bluuebunny/crossref_metadata_2025 huggingface dataset:
Radical Behaviourism and its Influence on Clinical Therapies
Authors: Cullen Chris
Published: June 2009

The philosophy of radical behaviourism continues to be misunderstood and the ways in which it influences therapy are still not widely appreciated. This paper shows that radical behaviourists do not ignore peoples' thoughts and feelings; that we consider people and their behaviour as part of the context in which they live; and that clinical problems are as much our concern as broader social problems. To illustrate the influence of radical behaviourism on clinical therapies Goldiamond's constructional approach and Hayes' comprehensive distancing are described.
Behavioural Medicine: The Application of Behaviour Therapy to Physical Health
Authors: Johnston Derek W.
Published: June 2009

Three typical areas of application of behavioural medicine are described: biofeedback, relaxation training, and various cognitive behavioural procedures. It is argued that biofeedback has led to few useful clinical treatments but both relaxation and more complex procedures and methods of analysis can contribute to the prevention and treatment of disease. This is illustrated with examples from the literature on headache and the prevention and treatment of coronary heart disease and cancer.
Sex Therapy
Authors: Hawton Keith
Published: June 2009

The introduction of sex therapy two decades ago was accompanied by largely uncritical enthusiasm, with the result that too few careful evaluative studies were conducted. Those that were indicated that a weekly or twice weekly schedule of treatment sessions was best and that treatment by individual therapists was as effective as co-therapy. Some of the major prognostic factors and the long-term results of sex therapy have now been elucidated. Low sexual desire has emerged as a problem for which our now traditional methods of treatment are often inadequate and new therapeutic approaches are required. Current efforts to explore the beliefs and cognitive processes associated with erectile dysfunction are proving rewarding and are likely to enrich therapeutic interventions in the future. Attention should now be paid to the beliefs and cognitions associated with other sexual dysfunctions, both male and female.
“Setting Events” as Determinants of Staff Behaviour: An Exploratory Study
Authors: Burdett Charles , Milne Derek
Published: June 2009

One of the major problems facing behaviour therapy has been the relative lack of success in bringing about lasting change in complex environments. The difficulty in assessing and understanding these failures may well be due to an unnecessarily narrow view of change in terms of small units of behaviour and short time-scales. In contrast, if one takes a “setting events” perspective, this might generate more explanatory hypotheses by focusing on larger behavioural units and longer time-scales. This exploratory study adopted such a perspective in order to consider staff opinions about the maintenance and generalization of an innovative behavioural programme in psychiatric rehabilitation. The results of a structured interview with a small group (n = 11) of multidisciplinary staff indicated the potential value of this perspective: factors traditionally regarded as obstructing innovation (such as not enough time, staff or facilities) were not in fact seen as problematic. On the contrary, factors which were more readily manipulable (such as feedback, nursing officer support and in-service training) were regarded as facilitating planned change. The implications of these findings and this perspective for sustained organizational development are discussed.
Pad-and-Buzzer Training, Dry-Bed Training, and Stop-Start Training in the Treatment of Primary Nocturnal Enuresis
Authors: Bennett Gerald A. , Walkden Victoria J. , Curtis Roy H. , Burns Laurence E. , Rees Janice , Gosling Judith A. , McQuire Neil L.
Published: June 2009

Forty primary nocturnally enuretic children were randomly assigned to one of four experimental conditions over a ten week period. These were (a) standard Pad-and-Buzzer Training (PBT), (b) Stop—Start Training (SST), involving practice in interrupting the flow of urine during micturition, (c) Dry Bed Training (DBT) and (d) Waiting List Control (WLC). Numbers of dry nights were assessed during a 14 days pre-treatment baseline period, and again during 14 days at the end of treatment and at 12 weeks follow-up. At the end of treatment the proportions of subjects in each condition achieving 14 consecutive dry nights were: PBT 44.4%, SST 16.6%, DBT 50% and WLC 0%. Each of the three treatments produced more dry nights than the WLC, but did not significantly differ from one another. The results were discussed in terms of their generalizability and in the context of superior results previously reported for DBT.
The Deception Study: A Potential Paradigm for the Evaluation of Generalizability of Social Skills Training
Authors: Wheldall Kevin , Alexander Richard
Published: June 2009

Research into social skills training has, in common with much other contemporary educational psychology practice, been beset by the problem of how best to evaluate effectiveness. Alongside the movement towards more behaviourally inclined approaches has grown a dissatisfaction with the traditional methods of evaluting effectiveness. If we recognize behaviour per se as being the appropriate level for intervention, whether in relation to academic skills teaching, classroom management, social skills training or whatever, then it follows that effectiveness can only logically be assessed in terms of measurable changes in observed behaviour. Evaluation methodology has tended to lag behind interventional methodology, however, so that it has not been uncommon to see behavioural work assessed in terms of changes in attitude and/or knowledge. On occasion evaluation is not even attempted and behaviour change is assumed to generalize outside the specific confines of the intervention situation.
Learning After Brain Injury by the Method of Vanishing Cues: A Case Study
Authors: Leng Nicholas R. C. , Copello Alexandre G. , Sayegh Antoine
Published: June 2009

