This paper presents two studies which attempt to clarify the processes by which families who have multiple problems respond to behavioural parent training procedures. Study 1 assessed a range of parent and child behaviours in diverse home and community childcare settings during baseline, child management training and 3-month follow-up. Results show that while treatment gains occurred in the home training setting with the therapist present, little generalization of therapeutic effects to other settings was found. At follow-up, the gains made in the training setting had largely reverted to baseline levels. Study 2 assessed the same parent and child behaviours across settings for another group of multidistressed families during baseline, child management training, generalization training (consisting of planned activities and a social-marital support intervention) and at follow-up. Results indicated that the generalization training was associated with further improvements in non-training settings for parent and child behaviour, and that these results had maintained or further improved at follow-up. The results are interpreted and discussed with reference to future research and clinical work with conduct disordered children and their families.

Behavioural Marital Therapy (BMT) has undergone significant changes over the last fifteen years. Empirical data supports its efficacy yet there has been widespread criticisms of the approach. Integrative behavioural models have been developed in response to some of these criticisms but the question remains as to the efficacy of these new behavioural innovations. This paper gives an account of the current status of BMT and details the new treatment extensions.

Previous (mainly classical) conditioning and current (mainly operant) approaches to the treatment of gambling addictions are reviewed in the light of recent evidence of the central importance of heightened arousal in the experience of normal gambling. Within a general framework which views the central features of addiction as the phenomenology of arousal and the acquisition of altered states of consciousness as goals, the possible contributions of reversal theory are explored. A more detailed examination of operant and classical conditioning analyses of the maintenance and reinstatement of excessive gambling behaviour appears to point towards a return to interventions based upon classical conditioning theory, although to cue exposure and the extinction of “peak experiences” rather than to aversion therapy.

The need to monitor the standards of care provided in settings for the long term psychiatrically disabled has become increasingly recognized. A critical review of the literature indicated that no comprehensive assessment procedure existed for settings providing some form of rehabilitation. However, five important aspects of care in each setting were identified: (i) Treatment Practices, (ii) Unit Management Practices, (iii) Community Contact Practices, (iv) The Physical Environment and (v) Staffing Resources.

A series of questionnaires was devised—The Model Standards Questionnaires—to assess each of these aspects of care. The questionnaires can be used to provide a profile of particular settings quality of rehabilitation and as a means of identifying how the quality of that rehabilitation might be improved.

An advice booklet was developed and evaluated over three studies of diminishing clinical contact. Study 1 (n = 5) utilized full support through clinic sessions and telephone contact. During study 2 (n = 5) therapists maintained reduced contact with families, while minimal therapist support or contact was employed in study 3 (n = 10). A multliple baseline design across families was used to evaluate studies 1 and 2. Additionally all phases were evaluated using a consumer satisfaction measure. Overall the results suggest that the booklet was moderately successful in reducing nighttime behaviour problems. While parents could use the booklet on a self administered basis, some families may require additional clinical support to succeed with effective management of their child's nighttime behaviour problems. The research findings point to the need for specific advice packages for use by parents in the management of simple problems evinced by their children.

Correctly construed, the concept of intervention requires that active consideration be given to the mechanisms by which any behaviour change produced by an intervention procedure may subsequently be generalized—across settings, across behaviours and, particularly, across time. Broad strategies that have been adopted with the aim of fostering generalization are reviewed. These may be seen to define a continuum along which scope for engineering behaviour change is “traded” with the probability of the contingencies required to maintain this change being assimilated within the “post-intervention” environment. Viewing strategies in this manner prompts consideration of interventions representing the extreme of this continuum, where scope for engineering change is minimal, but the probability of maintaining any change produced is very high. The implications of adopting such “minimal interventions” are examined, and these strategies shown to have some empirical support. A broad structure for implementing “minimal interventions” is proposed.

