It is argued that normalization and applied behaviour analysis represent the most significant developments of the past two decades in approaches to the design of services for people with learning difficulties. Problems in translating these approaches into practice have been compounded by an apparent conflict between them. The nature of this conflict is examined and suggestions for a rapprochement are made.

The functions of resistance and restraint are considered in three topographically distinct psychological disorders that are characterized by excessive behaviour. Certain similarities are observed and speculations about their common role are examined. Finally attention is drawn to the implications of this type of analysis for our understanding of such disorders and for psychological treatment.

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.

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.

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.

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.