Memory disorders feature amongst the most common complaints following brain injury. Theories of recovery and data derived from cognitive rehabilitation studies indicate that restoration of function is not a realistic goal, but recent work suggests that memory disordered patients often retain residual learning capabilities that can be utilized in teaching them certain kinds of information of practical use. This paper describes encouraging results obtained in teaching a patient computer related information by the method of vanishing cues. The patient learned more rapidly with this method than with anticipation learning, he showed evidence of good retention and, in contrast to earlier studies, he showed some evidence of generalization. However, the method may not be effective for all patients.
The Measurement of the Quality of Care in Psychiatric Rehabilitation Settings: Development of the Model Standards Questionnaires
Authors: Lavender A.
Published: June 2009

The need to monitor the standards of care provided in settings for the long term psychiatrically disabled has become increasingly recognized. A critical review of the literature indicated that no comprehensive assessment procedure existed for settings providing some form of rehabilitation. However, five important aspects of care in each setting were identified: (i) Treatment Practices, (ii) Unit Management Practices, (iii) Community Contact Practices, (iv) The Physical Environment and (v) Staffing Resources.

A series of questionnaires was devised—The Model Standards Questionnaires—to assess each of these aspects of care. The questionnaires can be used to provide a profile of particular settings quality of rehabilitation and as a means of identifying how the quality of that rehabilitation might be improved.
A Behavioural Family Intervention with a Schizophrenic Patient: A Case Study
Authors: Barrowclough Christine , Tarrier Nicholas
Published: June 2009

A schizophrenic patient and his family were provided with a nine month multi-component behavioural intervention programme as part of a controlled study. The patient was at high risk of relapse according to the High EE status of his parents. Multiple outcome measures were used to assess the efficacy of the programme. The components of the intervention are described in detail, and the specificity of component effects in this case are examined. Given the methodological limitations of this type of study, it is not possible to demonstrate conclusively intervention effects in the case reported. However, following the intervention the relapse rate of the patient was reduced, his social functioning improved and the EE status of his parents changed from High to Low.
The Effects of Stress Inoculation Training on Gymnastics Performance on the Pommelled Horse. A Case Study
Authors: Mace Roger , Eastman Clive , Carroll Douglas
Published: June 2009

A male gymnast who had represented his country in Olympic gymnastics and had developed a maladaptive mental approach to performing on the pommelled horse in competition was given stress inoculation training in order to help him overcome his difficulties. Preliminary interviews revealed that immediately before competing he became very tense, his arms started to shake and he had doubts about being able to complete his routine. In addition, he was unable to use visualization, a technique which he used for mental preparation on the other five pieces of apparatus in Olympic gymnastics competitions. Further interviews also strongly suggested that the subject had developed an unconscious set of negative self-statements. An intervention programme comprising 12 sessions of training in relaxation, visualization and making positive self-statements was implemented. Recorded interviews and comments made by the subject on completion of the training indicated that the programme had been successful. For many years the subject had experienced problems performing on the pommelled horse and he had frequently suffered falls in competition. Towards the end of the stress management training programme his performance began to improve. He also became more confident and he used his stress coping skills in competition. In the National Championships he was able to relax, visualize his routine and make positive self-statements. Shortly after this competition he successfully completed his routine to a high standard without any falls to win the individual title in the Midlands Regional Championships. In a subsequent international match he again successfully performed his routine to a high standard.
Benzodiazepines and the Behaviour Therapist: Managing Withdrawal and the Problems of Concurrent Treatment with these Drugs
Authors: Miller Edgar
Published: June 2009

Many of the clients being treated by behaviour therapists will also be taking benzodiazepines. The use of these drugs may interact with the problems presented to the behaviour therapist and complicate treatment. In addition the behaviour therapist may be asked to help in managing withdrawal in those who have become dependent on benzodiazepines. The evidence relating to the effects of these drugs and their withdrawal reactions is discussed and suggestions made as to how withdrawal might best be managed.
Behavioral Treatment of Drunk-driving Recidivists: Short-term and Long-term Effects
Authors: Connors Gerard J. , Maisto Stephen A. , Ersner-Hershfield Seth M.
Published: June 2009

