A six-year-old girl with surgically corrected imperforate anus and chronic faecal soiling was successfully treated by biofeedback. A portable biofeedback machine using an anorectal balloon was constructed and lent to the patient’s mother who administered the treatment at home following instruction in the clinic. Faecal incontinence was replaced by normal bowel evacuation habits after four weeks of the procedure. The effect was durable at least until follow-up at three months. Positive spin-offs were observed. The reversal of the child's encopresis suggested neuromuscular intactness of the anorectalregion despite the congenital malformation. Biofeedback probably compensated for an earlier learning fault. Domiciliary, parent-mediated biofeedback therapy is a cost-effective procedure and may be widely applicable to suitable patients within the population of children with primary expulsive and retentive bowel control disorders.

This study was designed to investigate the effects of a short-term cognitive-behavioural intervention, as part of a comprehensive medical project of withdrawal from hypnotics, on attitudes toward insomnia. Twenty-four subjects volunteered to participate in a withdrawal project conducted in a sleep clinic for five weeks. All subjects were chronic users of a long-acting hypnotic, and free from other psychotropic drugs. Along with the gradual decrease in hypnotics’ dosage, the programme consisted of sleep evaluations by polysomnography, actigraphic monitoring, daily sleep diaries, and periodical medical examinations. Upon termination of the withdrawal stage, all subjects received a short-term cognitive-behavioural treatment consisting of six sessions and directed at attitude change and correction of misconceptions about sleep and insomnia, and on promoting psychological strategies for coping with the sleep disturbances. Attitudes toward insomnia were measured by the DBAS – Dysfunctional Beliefs and Attitudes about Sleep Scale, administered at three points of time: on the first day of the programme (Time 1), at the termination of the medical withdrawal stage (Time 2), and a week after completion of the short-term cognitive behavioural treatment (Time 3). A multivariate analysis showed a significant effect of the time of measurement on all five subscales of the DBAS. Subsequent analyses indicated that the major change in attitudes was specific to the direct cognitive-behavioural intervention and occurred between Time 2 and Time 3. In follow-ups conducted at 3 and 12 months after completion of the withdrawal project, the majority of the participants (72%) reported refrain from hypnotic use, and regarded the psychological intervention as the major cause of their successful withdrawal from sleeping pills.

The colour-naming performance of a group of hospitalized anorexic women (N=12) was tested on initial admission, after 1 week of treatment and again after 12 weeks of treatment. Compared to a control population of non-clinical females (N=18), the anorexics colour-named both food and body shape words more slowly than their neutral matched words; although colour-naming times, in general, were slower for anorexics. The size of this colour-naming impairment decreased as a function of weight gain and improvement in psychopathology, although colour-naming times for food words improved more quickly than for body shape words for both clinical and non-clinical subjects. The results of correlational analysis between colour-naming times and Eating Disorder Inventory (EDI-2) responses lead to the conclusion that colour-naming performance for body shape, rather than food words, provides a clearer index of improvement in psychopathological status in anorexia nervosa.

A 34-year old woman with Generalized Anxiety Disorder and recently diagnosed multiple sclerosis was treated in a single case design. The case formulation approach was used to assess and integrate the various difficulties reported by the participant. Treatment interventions targeted intolerance of uncertainty, overestimation of the utility of worrying, problem orientation, and problem solving. Results indicated a decrease in the tendency to worry. Difficulties in the application of typical interventions for Generalized Anxiety Disorder to people with multiple sclerosis are discussed and suggestions are provided.

Individual cognitive behavioural interventions for psychosis are rapidly developing and are being shown to be effective. This paper examines the application of these interventions on a group basis. The nature of the group, treatment outcome and potential benefits of using this format are described. After the group intervention, all patients were less depressed, most had higher self-esteem and greater knowledge of schizophrenia, and half the group felt better able to cope with their symptoms. Patients reported feeling less isolated and two of the four group members stated a preference for group over individual treatment.

A case is described in which the patient’s perfectionistic assumptions seemed to play a major role in perpetuating his anxiety and depression. Techniques to deal with perfectionistic assumptions are discussed, and the various effects that perfectionism may have on therapy, both positive and negative, are considered.