Dependency levels of long-term mentally disabled people in hospital and community settings were compared using a behavioural rating scale called REHAB in a health district where a policy of community care had been implemented. It was found that the performance of subjects in the community settings was better than those on the admission ward, but was worse than half the people normally found in traditional psychiatric settings. The policy of community care would seem to have been successful insofar as this group of subjects was able to remain in community settings. Comparison of the REHAB factor scores suggested differences in the behavioural competence of subjects supported by community psychiatric nurses and social services staff compared to those attending a psychiatric day hospital.

The research comparing imaginal and in vivo exposure in the treatment of clinically significant fear, recently reviewed by James (1986), is reexamined from the perspective of bioinformational theory and the concept of emotional processing. Fear is assumed to be stored in long term memory as a network of propositionally-coded information, which has to be processed if treatment is to be successful. Emotional processing is indicated by activation of fear responses and their habituation within and across treatment sessions. Consistent with the theory, our review indicates that successful treatment via imaginal and in vivo exposure is indeed related to activation and habituation of fear responses; interference with processing has a negative impact upon fear reduction, regardless of the specific treatment techniques employed. Furthermore, some apparently discrepant findings in the available research literature can be understood in terms of the theories cited. These ideas provide a useful perspective from which to plan future research efforts and to advance our understanding of the processes underlying reduction of pathological fear.

A multiple linear regression analysis was made on behavioral, questionnaire and other data from 40 agoraphobic patients, who participated in a behavioral outcome study. The dependent variable was treatment outcome as determined by changes in behavioral, subjective and physiological data after treatment and at 7-month and 15-month follow-up. The main predictors of outcome were self-rated anxiety and heart-rate at a behavioral test, and scores on the Autonomic Perception Questionnaire and Fear Survey Schedule-III, all related to the phobia. However, both level of depression and marital relationship were found to be weak predictors.

Although cognitive restructuring (CR) procedures have not proven very helpful for phobics in recent studies, insight and rehearsal components of CR have often been confounded. To seek possible differences in effectiveness between insight and rehearsal, we treated 16 phobics (eight agoraphobics and eight others) with four sessions of each method, using a counterbalanced crossover design with 1-month follow-ups after each treatment component. Significantly fewer sessions were attended by the clients in the rehearsal/insight sequence, and benefit ratings made by project completers significantly favoured insight/rehearsal. Few other treatment group differences were seen, but those that emerged gave the advantage to insight. Rehearsal seemed unhelpful, particularly to non-agoraphobics. Conclusions are (1) that CR methods show some promise in application to phobias, provided that self-exposure homework forms the core of the treatment plan, and (2) that insight followed by rehearsal is the preferred sequence.

A behaviourally based Programme was developed to assist parents with problem children. The Programme was intended for the typical social service clientele of single parent, low income or state benefit families and may be administered by social workers or assistants conversant with the Programme Manual. The Programme consists of six 90 min sessions run at weekly intervals during which a variety of behavioural techniques are taught, largely through role play, with a seventh follow up session a month later.

The Programme was evaluated by a range of before and after measures on both a treatment group and a waiting list control group and maintenance of treatment gains was tested at three and, for some measures, six months interval. The Programme significantly reduced: the perceived number and intensity of child behaviour problems; parental depression, inward irritability and outward irrirability; and the level of perceived chlid conduct problems, impulsivity and anxiety. It significantly improved parents' chlid management skills. Improvement in parental depression and irritability was maintained at three months and reduction in chlid beviour problems was tested for and found at both three and six months.

The term “needs assessment” has been used previously to describe a variety of concepts relating to the relationships between service provision and users/consumers. Different meanings have been attached according to the means by which service agents have attempted to identify relevant services; limitations have been observed in needs assessments that have tried to define the need for change solely within individuals. An effort is made to extend the scope and range of such needs assessments beyond a consideration of the individual consumer and to enable assessors to make concurrent statements relating to the behaviour of both workers and service systems. An attempt is made to locate behaviourally-based work within an understanding of human need.