This study was designed to investigate the relative effects of two behavioral group treatments on short-term (knowledge and attitude change) and long-term (recidivism) variables among persons with multiple arrests for driving under the influence of alcohol (DUI). Subjects were randomly assigned to a behavioral treatment that was highly-individualized and focused on principles of self-control or to a general behavioral treatment (which focused on alcohol education, relaxation training, and guided reevaluation of situations typically associated with DUI arrests). Results showed that subjects in both groups reported, over treatment, a more frequent use of portable breath test devices for assessing blood alcohol levels and perceived an increased probability of being arrested if they drank and drove. In addition, subjects in the individualized behavioral groups reported that they subsequently spent more time thinking about avoiding DUI. However, the two treatment groups did not differ in their rates of DUI arrest recidivism (which averaged 11.7% per year over the three-year follow-up period). One third of the subjects were rearrested for DUI during the 36-month follow-up period, although there were indications that rearrests may have been delayed as a function of the treatment interventions. Taken together, the data suggest that these drunk-driving recidivists may be responsive to the treatment interventions described herein. Additional research is needed to specify the relative impact of the behavioral techniques utilized in the treatment programs and to identify strategies for maintaining treatment gains over longer periods of time.
The Functional Performance Record—An Observational Procedure for use with Disabled People
Authors: Mulhall David J.
Published: June 2009

The Functional Performance Record (FPR) identifies and provides a means of recording the actions, behaviour and functioning of those whose independence is reduced either permanently or for prolonged periods by physical or mental or psychiatric disabilities. It is for use in goal setting, evaluating outcomes, monitoring standards of care, service planning and research.
Levels of Dependency of the Long-term Mentally Disabled in Community and Hospital Settings
Authors: Linke Stuart , Taylor David
Published: June 2009

Dependency levels of long-term mentally disabled people in hospital and community settings were compared using a behavioural rating scale called REHAB in a health district where a policy of community care had been implemented. It was found that the performance of subjects in the community settings was better than those on the admission ward, but was worse than half the people normally found in traditional psychiatric settings. The policy of community care would seem to have been successful insofar as this group of subjects was able to remain in community settings. Comparison of the REHAB factor scores suggested differences in the behavioural competence of subjects supported by community psychiatric nurses and social services staff compared to those attending a psychiatric day hospital.
The Modification of Stereotyped and Self-injurious Behaviour by Room Management: Six Single Case Experiments
Authors: Crisp A. G. , Sturmey P.
Published: June 2009

Anecdotal evidence suggests that room management is useful in controlling the frequency of behavioural excesses in severely/profoundly handicapped persons. This study involves a systematic investigation of the effect of room management on inappropriate behaviour. Data was collected over a 10-day period on each of six subjects who manifested a range of stereotyped and self-injurious behaviours. Each day formed an ABA design, A representing baseline conditions and B, room management. Room management proved to be helpful in controlling the behaviour in some instances. For other subjects it was clearly not successful. This outcome is discussed in terms of inter- and intra-subject variability in response to environmental change.
Cognitive Strategies for the Management of Severe Sleep-Maintenance Insomnia: A Preliminary Investigation
Authors: Espie Colin A. , Lindsay William R.
Published: June 2009

Psychological treatments for sleep-maintenance insomnia have received little attention in the literature. Problems with staying asleep are commonplace, however, especially in the older age groups, and there is a need to develop effective management alternatives to night-time sedation. This single case report describes the sequential application of two cognitive interventions with treatment effects being evaluated by means of time series analysis. The mental overarousal model of sleep disturbance is discussed.
Generalisation of Toileting Skills of a Mentally Handicapped Boy
Authors: Heyward Eileen
Published: June 2009

A boy with mental handicap presented with problems of generalisation of toileting skills over a period of three years. From a variety of approaches attempted, one using transfer of stimulus control had initial success, and the process was completed using combined positive and negative reinforcement. Once generalisation to one novel setting had been achieved, generalisation to other novel settings proceeded without difficulty. There have been no further toileting problems in the four years since the completion of the programme.
Changing Disruptive Behaviour in an Adult Training Centre Client
Authors: Andrews Mike
Published: June 2009

A DRO approach was used to teach positive social behaviours in a young woman with mental handicap, and to decrease aggressive and disruptive behaviours. Reprimands were used on a few occasions for serious problem behaviours and did not result in an increase in these behaviours. As the problem behaviours receded the young woman became apparently happier and developed better relationships with her family, peers and Centre staff, and the improvement has been maintained over three years.
Rebound Effects of Thought Suppression: Instruction-Dependent?
Authors: Merckelbach Harald , Muris Peter , van den Hout Marcel , de Jong Peter
Published: June 2009

Previous studies have shown that when normal subjects are instructed to think of a white bear (“forced” expression instructions), they do so more frequently when they have previously suppressed the thought of a white bear than when they have not suppressed this thought. It has been proposed that this rebound effect of thought suppression provides a laboratory model for the development of real-life obsessions. The present studies were undertaken in order to explore further the tenability of this model. Rebound effects were evaluated when more “liberal” expression instructions (“you might think of a white bear, but you don't have to”) were used. In Experiment 1, no evidence was obtained to suggest that suppression results in a heightened frequency and/or accelerated rate of white bear thoughts during a subsequent expression period (with “liberal” instructions). Interestingly, initial suppression lead to an immediate and stable increase of thought related electrodermal fluctuations. In Experiment 2, it was found that successful suppressors (few target thoughts during suppression) report fewer white bear thoughts during expression (with “liberal” instructions) than unsuccessful suppressors (many target thoughts during suppression). Assuming that the ecological validity of “liberal” expression instructions is greater than that of “forced” instructions, the present findings cast doubt on the claim that the rebound effect mimics the etiology of obsessions. The findings also suggest that it may be the immediate counter-productive effects of suppression that are relevant to theories concerned with obsessions.
The Coping with Anxiety Questionnaire: A Replication and Extension
Authors: Bassett Michael , Edelmann Robert J.
Published: June 2009

