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

The “Cognitive Revolution” has involved substantial changes in the emphasis of clinical practice and research interests of behaviour therapists. Work carried out in this area suggests that earlier fears about the potentially damaging effects of cognitive-behaviour therapy were unfounded. It can be argued that cognitive orientations have gained such widespread acceptance amongst behaviour therapists because the approaches are highly compatible at clinical and research levels, and because behaviour therapy had already started to incorporate similar concepts. Furthermore, cognitive models have also provided a wealth of new ideas and methods which considerably enhance behavioural approaches whilst leaving the fundamentals intact.

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.

A programme of research is described which investigates the cognitive processing of phobic stimuli. Phobics show good perceptual “pick-up” of phobic words on a version of the Stroop test. However, their encoding appears to be poor, as indexed by recognition memory for phobic stimuli. Consistent with this, cognitive representations of phobic stimuli are poorly elaborated and differentiated. Brief desensitization was found to have stronger effects on perceptual and encoding phenomena than on cognitive representations. Finally, spider phobics were found to have poor recall of phobic words. This contrasts with the opposite phenomenon that has been reported for agrophobics and depressives.

There has been considerable variability in couples' responsiveness to Behavioural Marital Therapy. Many practitioners consider that the instrumental emphasis of this approach is too narrow and that there is a need for theoretical expansion. The perceptions and interpretations that partners place on each other's behaviour are critical: as such the behavioural model has been expanded, with consideration being given to the cognitive components within dyadic relationships.

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.

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.

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.