This article reports a longitudinal study of the psychophysiological responses of a schizophrenic patient towards his parents, in relation to their Expressed Emotion status. Recordings were taken during periods of relapse and remission. The results are discussed in the context of environmental and vulnerability factors affecting the illness.

Forty-eight children from grades 3 to 6 of two inner city primary schools were selected on the basis of poor performance on a social perception test. Subjects were randomly assigned to one of three experimental conditions: social perception training (SPT); attention placebo control (APC; drama activities) or a no treatment control (NTC; assessment only). The SPT and APC groups participated in nine twice weekly sessions over a five week period. Children receiving SPT did not show a significantly greater improvement in social perception skills than either of the control conditions. There was also no significant effect of SPT on certain measures of behavioral functioning which have previously been associated with social perception skill, namely peer sociometric status, Walker Problem Behaviour Checklist or Childrens' Depression Inventory. The findings are discussed in terms of implications for future research.

The use of room management techniques to increase the levels of engagement of people with a mental handicap has been well documented. The difficulties in using constructional approaches (as opposed to eliminative procedures) to deal with difficult and disruptive behaviour in residential settings has also been well documented. This study reviews the relevant literature and describes in detail the application of a room management technique in a women's hospital villa. The six residents who took part are described as severely mentally handicapped, difficult and disruptive. During the room management sessions the levels of engagement in purposeful activity of the women increased and the problem behaviour exhibited decreased. Both changes were statistically significant. The implications of these findings for the general management of people who exhibit difficult and disruptive behaviour are discussed.

Three experiments were conducted to investigate the effects of teaching chronic schizophrenic patients to verbally regulate their own behaviour by means of self-instructional training. In Experiment 1, self-instructional training on a short-term memory task produced improvements in performance which did not generalize to a second memory task. In Experiment 2 an attempt to enhance generalization by teaching a rehearsal strategy on two different memory tasks produced improvements of performance only on those new tasks that were similar to the teaching tasks. The third experiment compared task-specific and general problem solving self-instructions and showed no differences in the effectiveness of the two methods. Some of the difficulties encountered when teaching self-instructions to the subjects, together with the failure to produce adequate generalization of treatment effects, leave the clinical utility of the procedure uncertain. Before a practical cognitive therapy for chronic schizophrenics can be developed it will be necessary to explore more fully the relationships that exist between the verbal and non-verbal behaviour of these patients.

Four developmentally handicapped (autistic) boys in a treatment centre for behavior disordered children were taught to perform coloring and block-assembly play responses within a discrete trial format training paradigm. Two training strategies that differed with respect to antecedent cueing methods were examined. Specifically, a “naturalistic” cueing procedure, involving the simple presentation of play materials to set play in motion, was compared to the more conventional approach of giving verbal instructions to instigate play responses. Generalization across comparable play “tasks” with only naturalistic cueing was probed. Findings indicated that, with all participants, where the antecedent cues for training matched those found in the generalization condition, there was substantially more carry-over. Suggestions for future remedial practice based upon antecedent control factors are offered.

A schizophrenic patient and his family were provided with a nine month multi-component behavioural intervention programme as part of a controlled study. The patient was at high risk of relapse according to the High EE status of his parents. Multiple outcome measures were used to assess the efficacy of the programme. The components of the intervention are described in detail, and the specificity of component effects in this case are examined. Given the methodological limitations of this type of study, it is not possible to demonstrate conclusively intervention effects in the case reported. However, following the intervention the relapse rate of the patient was reduced, his social functioning improved and the EE status of his parents changed from High to Low.

Anecdotal evidence suggests that room management is useful in controlling the frequency of behavioural excesses in severely/profoundly handicapped persons. This study involves a systematic investigation of the effect of room management on inappropriate behaviour. Data was collected over a 10-day period on each of six subjects who manifested a range of stereotyped and self-injurious behaviours. Each day formed an ABA design, A representing baseline conditions and B, room management. Room management proved to be helpful in controlling the behaviour in some instances. For other subjects it was clearly not successful. This outcome is discussed in terms of inter- and intra-subject variability in response to environmental change.