In a recent questionnaire study Watts (1989) examined coping strategies including attentional and “self talk” strategies used by agoraphobics. This paper reports the findings of a revised coping with anxiety questionnaire administered to over 200 agoraphobic subjects to examine two issues raised by the Watts' study: firstly, the existence of discrete factors related to distraction techniques and focused attention to anxiety cues; and secondly, perceived levels of voluntary control in relation to different coping strategies. The results partially confirmed the factor analytic results obtained by Watts, although there was no evidence for discrete attentional factors related to distraction or calm focused attention. There was evidence consistent with the claim that self talk strategies are largely under voluntary control. The implications of the results for treatment are discussed.
A Multi-Component Intervention with an Olympic Archer Displaying Performance Related Anxiety: A Case Study
Authors: Houghton Stephen
Published: June 2009

A multi-component intervention programme comprising 12 sessions is described which successfully enabled an Olympic archer to overcome performance related anxiety.
Do Operant Treatments of Chronic Pain Adhere to Precepts of Behavioural Analysis?
Authors: Hardardottir Drifa , James Jack E. , Owen Neville
Published: June 2009

Fordyce's (1976) analysis of pain behaviour provides a framework for evaluating the extent to which empirical studies of the operant treatment of chronic pain have adhered to appropriate behaviour–analytic principles. These are the identification of target behaviours and their reinforcing contingencies, the specification of individualised reinforcers to be used in treatment, and the generalisation and maintenance of treatment effects. Twenty-five studies that reported having used an operant approach in the management of chronic pain problems were reviewed. With one exception, none of the studies reported sufficient data to indicate the degree of adherence to behaviour–analytic principles. Until more such data are reported, it will continue to be difficult to determine clearly those factors that contribute to the efficacy of operant approaches to chronic pain management.
Treating the System or Symptom: Investigating Family Therapy for Alcohol Problems
Authors: Bennun Ian
Published: June 2009

This paper investigates two contrasting family therapy approaches in the treatment of alcoholism. Twelve families were randomly assigned to either a symptom-focused or systems-focused treatment. Measures of marital satisfaction, family satisfaction and alcohol dependency were recorded before treatment commenced, after treatment and at a six-month follow up. The results showed that both treatments were equally effective in producing desired change, thus offering clinicians increased choice in the range of effective family interventions.
The Maintenance of Client Activity and Staff–Client Interaction in Small Community Houses for Severely and Profoundly Mentally Handicapped Adults: A Two-Year Follow-Up
Authors: Saxby Helen , Felce David , Harman Martin , Repp Alan
Published: June 2009

In a previous study (Felce, de Kock and Repp, 1986), appropriate client activity was found to be considerably higher in two community homes for severely and profoundly mentally handicapped adults than in a number of institutions. Client activity was also shown to be related to the extent of staff interaction. The method of this study was replicated in a two-year follow-up to investigate whether these desirable levels of staff interaction and client activity were maintained. Client engagement in appropriate activity remained similar for five subjects but had fallen slightly for a further five. The duration of instruction given to the majority of subjects by staff had declined but so too, for a variety of reasons, had staff–client ratios. Overall, the follow-up data give a general impression of the maintenance of client activity with some subjects engaging with greater independence. However, interpretation is dependent on the role that staff–client ratio may play in determining staff performance and in particular their level of interaction with clients.
The Treatment of a Snake Phobia by Imaginal Exposure
Authors: Richards David A.
Published: June 2009

A severe phobia of snakes was treated by exposure in imagination, no in vivo exposure taking place. Imaginal exposure homework was given with the aid of audio-tapes of the treatment sessions. After treatment, in a behavioural test, the client experienced rapid habituation of anxiety to handling a live snake. The total amount of time taken for the treatment was similar to the time taken in treating other small animal phobics by in vivo exposure alone. It is suggested that for specific phobics the use of imaginal rehearsal prior to in vivo exposure may optimise the conditions under which in vivo exposure takes places and require no more of the therapist's time than the usual in vivo methods.
Effectiveness of Pre-release Alcohol Education Courses for Young Offenders in a Penal Institution
Authors: Baldwin S. , Heather N. , Lawson A. , Ward M. , Robb E. , Williams A. , Greer C. , Gamba S. , Robertson I.
Published: June 2009