The present study used two single case studies to evaluate clinical improvement as a result of cognitive behavior therapy in panic disorder with or without agoraphobia (PDA). A special emphasis was placed on assessing the reduction in catastrophic cognitions, which are considered to be of prime importance in PDA. Multiple measures were employed, during pre and post treatment and at a six month follow-up. Data from self-report questionnaires, physiological measures and cognitive sampling during in vivo exposure were used. Convergent results demonstrated clinical improvement and supported the importance of catastrophic cognitions in the process of change for treatment outcome of PDA.

This preliminary study examined the short-term effect of a videotape intervention “Step-by-Step“ on 30 individuals referred with symptoms of panic disorder, before they had received any formal support from mental health services. It was hypothesized that a videotape intervention would reduce the symptoms and the frequency and strength of maladaptive cognitions associated with the consequences of having a panic attack, more effectively than the same information in written form. The results of this small scale study are promising. Some interesting trends were found within the video group, which provide some evidence to support the research hypotheses.

Dizziness is a distressing symptom that is often associated with fear and anxiety, as well as organic balance system dysfunction. We report here on the successful treatment of a 68-year-old woman with dizziness and balance problems. Treatment was given within a cognitive behavioural framework, but also included physiotherapy in the form of head movement exercises. Results were evaluated by a balance platform test, a behavioural provocation test and questionnaire data. Positive results were found in each of these three assessment domains.

Hospitalized older adults with dementia often have few opportunities for social interaction and psychological stimulation. Their psychological functioning is affected by the dementing illness, sensory impairment and the effects of living in an institutional environment. The adverse effects of sensory deprivation may be particularly relevant for this client group. Using a multiple single case design, we evaluated the effects of individual sensory stimulation sessions on four elderly patients with dementia. All were living on a hospital continuing care psychiatric ward. Detailed behavioural observations were made before, during and after sessions to assess patients’ responses. Adaptive functioning and wellbeing were also investigated. Results indicated that the intervention led to observable changes in levels of interaction, active looking and interest. The effects were transitory with the exception of active looking, which endured following the session. Adaptive behaviours also improved, though there was no change in wellbeing. The study indicates that sensory stimulation is a valuable therapeutic intervention with this client group.

Behaviour change is often a desired outcome for carers and professionals who work with people with learning disabilities and challenging behaviours. Managing these behaviours in the short term is an important step towards this goal. This single case study presents the use of a low arousal approach in managing challenging behaviours in a young man labelled with severe challenging behaviour. This strategy focuses on the interaction of the carers with the client and how their approach has an important impact on the behaviour of the client. The study documents the incidents of challenging behaviour and shows a decline in their frequency from baseline over a one-year period. These gains were maintained at five-month follow-up. The implications for services of these findings are discussed.

Sensitization Alternating Desensitization (SADTM) is a revolutionary, Paradigm-Shifting approach for treating post-traumatic stress disorder and most other psychological and physiological problems. It has been clearly shown to be efficacious through anecdotal evidence and a complete lack of findings from controlled-outcome studies. (Satirical)

The present study examined whether trait anxiety as indexed by the Spielberger State-Trait Anxiety Inventory (STAI) can be employed as a predictor of behaviour therapy outcome. Thirty-six female spider phobic patients completed the STAI trait anxiety scale, and then received one 2.5 hours session of exposure in vivo treatment. Therapy outcome was evaluated by means of standardized self-report measures and a behavioural approach test. Results showed that STAI trait anxiety substantially contributed to therapy success on all outcome measures: the higher the trait anxiety scores, the less patients profited from behaviour therapy.

A portable device providing vibratory feedback was used for reducing excessive vocal loudness in a man with intellectual disability and autistic-like behaviours. The use of the device was combined with reinforcement. The data showed that the device (together with reinforcement) was rapidly effective in reducing the occasions of excessive vocal loudness and maintained the positive effects over time. Implications of the findings and limitations of the study are discussed.

The study aimed to investigate why patients suffering from chronic schizophrenia discontinue psychological therapy. Patients who dropped out of a randomized controlled trial of cognitive-behaviour therapy and supportive counselling in the treatment of persistent positive psychotic symptoms were asked to complete a questionnaire on their reasons for doing so. Nine out of 12 patients who dropped out completed the questionnaire which consisted of 22 items that could be rated true or false. Although the size of the sample was small, the response rate was acceptable at 75%. The median number of reasons given was 7 (range 3 to 12), with the most common reason being that therapy was not perceived as suitable for the individual’s particular problems. The characteristics of the patients who dropped out are described.