non-equivalent control group design. Four special school teachers were given E.D.Y. training and compared with four control teachers pretraining, post-training and at a fourteen month follow-up. Results indicated that experimental teachers changed their behaviour following training in the expected direction and maintained this change at follow-up. Control group teachers showed no behavioural change from occasion to occasion and scored significantly lower than the experimental group on the dependent variable on each occasion. The results are discussed in terms of the effectiveness of the package and the maintenance and generalization of skills.
Hemifacial Spasm and Blepharospasm: Case Reports, Treatment Considerations and Implications for Etiology
Authors: Fielding R.
Published: June 2009

Previous reports of the effectiveness of behavioural approaches in the treatment of blepharospasm prompted application of a modified behavioural package to two hemifacial spasm patients. The presentation and treatment details of these two cases are described with complete remission of symptoms in one patient and 50% reduction in severity for the second patient. Both hemifacial spasm and blepharospasm are traditionally unresponsive to medication and are treated by a variety of neurosurgical techniques, thus implying a strong organic etiology for the conditions. The cases presented here, and earlier cases presented elsewhere suggest that a learning model may be appropriate to explain etiology for an unknown number of patients who are surgically treated at present. This is discussed in the light of existing literature on the conditions along with methodological and theoretical issues.
Cognitive Therapy of Obsessive – compulsive Disorder: Treating Treatment Failures
Authors: Salkovskis Paul M. , Warwick Hilary M. C.
Published: June 2009

Foa (1979) has identified two groups of obsessional patients for whom behaviour therapy is ineffective; those with severe concurrent depression and those with “overvalued ideation”. She has also highlighted the need for the development of new treatment strategies for these individuals. A case history illustrating the development of overvalued ideation in a previously typical obsessional patient is described, together with an account of a successful treatment based on Beck's cognitive therapy combined with exposure. The implications of this report for views on the development of overvalued ideation in obsessionals are discussed. It is argued that cognitive–behavioural interventions such as the one described here may be useful as an adjunct to more traditional behavioural treatments for obsessional disorders as well as in the treatment of patients with overvalued ideation.
Training Social Perception Skills with Primary School Children: A Cautionary Note
Authors: Milne Janet , Spence Susan H.
Published: June 2009

Forty-eight children from grades 3 to 6 of two inner city primary schools were selected on the basis of poor performance on a social perception test. Subjects were randomly assigned to one of three experimental conditions: social perception training (SPT); attention placebo control (APC; drama activities) or a no treatment control (NTC; assessment only). The SPT and APC groups participated in nine twice weekly sessions over a five week period. Children receiving SPT did not show a significantly greater improvement in social perception skills than either of the control conditions. There was also no significant effect of SPT on certain measures of behavioral functioning which have previously been associated with social perception skill, namely peer sociometric status, Walker Problem Behaviour Checklist or Childrens' Depression Inventory. The findings are discussed in terms of implications for future research.
Rapid Audio-tape Treatment of Obsessional Ruminations. A Case Report
Authors: Headland Karina , McDonald Bob
Published: June 2009

An audio-tape technique was used in the treatment of a 35-year-old male with a 13 year history of obsessional rituals and ruminations. His rituals responded to exposure and self-imposed response prevention but the ruminations remained as before.

The audio-tape treatment, which involved him listening to his own voice reciting his ruminative content, resulted in a rapid and substantial reduction in frequency of ruminations and this was maintained to one month follow-up.

The clinical and theoretical implications of this treatment approach are discussed.
The Nature and Elicitation of Social Support: Some Implications for the Helping Professions
Authors: Winefield Helen R.
Published: June 2009

Long recognized as an important modifier in the relationship between stress and illness, social support appears in the light of recent research to include emotional, informational and practical components available from a variety of lay and professional sources. Health and mental health disturbances are more closely associated with inadequate than with unavailable social support. Individuals who report inadequate social support may lack skills in support-elicitation, of which this paper specifies several based on what is known of interpersonal style in depression and loneliness. The implications of this analysis for the helping professions refer to both therapeutic practice and the helper's work satisfaction.
Training Children to Eat Independently: Evaluation of Mealtime Management Training for Parents
Authors: Dadds Mark R. , Sanders Matthew R. , Bor Bill
Published: June 2009

This study assessed the effects of training the parents of children displaying problematic eating behaviors in child management skills. Specifically, parents were taught to apply a range of management procedures, e.g. differential reinforcement, behavior correction routines, extinction and time out, to their child's behavior during mealtimes. Subjects were four families, each of which contained a child displaying high rates of disruptive behavior, e.g. non-compliance, complaining, leaving the table during mealtimes, and low rates of food consumption. Each family underwent baseline, mealtime management training (M.M.T.), follow-up conditions within a multiple baseline across families' design. Home observations were conducted four nights each week, during the families' evening meal, and the dependent measures recorded were child behaviour, eating responses, and weight of food eaten. The results showed that M.M.T. was effective in decreasing disruptive behaviour for three of the four families. The fourth family also required home feedback training which resulted in a marked decrease in disruptive behavior. Changes in eating responses were less marked and highly variable among individual families. Follow-up results and the implications for clinical practice are discussed.
The Medium-Term Future
Authors: Rachman S. J.
Published: June 2009

Two branches of behaviour therapy will, I believe, dominate the course of events in the coming decade. The cognitive interpretation of behavioural problems (and cognitive solutions) can be expected to expand and deepen. The infusion of cognitive analyses will broaden out from the established bases, the successes achieved in tackling depression and panic disorder, to encompass a wide range of psychological problems. (The need for a coherent and efficient cognitive behavioural psychology will be particularly acute when the current infatuation with biological psychiatry wanes.) This expected expansion will then merge with the other development, the slow (too slow indeed) but steady growth of behavioural medicine. In truth, behavioural medicine, conceived as the application of psychological science to medical problems additional to the psychiatric ones, has been retarded by institutional and intellectual obstacles. For economic and scientific reasons there is likely to be an acceleration of progress in the next decade, and the entire process will, or should, be enriched and enlivened by the introduction of a more cognitive approach to behavioural medicine.