Young males with alcohol-related offending behaviours were recruited into a research study. In a Young Offenders' Institution, pre-release offenders were allocated to a behavioural Alcohol Education Course (AEC) or a non-intervention control group. At follow-up, dependent variable differences were observed between the two groups. Results are discussed in the context of policy and practice.
Momentary and Partial Interval Time Sampling: A Reply to Harrop, Daniels and Foulkes (1990)
Authors: Adams Robert M.
Published: June 2009

Momentary time sampling (MTS) is described as an unbiased method of estimating time spent engaging in target behaviour. Conclusions that MTS with long sampling intervals or for short sessions results in large error are based on studies which use too few observations (a too-small sample size) to expect small sampling error. Partial interval (PI) sampling is a biased method, and the degree of bias changes as the characteristics of the behaviour change, a particular problem for intervention studies.
A Clinical Pilot Study of Cognitive-behavioural Therapy for Anxiety Disorders in the Elderly
Authors: King Paul , Barrowclough Christine
Published: June 2009

Ten elderly patients with anxiety problems were treated individually using cognitive-behavioural interventions. These involved helping the patients reinterpret their anxiety symptoms in a non-threatening way. Questionnaire and self-report data suggested that cognitive-behavioural therapy may be an effective intervention for elderly patients with anxiety problems.
Individualized Behavioural Treatment of Severe Stuttering
Authors: Ecker Willi , Meyer Victor
Published: June 2009

This case study illustrates the reduction of severe stuttering by an individually tailored treatment programme. Interventions are derived from a tripartite analysis (Lang, 1971) and include EMG biofeedback, regulated breathing, exposure in vivo to stressful communication situations and cognitive techniques to reduce relapse risk. The role of dysfunctional response system interactions in stuttering is emphasized. Treatment resulted in a marked reduction of stuttering and associated facial contortions during videotaped conversations with strangers and oral reading. Improvement was maintained at one-year follow-up.
The Therapeutic Relationship in the Behavioural Treatment of Anxiety Disorders
Authors: Keijsers Ger , Schaap Cas , Hoogduin Kees , Peters Wilma
Published: June 2009

The present study investigates the prediction of treatment outcome in the early stages of therapy by examining the quality of the therapeutic relationship. Furthering our understanding of the critical relationship variables may be useful for intervening in unsuccessful treatment outcomes. Two self-report instruments are used to assess the client-therapist interaction: the EPIN and the TCRS. Results show the client's assessment of the quality of the therapeutic relationship, as assessed with the EPIN, is related to treatment outcome. None of the subscales of the TCRS showed significant correlations. We conclude that in the early stage of treatment, the establishment of an accepting, empathic and supportive relationship with the client (as perceived by the client), is important for the progress of directive behaviour therapy.
The Differential Reinforcement of Incompatible Responses in the Reduction of Self-Injurious Behaviour: A Pilot Study
Authors: Jones Robert S. P. , Baker L. J. V.
Published: June 2009

The latency of the self-injurious behaviour of a severely handicapped, Down's-syndrome boy, aged 9 years, was increased by a factor greater than three. Vibration was presented as the reinforcer in a discrete-trial, DRI-schedule procedure in which the incompatible response was physically prompted. A single-subject, ABAB design was used. It is suggested that the DRI schedule used in this way is a valuable initial procedure for decreasing self-injurious behaviour to a level where other procedures may then be applied.
Behavioural Family Intervention in Schizophrenia: A Case Study
Authors: McCune Noel
Published: June 2009

A case study is described which illustrates the use of behavioural techniques in a family intervention where the patient had been diagnosed as having schizophrenia. The relative merits of behavioural techniques and the difficulties encountered in applying them are noted.
Observation in Training Parents of Handicapped Children: A Review
Authors: Wood J. R. A.
Published: June 2009

Research and service-oriented studies are reviewed to indicate issues and promising strategies for evaluation of field-based parent-training. The main areas which professionals and researchers must address themselves to are indicated. A variety of multiple-outcome measures are used. Skill development and transfer of skills to the natural environment remains a poorly evaluated area. Professional workers need to attempt more control in methodology, reporting practice and using research analyses. Researchers will have to direct study to assessing realiability and validity and developing practical instruments for widespread use. The implications of previous work are discussed. The emphasis of the paper is that direct observations of parents working in their natural settings should be the preferred means of evaluation.
Detail and Elaboration in Phobic Imagery
Authors: Watts Fraser N. , Sharrock Robert , Trezise Lorna
Published: June 2009

It is hypothesized that phobics have cognitive representations of phobic stimuli that are relatively lacking in detail and elaboration, and that this is reflected in imagery relating to them. In a study of verbal imagery for coping with a spider, the accounts of phobics were found to be briefer and to include fewer stages. In a study of stimulus imagery, vividness was separated into its two components of (a) awareness of the image and (b) degree of detail, following a similar distinction proposed by Klinger. Awareness, but not detail, was found to be greater in phobics, though the hypothesis of less detail in phobics was not confirmed. It is suggested that a lack of elaboration of phobic imagery is likely to impede anxiety reduction in imaginal desensitization, and to reduce the effectiveness of imaginal representations of coping behaviour.
Obsessive Compulsive Neurosis: A Speculative Account of an Unusual Case
Authors: Sumners David , Gournay Kevin
Published: June 2009

