In his address to the Annual Conference of the Australian Behaviour Modification Association in 1986, Dr. Robin Winkler chose the topic “The social history of behaviour modification in Australia” (Winkler & Krasner, 1987). Dr. Winkler was concerned to recognise the contributions of a number of individuals who were prominent in the new movement in the 50s, 60s and 70s. My aim is rather different. I want to try to capture what the early workers were trying to achieve, what they saw as the problems, and how they viewed the early developments. I will then look at more recent developments in Australian behaviour therapy, and try to characterise its current status. Finally, I'll discuss what seem to me the major current problems, and suggest some possible solutions. Where I feel able to do so, and it seems to me appropriate, I'll make some comparisons with the situation in the USA. Many of the more general points, of course, will be relevant to behaviour therapy in any country.

Lovibond (1993), weaves an exciting first person narrative of the development of behaviour therapy in Australia. His paper, derived from his years of experience and leadership, provides rare insight into the people and programs which have shaped behavioural practice today. In chronicling these early years, he well and fully elucidates the historic shortcomings of the larger field of Australian clinical psychology to provide minimal standards for science or practice, to effectively evaluate its practitioners, or to be a potent, united voice for the scientist/practitioner model. To remedy these shortcomings, he proposes the development of a new entity, largely independent of traditional clinical psychology or behaviour therapy, to simultaneously address issues of science, standards, and practice.

In the remainder of this article I should like to address what I consider to be primary issues in the advancement of an experimentally based psychology applied to human problems; to frame the current issues within professional psychology in the US which are germane to Lovibond's notions; and to lobby strongly for the maintenance of a separate and independent behaviour therapy community as the basis for the practice of scientific psychology.

It was with great interest that I read Professor Lovibond's paper, not the least because of the fact that before returning to the UK in 1991 I had spent approximately 2½ years working in Australia. In his article Professor Lovibond charts the history of behaviour therapy in Australia and comments on the current academic and professional situation there. He raises issues concerning scientific rigour, clinical practice, service delivery, and professional organisation. Some of these are general issues and many readers from many places around the world will find sympathy with these. Others are relevant to the local circumstances within Australia and are less pertinent to other countries. My first reaction to the article was surprise that problems within clinical psychology were being aired at a World Congress of Behaviour Therapy and within a behaviour therapy journal. This is perhaps explained by Professor Lovibond's view that behaviour therapy is too narrow a term for what is really clinical psychology and should be so entitled. But from a UK perspective there is here a confounding between the theory and practice of behaviour therapy (I will use the term cognitive-behaviour therapy as being more reflective of current thinking) and the profession of clinical psychology. I will devote most of this short article to outlining the situation in the UK so that it can be seen why Professor Lovibond's suggestion that behaviour therapy and clinical psychology are synonymous would not be readily acceptable in the UK. Firstly, I would like to comment on the situation regarding behaviour therapy before briefly describing that of the profession of clinical psychology.

The fourth World Congress of Behaviour Therapy held at the Gold Coast was a great success as the first worldwide congress on behaviour therapy in South East Asia and Oceania countries. The fact that an academic association can sponsor a world congress is a good index of the level of development of a host academic association as a leader in that field. We can say that the ABMA has come to play a leading and important role in behaviour therapy in the world.

Lovibond's paper (Lovibond, 1993), based on his keynote address at the Fourth World Congress of Behaviour Therapy, is interesting for an understanding of not only the current status of behaviour therapy in Australia, but also for typical courses of the development of behaviour therapy in many countries where behaviour therapy has not been a major clinical approach, having been “imported” from countries where behaviour therapy has been highly developed from early times.

The courses of the development of behaviour therapy in Australia and Japan are considerably similar, that is, clinical psychologists in both countries have tried to develop a scientific clinical psychology since the dawning of behaviour therapy, as Lovibond (1993) has pointed out. However, there are some differences between these countries on the current status of behaviour therapy. In order to compare the courses of the development and the current status of behaviour therapy in both countries, an introduction to a brief history of behaviour therapy in Japan might be helpful.

