Previous reports of the effectiveness of behavioural approaches in the treatment of blepharospasm prompted application of a modified behavioural package to two hemifacial spasm patients. The presentation and treatment details of these two cases are described with complete remission of symptoms in one patient and 50% reduction in severity for the second patient. Both hemifacial spasm and blepharospasm are traditionally unresponsive to medication and are treated by a variety of neurosurgical techniques, thus implying a strong organic etiology for the conditions. The cases presented here, and earlier cases presented elsewhere suggest that a learning model may be appropriate to explain etiology for an unknown number of patients who are surgically treated at present. This is discussed in the light of existing literature on the conditions along with methodological and theoretical issues.

Two patients suffering from long-standing psychogenic nausea were treated by paradoxical intention and exposure in vivo within an A–BC–B–BC single case experimental design. Each received six treatment sessions. At the six month follow-up, both patients had improved substantially. Contrary to what was expected, paradoxical intention produced adverse outcome; both patients because nauseous and even vomited a few times while practicing the technique. Exposure in vivo gave better results.

A child's ability to attend selectively to stimuli is central to the learning process. The length of time for which a child will attend (the child's attention span) is of equal importance. In general, mentally handicapped children have exteremly short attention spans. This study reviews the relevant literature and describes in detail an operant procedure designed to increase the attention spans of five mentally handicapped children, using parents as agents of change.

All parents were successful and the resulting increase was statistically significant. Short term follow up indicated that any increase in attention span may well be reduced if the procedure is discontinued, thought subsequent attendances at a nursery school appeared to maintain the gains achieved by the intervention process.

Three non-verbal, autistic boys of 9, 12 and 16 years served as subjects in two experiments and a nurse play-therapist acted as the agent. The first experiment compared the effects upon a motor coordination task of each subject's preferred sensory reinforcer with those of the sensory reinforcer preferred by the other two subjects. On-task performances were maintained by prompting and by contingent presentation of each reinforcer in a multiple-baseline design across subjects. All subjects showed higher levels of on-task performance for their preferred sensory activity. In the second experiment a multielement-baseline design compared the effects of the preferred sensory reinforcer with those of a preferred edible reinforcer. All subjects showed higher levels of on-task performance for their preferred sensory activity. Inter-observer reliability remained above 90%. A role for sensory reinforcement in training autistic children is suggested.

Foa (1979) has identified two groups of obsessional patients for whom behaviour therapy is ineffective; those with severe concurrent depression and those with “overvalued ideation”. She has also highlighted the need for the development of new treatment strategies for these individuals. A case history illustrating the development of overvalued ideation in a previously typical obsessional patient is described, together with an account of a successful treatment based on Beck's cognitive therapy combined with exposure. The implications of this report for views on the development of overvalued ideation in obsessionals are discussed. It is argued that cognitive–behavioural interventions such as the one described here may be useful as an adjunct to more traditional behavioural treatments for obsessional disorders as well as in the treatment of patients with overvalued ideation.

Research into social skills training has, in common with much other contemporary educational psychology practice, been beset by the problem of how best to evaluate effectiveness. Alongside the movement towards more behaviourally inclined approaches has grown a dissatisfaction with the traditional methods of evaluting effectiveness. If we recognize behaviour per se as being the appropriate level for intervention, whether in relation to academic skills teaching, classroom management, social skills training or whatever, then it follows that effectiveness can only logically be assessed in terms of measurable changes in observed behaviour. Evaluation methodology has tended to lag behind interventional methodology, however, so that it has not been uncommon to see behavioural work assessed in terms of changes in attitude and/or knowledge. On occasion evaluation is not even attempted and behaviour change is assumed to generalize outside the specific confines of the intervention situation.

Paradoxical instructions were presented to a 13-year-old male client presenting with urinary frequency associated with school attendance. This resulted in sudden change in frequency behaviour which was maintained at follow-up. This case study represents the first report of the application of paradoxical intention to the problem of urinary frequency, and an explanation of the treatment success is offered.

The effects of applied relaxation and stress-inoculation respectively were tested in an A–B design for one patient with panic disorder and one with generalized anxiety disorder. The treatments took 13 and 12 sessions respectively, and both patients were improved to a large extent as assessed by self-report, self-observation and physiological measures. The improvements were sustained or furthered at the one-year follow-up.

Persistent night-time disturbance in a small dog was treated by extinction. The difficulties of carrying out the programme, which in this case necessitated the use of an associate therapist, are discussed. Although a reversal design was not employed and therefore contingency control could not be indisputably demonstrated, the programme was judged to have been successful.