A case of “checking” obsessive compulsive neurosis in a young adult is described. It's evolution is traced from early behaviour viewed as adaptive to partial sightedness which becomes maladaptive when autonomous obsessions and rituals develop. The concepts of “preparedness” and “self-stimulatory behaviour” amongst others are used to examine possible reasons for this change. The relevance to more usual cases where no predisposing handicap exists is discussed.
Individualized Cognitive Behavioural Treatment of Chronic Pain
Authors: Thorn Beverly E. , Williams David A. , Johnson Patrick R.
Published: June 2009

Cognitive behavioural treatment for chronic pain was individually tailored based on pre-treatment assessment of the subjective pain experience of each patient. Eight chronic pain patients completed the individualized treatment program which consisted of relaxation techniques, hypnotic deepening strategies, a relabeling hierarchy based upon pain descriptors, positive self-statements, didactic information, and cognitive-restructuring techniques. Patients self-monitored their pain during a two week pre-treatment baseline period, during the eight weeks of treatment and for one week post-treatment. Additional treatment outcome measures were also taken. Compared to baseline data, patients reported positive changes on many of the treatment outcome criteria, including McGill Pain Questionnaire indices, reduction in the number of hours spent in pain, and follow-up questionnaire responses. Treatment outcome measures collected at one week, six months, and 15 months post-treatment all suggested positive treatment gains. The greatest gains were reported at the six month post-treatment assessment suggesting a generalization or practice component to the therapy. Additionally, patients with constant pain were found more refractory to treatment than patients with intermittent pain.
A Comparison of the Effects of Massed Practice and Relaxation upon the Frequency of a Facial Tic
Authors: Crawley Bronach , Powell Graham
Published: June 2009

The effect of two treatments on a facial tic was examined experimentally. The subject, a 53-year-old male, carried out massed practice or relaxation for two periods of 5 min alternating with 5 min assessment periods during which he engaged in free conversation around key words. This was followed by a further two periods of the alternative treatment and intervening assessment periods. Pulse rate was monitored throughout and the procedure concluded with a 5 min period of covert assessment of tic frequency. Sessions were held on four consecutive days. Tic frequency was observed to increase following massed practice and marginally following relaxation. The latter treatment, however, was found to be effective in reducing tic frequency during the treatment block itself. The results are discussed in terms of the subject's general level of anxiety and the anxiety induced by the massed practice procedure.
Behavioral-Clinical Administration in the Real World: Crisis Intervention in a Large Community Residence
Authors: Beck Jeffrey , Lieberman Harvey J.
Published: June 2009

Discharged psychiatric patients at a large community residence were noted to be experiencing increased agitation, anger and anxiety in connection with repeated vandalism and unauthorized visits by members of the surrounding community. An intervention based on behavioral concepts and technology was formulated utilizing many parts of the social matrix of the residence, including clinical staff, direct care staff and the residents. Resident behavior was successfully changed as a result of the intervention. It appears that behaviorally based, clinical-administrative solutions to “real world” problems can be effective in teaching passive, chronic mental patients safety conscious behavior and helping them to assume responsibility for their community-based living space.
Cognitive Therapy for Anxiety
Authors: Clark David M.
Published: June 2009

Cognitive therapy for depression is well-established. However, it is only recently that Beck and his colleagues have turned their attention to the development of a cognitive therapy for anxiety. The present article provides a brief overview of cognitive therapy for anxiety and also presents outcome data on six anxious patients who were treated with cognitive therapy. Considerable reductions in anxiety and depression occurred during the course of treatment. In addition, much of the observed improvement occurred after as little as eight sessions. These results suggest that cognitive therapy is a promising approach to the treatment of anxiety disorders. However, final evaluation of its effectiveness must await the publication of large scale, controlled trials.
Cognitive Approaches to the Treatment of Chronic Benign Headache: A Review and Critique
Authors: Morley Stephen
Published: June 2009

Psychological treatments of headache are becoming increasingly influenced by cognitive therapy. This paper addresses three issues relevant to the development and evaluation of cognitive therapy. 1. It is argued that current assessment measures for evaluating treatment are founded on a theory of pain which is inadequate and as a result they are not sufficient for the evaluation of cognitive therapy. 2. The assumptions on which cognitive therapy for headache is based have not been verified. Recent research indicates a degree of complexity in the relationships between cognition, emotion and pain which has yet to be assimilated. 3. It is noted that cognitive therapy for headache lacks an explicit model of pain which would facilitate the precise formulation and testing of interventions.
Treatment of Sleep-maintenance Insomnia: A Case Study Using Time-series Analysis
Authors: Hohenberger-Sieber E. , Mueller G. , Schindler L.
Published: June 2009

