Background: This study adds to the body of evidence regarding the theoretical underpinnings of interpersonal psychotherapy and the mechanisms through which it impacts upon depression in adolescents. Aims: The aims were to determine whether the interpersonal constructs proposed to underpin interpersonal psychotherapy do indeed change in response to this therapy and whether such changes are associated with changes in depression in young people. Method: Thirty-nine adolescents, aged 13–19 years, with a primary diagnosis of major depressive disorder, were randomly assigned in blocks to group or individual treatment. Assessments were conducted at pre and posttreatment, and 12-month follow-up. Results: The results supported the hypotheses, with significant improvements in social skills, social functioning, and the quality of parent-adolescent relationships, and an increase in secure attachment style and decrease in insecure attachment style being evident following treatment. Benefits were maintained at 12-month follow-up. Adolescents who showed greater reductions in depressive symptoms over this period tended to also show greater improvement in parent reported social skills, quality of the parent-adolescent relationship, and attachment style from pretreatment to 12-month follow-up. Conclusions: The findings are consistent with the proposed underpinnings of interpersonal psychotherapy. Adolescents showed significant improvements in interpersonal functioning and changes in attachment style following treatment, and changes in social skills, parent-adolescent conflict and attachment style were associated with reductions in depression. As such, the results add to the body of knowledge regarding the construct validity of interpersonal psychotherapy as an intervention for depression in young people. Clinical implications and directions for future research are discussed.

The area of psychosexual dysfunction in the elderly has been relatively ignored and very little research has been conducted into the aetiology, assessment, and treatment of such disorders. Many negative attitudes have been held traditionally relating to the sexual behaviour of older people, and this may account for the reluctance of many elderly clients to seek help, and for the lack of attention paid by helping professionals. The number of referrals for sex therapy from older persons is now beginning to increase, and evidence confirms that the majority of healthy older persons remain sexually active and sexually capable throughout their later years. Although there is a marked lack of empirical research, case studies suggest that cognitive-behavioural approaches offer promise in the treatment of psychosexual dysfunction in the elderly. Factors are discussed that relate specifically to older clients in the application of a cognitive-behavioural approach to assessment and therapy.

This study examined the effectiveness of emotive imagery as a treatment for clinically significant darkness phobia in 7- to 10-year-old children. Twenty-four clinically diagnosed children were randomly assigned to either emotive imagery treatment or a waiting-list control condition. Emotive imagery was conducted over six sessions, one per week. The results demonstrated that the emotive imagery group showed significantly greater reductions in darkness fears and anxiety according to child and parent reports and a behavioural darkness probe task, in comparison to the waiting-list group. The waiting-list children showed minimal reductions in fearfulness over the 20-week waiting-list period. The improvements of the emotive imagery group were maintained at the 3-month follow-up.

Individuals with chronic pain differ markedly in their physical and psychological adjustment to the pain condition. Many factors influence this adjustment process, and the nature and severity of the physical injury or illness and the degree of pain experienced cannot account fully for the impact of chronic pain. A variety of other psycho-social factors are involved, including the individual's attitudes and beliefs about his or her condition, coping skills, operant reinforcement factors, avoidance learning, and psychophysiological variables. Intervention programs that are designed to facilitate positive adjustment to chronic pain need to consider these biological, psychological, and social factors within an integrated framework. Cognitive therapy has a significant role to play in this process, in order to tackle maladaptive cognitive factors that interfere with adjustment. Evidence concerning attitudes and beliefs relevant to the pain condition and their relationship with the use of coping skills and response to pain, is reviewed.

The present paper reviews recent developments in the assessment of children's social competence and social skills. Current conceptual models of social competence and social skills are discussed and provide a basis against which assessment measures can be evaluated. Although many measures are now available, there is a lack of integration of assessment devices within a conceptually sound framework of an assessment system. Such an assessment system should distinguish between social competence and social skills, should take into account developmental, sex and cultural factors, and should assess at micro-versus macro-skill and overt versus cognitive levels of behaviour. The system should then integrate information within a cognitive-behavioural analysis, using data from a wide range of informants, from a range of settings. Greater attention to matters of reliability and validity of assessment measures is also necessary in the development of such a system.

The present study investigated the effectiveness of a cognitive-behavioural approach to the management of chronic work-related upper limb pain. Clients included three females who had experienced severe upper limb pain for 7, 3.5 and 1.5 years respectively and whose condition had been labelled by medical specialists as occupational overuse syndrome. Clients commenced treatment in a sequential manner, following a staggered baseline monitoring phase in order to produce a multiple baseline design across cases. Treatment involved 8 sessions over a 4-week period, covering pain management procedures, cognitive restructuring of maladaptive cognitions, relaxation training and EMG biofeedback. All cases showed some improvement in pain, distress and interference caused by pain. In addition, changes in depression, anxiety, coping strategies and sleep disturbance were reported. Therapy gains were maintained at the 6-month follow-up assessment for 2 of the 3 cases.

Very few attempts to enhance children's social competence have incorporated both cognitive and overt skill components. A case is made for the importance of cognitive influences upon children's social functioning. These include not only social-cognitive skills such as social perception, social problem solving and self monitoring but also the role of maladaptive cognitive events which interfere with adequate social response. Evidence concerning the importance of social-cognitive skills is discussed and the need for an integrated cognitive-behavioural approach in children's social enhancement programs is highlighted.