It was with considerable interest that I read the comments on my paper (Lovibond, 1993) offered by our three international colleagues. It is at once apparent from the commentaries that the issues in clinical psychology to which I drew attention are in no way unique to Australia. Quite clearly, however, in Japan behaviour therapy (or CBT) has not yet reached that stage of development where the problems I posed become relevant. For this reason I shall concentrate mainly on the comments of Professors Russo and Tarrier. Each of the commentators, but particularly Dr. Russo, found points of agreement with my statement of the issues, but none expressed support for the program of action I suggested. Surprisingly however, none had alternative solutions to offer.

I believe the most important issue I raised was the threat to the primacy of the scientist-professional model in the education/training/practice of clinical psychologists. Professor Russo clearly shares my concerns here, but Professor Tarrier makes no mention of the scientist-professional model or the need to maintain links with the basic discipline of psychology. From the general tenor of his remarks, I gather that Professor Tarrier does not regard the fate of the scientist-professional model as a major issue, and indeed he seems quite satisfied with the status of clinical psychology in the UK. Interestingly however, the report of the Manpower Planning Advisory Group, which Professor Tarrier quotes at another point, suggests that in the UK “clinical psychologists' roles are seen as ambiguous by others, confused with the roles of other disciplines and further confused by the variety of ways in which psychology services are delivered and practised. The research also found poor promotion of clinical psychologists' contributions to services and an inappropriately low profile in view of the impact that clinical psychologists could be having on the effectiveness of services” (MPAG, 1990, p. 8).

This paper argues for an expansion of the field of behaviour therapy from a predominant focus on individual and family based treatment of problems into the prevention of physical illness at a population level. It outlines criteria which can be used to make rational decisions about which domains behaviour therapists should focus on, it then provides a rationale for placing more emphasis on population based strategies of prevention. The particular contributions which the discipline of behaviour therapy has to offer to such an expanded role are then delineated and the benefits of an expanded role into primary and secondary prevention of physical disease are discussed in relation to past research.

A single-case design was used to explore the effects of EMG feedback versus EMG-plus-posture feedback in the treatment of overt symptoms of torticollis in an elderly female patient. It was found that EMG levels of the sternomastoid muscle were inversely related to EMG of the trapezius muscle, rather than systematically related to components of treatment. Resting posture showed a pattern of improvement, especially with regard to shoulder asymmetry and forward flexion. Also, the patient's voluntary control over posture showed marked improvement between pre- and postphases of treatment; this was maintained at follow-up 8 weeks after treatment. Implications are raised for further research, in particular, the importance of assessing multiple aspects of posture and recording EMG from more than one site simultaneously.

Carers observed problem behaviours of two people with intellectual disability in natural settings. Data recorded on Antecedent-Behaviour-Consequence (A-B-C) charts were analysed quantitatively by calculating the relative likelihoods of each target behaviour occurring in different situations. Functional analyses were conducted, and individualised interventions were based on these. In one case, a client behaved differently in different situations. Interventions were introduced to teach the client to emit a different prosocial behaviour in each situation. The second client behaved similarly in two situations, suggesting that the behaviours were functionally equivalent for the client. The behaviours of both clients were interpreted as attention seeking behaviours as both antecedents and consequences involved the provision of attention by carers. However different interventions were used in the two cases, and were effective in reducing target behaviours both immediately and in follow-ups.

While structured behavioural interviews are often used in the assessment of problem behaviours among persons with developmental disabilities, there are no data on the reliability of this assessment methodology. In the present study, the reliability of a 15 item interview protocol was determined by comparing the answers provided by different staff concerning the aggressive behaviours displayed by 18 persons with severe disabilities. Agreement was generally low with an overall mean of 43% across clients and questions. The results suggest that information obtained from structured behavioural interviews should be verified by direct observation.