A behaviour-therapeutic approach in a case of chronic insomnia is illustrated. Based on research reported in the literature the treatment programme consists of sleep-related interventions as well as of training in coping with conditions which influence sleep negatively. Data on the short- and long-term effects of therapy, especially during the follow-up period of two years, are discussed.
Behavioural Management of Hysterical Pseudoseizures
Authors: Montgomery James M. , Espie Colin A.
Published: June 2009

This paper presents a single case study of an epileptic hostel resident who presented behavioural problems in the form of high frequency pseudoepileptic seizures in association with an attention-seeking personality. Psychological intervention along behavioural lines was found to be lastingly effective in reducing the frequency of these seizures and generalized improvements were obtained in other areas of social skill. The results are discussed with reference to suggested implications for clinical practice.
Measuring Levels of Experiential States in Clinical Applications by Discan: A Discretized Analog Method
Authors: Singh Avinash C. , Bilsbury Christopher D.
Published: June 2009

A clinically-oriented description is provided of the Discretized Analog or Discan method (Singh and Bilsbury, 1984) for obtaining reliable and precise measures of subjectively experienced dysfunction variables whose possible values form a continuum. The method can provide a 14-point ordered categorical scale with only four reference levels which represent some of the possible values of intensity of the variable. The process of Discan administration consists of a series of repeated comparisons of the true or perceived level with one or two reference levels at a time. It therefore allows for use of elaborate descriptive statements for reference levels. It is recommended following Shapiro (1961, 1975) that the reference levels be ideographic, ipsitive and should reflect ordered steps of recovery from the dysfunction. Discan overcomes several limitations of the commonly used rating scales. An application of Discan to the MSB relaxation technique is presented as an illustration.
Sexual Dysfunctions Among Women Clients Who Were Sexually Abused in Childhood
Authors: Jehu Derek
Published: June 2009

In a series of 51 previously sexually abused women who entered therapy 94% were found to be sexually dysfunctional. It is proposed that these dysfunctions may stem from certain mood disturbances, interpersonal problems, and sexual stresses, that are associated with the earlier traumatic experience of sexual abuse and its surrounding circumstances.
A Component Analysis of the Room Manager Role
Authors: Sturmey P. , Crisp A. G.
Published: June 2009

A component analysis of the room manager role (Porterfieldet al., 1980) was performed in a series of four experiments. The subjects were one nursing staff and 13 severely and profoundly mentally handicapped young adults. The experiments took place in a hospital adult training unit. Five components (presence of toys in the room, providing a toy, replacing toys, prompting, and the full room manager role) were compared. Increases in the proportion of time on task were associated with the antecedents; praising had no effect. For residents with high Vineland Social Age regularly replacing toys was associated with the greatest increase in the proportion of time on task. For residents with low Vineland Social Age prompting was associated with the greatest increase in proportion of time on task. Implications for modification of the room manager role are considered and limitations to the present study discussed.
Treatment of Dental Fear: Systematic Desensitization or Coping?
Authors: Harrison Joel A. , Berggren Ulf , Carlsson Sven G.
Published: June 2009

Thirty-two extremely anxious dental patients were given a modified form of systematic desensitization. In order to evaluate the importance of cognitive factors, a procedure of cognitive coping was added to the therapy program for half of the patients. Results show that treatment outcome was significantly better for the group without the addition of coping elements. It is suggested that the adverse effect observed may reflect an interference by the cognitively-oriented therapeutic activities with an otherwise effective therapeutic process.
Brief Prescriptive Therapy in Two-plus-one Sessions: Initial Cases from the Clinic
Authors: Barkham Michael
Published: June 2009

This paper presents the rationale for, and implementation of, a brief form of cognitive-behavioural (termed Prescriptive) therapy based on both behavioural and cognitive traditions. Clients are seen for two sessions 1 week apart followed by a third session 3 months later. The model, termed 2 + 1 Prescriptive psychotherapy, is derived from both clinical and research bases, and is an attempt to implement a planned brief form of therapy in response to service deliver needs. The essential components of the model are presented together with outcome data from three initial clients' treatment in this model. In addition, one of these cases is presented as a clinical case study. The model is evaluated according to criteria of therapeutic effort, research parameters, and clinical mechanisms. The limitations and potenial of the model are presented.
Adjuvant Psychological Therapy: A Cognitive Behavioural Treatment for Patients with Cancer
Authors: Moorey S. , Greer S.
Published: June 2009

Cancer and its treatment are known to have a substantial psychological morbidity, but relatively little work has been done to investigate the effectiveness of psychotherapy with this group of patients. This paper outlines a newly developed cognitive behavioural approach for distressed cancer patients based on Beck's cognitive therapy. In addition to using cognitive and behavioural techniques to relieve depression and anxiety Adjuvant Psychological Therapy seeks to help patients develop a fighting spirit towards their illness. The application of the treatment is illustrated with the use of two case reports.
Explanation and Prediction in Functional Analysis: A Reply to Jones and Owens
Authors: McDonnell Andrew A. , Samson David M.
Published: June 2009

