The National Institute for Clinical Excellence has recommended cognitive behaviour therapy (CBT) for a number of common child and adolescent mental health disorders. The aim of this study was to clarify the practice of CBT within specialist child and adolescent mental health services in the United Kingdom. A survey was distributed to specialist child mental health workers through national organizations and professional bodies. Approximately 10% of specialist CAMHS professionals replied (n = 540). One in five reported CBT to be their dominant therapeutic approach, whilst 40% rarely used CBT. Specialist post-qualification training had been undertaken by 21.0% of respondents, with over two-thirds identifying training needs in the core skills of CBT. This survey suggests that the capacity of specialist CAMHS to meet the requirements of NICE in terms of the availability of CBT skills is doubtful. There is a need to develop CBT training and supervision infra-structures.

The policies of the so-called great Powers toward China in the twentieth century have frequently given rise to serious diplomatic disputes. Fortunately, in many cases, these differences have tended to clarify conflicting interpretations of policy, and by so doing have led to a better understanding of principles on which more complete agreement might be achieved. Conspicuous among such cases is the policy usually referred to as the Open Door. From 1899 until 1922 the Open Door in China was a subject of almost constant international friction, due, in part, to a lack of common agreement as to the precise commitments to which the Powers were pledged. Specific cases of disagreement led finally to a better appreciation of the principles involved, and in 1922 the Open Door policy was given its first treaty definition. The following pages are an attempt to analyze a series of events in 1916-17 which demonstrated the wide gulf between American and European interpretations of the Open Door, and the imperative need of a new definition of the policy. The essential background of the discussion may be stated briefly.