Twenty-nine outpatients (24 men) with a history of problem-drinking and alcohol dependence were assigned at random to one of three covert sensitization procedures varying in the nature of stimulus elements in aversion scenes. Group 1 received standard nausea imagery, whereas Group 2 received similar scenes “assisted” by noxious odors. Imagery used in Group 3 scenes was unrelated to nausea but focused instead on disturbing potential consequences of drinking. The occurrence of conditioned aversion responses (CR) was verified by observational, self-report and physiological measures. The observed pattern and frequency of conditioning corresponded closely to data reported by Elkins (1980). Favourable outcomes at 18 months (abstinent, controlled or improved) were observed in 45, 56 and 67% of clients in each group, respectively. The groups did not differ significantly in effectiveness. Within both of the nausea sensitization groups (1 and 2), successful remission at 18 months occurred only in individuals who had shown CR, whereas in emotive sensitization (Group 3) there was no apparent relationship between conditioning and outcome.

It is becoming increasingly evident that informal psychotherapy plays a significant part in the coping strategies people use to alleviate personal distress. A form of this “social support” was evaluated in a pilot study in which ex-clients served as therapists for informal community groups made up of people experiencing clinical anxiety. Three major questions were addressed: what are the training effects of a short workshop on the ex-clients' social support skills?; can the trained ex-clients help people suffering with clinical anxiety?; and finally, does this involvement have an adverse effect on the psychological well being of these lay therapists. Between and within group analyses with multiple measures indicated that the workshop was successful in all three targeted areas. Implications are drawn for the pattern of formal psychotherapy services.

Four dimensions thought to be basic to all child behavior therapy are specified. These are: (a) manipulation of the consequences of inappropriate behavior; (b) short-term prevention by ecological change; (c) teaching more appropriate alternatives and (d) long-term prevention by remedying more fundamental behavioral deficits. It is proposed that all four dimensions are needed for the design of any clinical treatment. The model therefore illustrates how ostensibly opposing intervention strategies in behavior therapy are really complementary. Since children's clinical problems rarely occur as isolated behaviors, and since behavioral psychotherapy involves development of more adaptive skills that influence the target problems indirectly, the dimensional model allows cross-referencing of the interrelated target behaviors in the child-client's repertoire. This is illustrated by describing typical intervention designs for two children with behavior problems. By formally specifying the realities of clinical treatment design, the relevance of therapy outcome research to clinical practice should be enhanced.

The difficulty in predicting outcome from therapist behaviour has been attributed to the neglect of some important variables, including the amount and type of therapy, and the skilfulness and interpersonal manner of the therapist. The present study investigated one therapists behaviour in terms of these four dimensions for a random sample of 10 adult outpatients, for whom outcome data were available. Results indicated that the type of therapy was intermediate between prescriptive and exploratory modes, that it was practiced at a satisfactory level of proficiency, and that interpersonal effectiveness was high. The related Clinical outcomes were also satisfactory in relation to the amount of therapy. In addition to illustrating a procedure for evaluating therapist behaviour and showing the correspondence between process and outcome, this “case study” provides evidence to support the need for more objective accounts of therapist behaviour.

Five patients suffering from chronic and distressing psychotic symptoms were treated with a cognitive-behavioural approach designed to modify their beliefs that their auditory hallucinations were real, and to enhance their ability to control psychotic experiences. Four of the patients reported an increase in their ability to control hallucinations, but only one of these also reported a decreased frequency of hallucinating and a reduced belief in the reality of hallucinations. The discussion focusses on the implications for future interventions in this area.

This study explores the possibility of teaching nurses behavioural tehniques so that patients with intractable pain problems can be treated confidently, and subjective labelling, which obstructs a goal oriented approach, can be avoided.

Three seminars were given which included formal teaching, role-plays and practical between-session tasks.

Of the four assessment procedures used, the nurses showed a significant change in their knowledge of behavioural principles, their attitudes to disabled people, and their response to pain behaviours. Their ability to specify problem behaviour did not improve and some reasons for this are discussed

Dry Bed Training is an effective and rapid method for the elimination of primary nocturnal enuresis. However, like the urine alarm the approach demands very close clinical supervision. This is a Pilot Study to evaluate the effectiveness of a self-help approach (based on Dry Bed Training), administered using a minimum contact self-help manual, and a video in which a young mother and son demonstrated treatment techniques. Ten severe primary nocturnal enuretics, acting as their own controls, were treated using this approach. Results show initial remission in 80% of the cases, with 20% of the subjects dropping out. Of those who completed treatment 25% relapsed. These results were obtained with a significant reduction in staff time. The role of clinical supervision is critically examined. Elements of a cost-benefit analysis are identified in order to highlight the strengths and weaknesses of this approach.