Samson and McDonnell (1990) proposed a definition of the term functional analysis. In a reply to that article, Jones and Owens maintained that Samson and McDonnell had failed to address sufficiently the complexities of this approach, particularly in the use of unobservables in functional analysis and the contextual nature of challenging behaviours. This paper attempts to provide a short reply to these contentions.
Cognitive Therapy in a Case of Choking Phobia
Authors: Öst Lars-Göran
Published: June 2009

A 68-year old female with a phobia of choking on fluids was treated first with exposure in vivo and then with cognitive therapy. The exposure increased her water drinking to some extent, but the cognitive change was negligible. However, the cognitive therapy led to a dramatic change in the catastrophical misinterpretations and a fourfold increase in her water consumption. The effects of treatment were maintained at a 1-year follow-up.
Treatment Acceptability for Anorexia Nervosa: Effects of Treatment Type, Problem Severity and Treatment Outcome
Authors: Sturmey Peter
Published: June 2009

One hundred and ninety two students from schools and university rated the acceptability of treatments for anorexia nervosa as presented in written vignettes. Psychologically-based treatments, such as counselling and behaviour therapy, were rated more acceptable than drugs; flooding occupied an intermediate position. Context variables such as problem severity and outcome did not significantly effect treatment acceptability.
Covert Sensitization: Alternative Treatment Procedures for Alcoholism
Authors: Miller William R. , Dougher Michael J.
Published: June 2009

Twenty-nine outpatients (24 men) with a history of problem-drinking and alcohol dependence were assigned at random to one of three covert sensitization procedures varying in the nature of stimulus elements in aversion scenes. Group 1 received standard nausea imagery, whereas Group 2 received similar scenes “assisted” by noxious odors. Imagery used in Group 3 scenes was unrelated to nausea but focused instead on disturbing potential consequences of drinking. The occurrence of conditioned aversion responses (CR) was verified by observational, self-report and physiological measures. The observed pattern and frequency of conditioning corresponded closely to data reported by Elkins (1980). Favourable outcomes at 18 months (abstinent, controlled or improved) were observed in 45, 56 and 67% of clients in each group, respectively. The groups did not differ significantly in effectiveness. Within both of the nausea sensitization groups (1 and 2), successful remission at 18 months occurred only in individuals who had shown CR, whereas in emotive sensitization (Group 3) there was no apparent relationship between conditioning and outcome.
A Multidimensional Evaluation of Therapist Behaviour
Authors: Milne Derek
Published: June 2009

The difficulty in predicting outcome from therapist behaviour has been attributed to the neglect of some important variables, including the amount and type of therapy, and the skilfulness and interpersonal manner of the therapist. The present study investigated one therapists behaviour in terms of these four dimensions for a random sample of 10 adult outpatients, for whom outcome data were available. Results indicated that the type of therapy was intermediate between prescriptive and exploratory modes, that it was practiced at a satisfactory level of proficiency, and that interpersonal effectiveness was high. The related Clinical outcomes were also satisfactory in relation to the amount of therapy. In addition to illustrating a procedure for evaluating therapist behaviour and showing the correspondence between process and outcome, this “case study” provides evidence to support the need for more objective accounts of therapist behaviour.
The Cognitive-Behavioural Treatment of Hallucinations and Delusions: A Preliminary Study
Authors: Fowler David , Morley Stephen
Published: June 2009

Five patients suffering from chronic and distressing psychotic symptoms were treated with a cognitive-behavioural approach designed to modify their beliefs that their auditory hallucinations were real, and to enhance their ability to control psychotic experiences. Four of the patients reported an increase in their ability to control hallucinations, but only one of these also reported a decreased frequency of hallucinating and a reduced belief in the reality of hallucinations. The discussion focusses on the implications for future interventions in this area.
Bibliotherapy-based Dry Bed Training: A Pilot Study
Authors: Hunt Stephen , Adams Malcolm
Published: June 2009

Dry Bed Training is an effective and rapid method for the elimination of primary nocturnal enuresis. However, like the urine alarm the approach demands very close clinical supervision. This is a Pilot Study to evaluate the effectiveness of a self-help approach (based on Dry Bed Training), administered using a minimum contact self-help manual, and a video in which a young mother and son demonstrated treatment techniques. Ten severe primary nocturnal enuretics, acting as their own controls, were treated using this approach. Results show initial remission in 80% of the cases, with 20% of the subjects dropping out. Of those who completed treatment 25% relapsed. These results were obtained with a significant reduction in staff time. The role of clinical supervision is critically examined. Elements of a cost-benefit analysis are identified in order to highlight the strengths and weaknesses of this approach.