The need for development of effective models of training and superivision for trainee clinical psychologists to build CBT competencies and to implement high-quality CBT is frequently highlighted. Effectiveness of trainee therapist outcomes working within different models of training, supervision and services is also important to establish. This paper reports on the development and outcome effectiveness of a model of training and supervision aimed at increasing CBT clinical skills and competence of trainee clinical psychologists offering CBT for anxiety disorders in an anxiety disorders clinic (ADC) in inner-city London. Details of the training and supervision model are provided, which was conducted over a period of 3 months, with ongoing weekly supervision throughout the intervention period. Pre- and post-intervention data were analysed from service users who attended the ADC over a 2-year period. Over the 2-year period, 10 trainees treated 57 clients. Data from completer and intention-to-treat samples indicated that scores on four outcome measures improved significantly: at post-therapy, 75% of service users who completed the intervention showed reliable and clinically significant recovery or improvement. When supported by appropriate training and supervision, as outlined in this training model, initially inexperienced trainee psychologists can achieve outcomes comparable to those obtained in other secondary-care settings with qualified therapists.

The functions of resistance and restraint are considered in three topographically distinct psychological disorders that are characterized by excessive behaviour. Certain similarities are observed and speculations about their common role are examined. Finally attention is drawn to the implications of this type of analysis for our understanding of such disorders and for psychological treatment.

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.