In selected adult neurotics, nurse-therapists have a significant contribution to make in giving behavioural psychotherapy to patients who were formerly denied it for lack of trained personnel (Marks et al. 1977). Perhaps 10% of all adult psychiatric outpatients can benefit from behavioural psychotherapy as the main approach for those categories of problem where established behavioural methods have been found to be superior to contrasting treatments (Marks, 1976).

Recent articles in this journal have argued for and against the admission of cognitive concepts in discussion of behavioural therapies. The intention of this article is to clarify some of the issues and hence to try and reduce some of the confusion.

Much of the confusion stems from a misunderstanding of behaviourism, particularly of the approach variously called radical, analytical, or systematic behaviourism. This approach, associated with Skinner in particular, must be clearly demarcated from methodological behaviourism which simply distinguishes between the public and the private, and then studies only the former, thus maintaining a dualist ontology between the physical and the mental. Analytical behaviourism, on the other hand, only accepts the existence of the physical, but also distinguishes between the public and the private (Skinner, 1945, 1953, 1964).