Peer interaction problems are often difficult to ameliorate in a clinical setting. In this study, four boys, whose many problems included difficulties with peer relationships, were given social skills training in a group over ten sessions. The main aim was to improve cooperative play, effective communication and conflict resolution skills by using a general problem-solving framework combining behavioural and cognitive techniques. The formal measures failed to show change, which may be due in part to inadequacies in the measures. Reports from therapists, teachers and parents suggested that there was considerable change within sessions, some improvement at school but very little at home.

A male gymnast who had represented his country in Olympic gymnastics and had developed a maladaptive mental approach to performing on the pommelled horse in competition was given stress inoculation training in order to help him overcome his difficulties. Preliminary interviews revealed that immediately before competing he became very tense, his arms started to shake and he had doubts about being able to complete his routine. In addition, he was unable to use visualization, a technique which he used for mental preparation on the other five pieces of apparatus in Olympic gymnastics competitions. Further interviews also strongly suggested that the subject had developed an unconscious set of negative self-statements. An intervention programme comprising 12 sessions of training in relaxation, visualization and making positive self-statements was implemented. Recorded interviews and comments made by the subject on completion of the training indicated that the programme had been successful. For many years the subject had experienced problems performing on the pommelled horse and he had frequently suffered falls in competition. Towards the end of the stress management training programme his performance began to improve. He also became more confident and he used his stress coping skills in competition. In the National Championships he was able to relax, visualize his routine and make positive self-statements. Shortly after this competition he successfully completed his routine to a high standard without any falls to win the individual title in the Midlands Regional Championships. In a subsequent international match he again successfully performed his routine to a high standard.

A female irritable bowel syndrome sufferer was offered several strategies sequentially for coping with the complaint. Of these, bowel retraining established desired bowel frequency and exposure in fantasy resulted in decreased frequency and intensity of pain attacks. Both of these effects were maintained to 18-month follow-up.

An audio-tape technique was used in the treatment of a 35-year-old male with a 13 year history of obsessional rituals and ruminations. His rituals responded to exposure and self-imposed response prevention but the ruminations remained as before.

The audio-tape treatment, which involved him listening to his own voice reciting his ruminative content, resulted in a rapid and substantial reduction in frequency of ruminations and this was maintained to one month follow-up.

The clinical and theoretical implications of this treatment approach are discussed.

Psychological treatments for sleep-maintenance insomnia have received little attention in the literature. Problems with staying asleep are commonplace, however, especially in the older age groups, and there is a need to develop effective management alternatives to night-time sedation. This single case report describes the sequential application of two cognitive interventions with treatment effects being evaluated by means of time series analysis. The mental overarousal model of sleep disturbance is discussed.