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

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.

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.

The five participants in this study were adult long-term residents of institutions for people with mental handicap who had only rudimentary numerical and monetary skills. All were successfully trained, using methods based on “errorless stimulus fading” techniques within a multiple-baseline experimental design, to recognize the seven British coin types and to judge their relative value. Recognition training incidentally resulted in ability to name the coins. Training at each skill required four to seven sessions of up to 20 minutes each, at intervals of 24 hours or more. Performance remained accurate at three-week and six-month follow-up. In four out of five subjects, improvement at recognition could be attributed specifically to the training sequence.

Four women with cyclical changes in negative emotions related to their menstrual cycle were treated individually with a combination of psychological interventions, These included problem solving, autogenic training, and anxiety and anger control strategies. Cognitive issues and attributional patterns were also considered. Analysis of symptoms using permutation statistics indicated significant improvements. The problems of open trials and extrapolation from case reports are noted. Important clinical issues which arise in psychological intervention for premenstrual emotional symptoms are also considered.

A component analysis of the room manager role (Porterfield et 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.

This study explores the possibility of teaching nurses behavioural tehniques so that patients with intractable pain problems can be treated confidently, and subjective labelling, which obstructs a goal oriented approach, can be avoided.

Three seminars were given which included formal teaching, role-plays and practical between-session tasks.

Of the four assessment procedures used, the nurses showed a significant change in their knowledge of behavioural principles, their attitudes to disabled people, and their response to pain behaviours. Their ability to specify problem behaviour did not improve and some reasons for this are discussed

The procedure of cue-exposure response prevention has been successful in reducing subjective urges and overt behaviour associated with a number of compulsive disorders. Despite this it has not been systematically applied to the problem of smoking cessation. An individual case is presented which demonstrates the successful decrement of urges to smoke as a result of cue-exposure response prevention. The relevance of such a procedure to relapse prevention is discussed.

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.

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.

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.