Although much has been written about the need for prevention of anxiety disorders in children, there has been a marked absence of empirical research to evaluate the effectiveness of such programs. This paper suggests that there is now sufficient evidence to identify risk and protective factors for the development of childhood anxiety disorders. Early childhood temperament, negative life events, and children's coping styles are suggested to play a significant role. Acting in association with these variables are parental behaviours that serve to model, prompt, and reinforce anxious behaviour and emphasise the threatening nature of events. Our knowledge of these causal variables enables us to identify children at risk for the development of anxiety problems and highlights variables that should be targets of change in prevention programs. Indicated prevention is designed to disrupt the trajectory towards the development of clinical levels of psychological disorder. This paper describes an “indicated” preventive program for children identified as being at risk for the development of anxiety disorders given evidence of mild anxious symptomatology.

Background: This study adds to the limited evidence concerning the benefits of Interpersonal Psychotherapy (IPT) with depressed adolescents. It evaluates the long-term effects of group versus individual delivery of this treatment approach. Aims: To conduct a small-scale examination of the long-term efficacy of group versus individual delivery of IPT for depressed adolescents. Method: Thirty-nine adolescents, aged 13–19 years, with a primary diagnosis of Major Depressive Disorder, were randomly assigned in blocks to either group or individual delivery of IPT. Standardized clinical interview and questionnaire assessments were conducted at pre- and posttreatment, and 12-month follow-up. Results: Intent-to-treat (ITT) analyses indicated significant improvements in depression, anxiety, youth-reported internalizing problems, and global functioning from pre- to posttreatment for those receiving IPT, with no significant differences in outcome between group and individual formats of delivery. Improvements were maintained at 12-month follow-up. Completer analyses also revealed significant and sustained improvements on these measures for those receiving IPT, with no differences in outcome between therapy formats for most measures. Individual IPT showed significantly greater improvements than group IPT in parent-reported internalizing problems for the completer but not the ITT analyses. Conclusions: Both individual and group formats of IPT offer promise in producing long-term benefits in the treatment of depression among adolescents.

This paper examines a range of theoretical issues and the empirical evidence relating to clinical supervision in four mental health professions, namely clinical psychology, occupational therapy, social work, and speech pathology. Despite the widespread acceptance of the value of supervision among practitioners and the large quantity of literature on the topic, there is very little empirical evidence in this area. It is not clear whether supervision actually produces a change in clinician behaviour, nor whether it produces benefits in terms of client outcomes. To date, there is insufficient evidence to demonstrate which styles of supervision are most beneficial for particular types of staff, in terms of their level of experience or learning style. The data suggest that directive forms of supervision, rather than unstructured approaches, are preferred by relatively inexperienced practitioners, and that experienced clinicians also value direct supervision methods when learning new skills or dealing with complex or crisis situations. The available evidence suggests that supervisors typically receive little training in supervision methods. However, to date, we have little information to guide us as to the most effective ways of training supervisors. While acknowledging the urgent need for research, the paper concludes that supervision is likely to form a valuable component of professional development for mental health professionals.

Risk and protective processes and mechanisms associated with depression in youth are discussed within a developmental–ecological framework. Risk factors at the individual (genetics, biology, affect, cognition, behaviour) and broader contextual levels (e.g., family, school, community) are proposed to interact, leading to the development of depression in youth. Transactions between these individual and contextual factors are suggested to be dynamic and reciprocal, and these transactions are expected to change over time and developmental course. The ‘best bet’ for the prevention of depression may be multicomponent and multilevel interventions that address the multiple risk and protective factors associated with depression. Preventive interventions need to focus on building protective factors within young people themselves, as well as creating health-promoting environments at home and at school. These interventions likely need to be long term and geared towards assisting youth across successive periods of development.

This paper describes the rationale for and development of an online cognitive-behavioural treatment for child and adolescent anxiety (BRAVE–ONLINE). It highlights the challenges involved in adapting a clinic-based intervention for delivery using the internet, with separate sessions for parents and their children (or adolescents). We outline strategies to ensure that young people remain engaged in online therapy, and describe techniques designed to optimize the alliance between clients and the online therapist. Two case studies are presented that illustrate the practical and technical aspects of implementing the intervention, and demonstrate the feasibility of achieving successful outcomes using online delivery of CBT for child and adolescent anxiety. However, firm conclusions regarding the efficacy of this approach cannot be drawn until the results of randomized controlled trials are available. The paper identifies directions for future research.

The present study examined whether wording changes in a self-report anxiety scale for children were better able to distinguish anxious from non-anxious children than traditional wording. Furthermore, the study explored whether phrasing the items as either stimulus or consequences (outcomes) of events, would give a better assessment of fear and anxiety in children and adolescents. The four questionnaires were administered to an anxiety-disordered group and a non-anxious group of children aged from 6 to 15 years. Anxious children reported that they thought more about negative outcomes than non-anxious children. However, there were no differences in scores between the two groups using stimulus items. All children regarded negative physical consequences as aversive. However, anxious children reported thinking more frequently about negative physical outcomes than did non-anxious children. All children also thought about negative social outcomes. However, anxiety-disordered children rated negative social outcomes as more aversive than did non-anxious children. None of the four measures discriminated between the different anxiety disorders. Implications for children's self-report data on anxiety are discussed.