The clinical literature has long acknowledged the paradoxical findings that deliberate attempts to suppress particular thoughts actually increase their occurrence. The unwanted, intrusive thoughts that are a major feature of obsessive disorders, depression, sleep disorders, and a range of other disturbances are of particular clinical concern. The exploration of psychological factors associated with cognitive control is, therefore, clinically relevant. The present paper considers the role of mental control and thought suppression in bulimia nervosa in explaining the occurrence of unwanted thoughts and feelings, specifically in relation to weight, shape, and food. Our fundamental argument is that suppression of thoughts of food, weight, and body shape can lead to the increased frequency of these thoughts. The increase in unwanted thoughts is likely to result in a loss of control over eating, and lead to the escalation and perpetuation of bulimia. Dietary restriction is likely to be associated with successful suppression, and binge-eating with failed suppression. Indeed, the initial success of suppression paradoxically causes its inevitable failure. We conclude that the suppression of thoughts of food and weight or shape in bulimia nervosa is maladaptive and counterproductive. In addition, the therapeutic implications of thought suppression are considered.

This paper describes the employment achievements of people following spinal cord injury, and briefly reviews the literature on methods used by job seekers in obtaining employment. The scientific literature on job seeking supports the social validity claims of Azrin's behaviourally-based job club methodology (Azrin, Flores, & Kaplan, 1975) and thus suggests that the job club approach might be successfully offered to people with a spinal cord injury who wish to work. A group case study is presented wherein a modified job club format was utilised with ten spinal cord injured people. Encouraging results were obtained, both in terms of changed behaviour and in actual employment status.

Cue reactivity has been assessed in women with bulimia nervosa both in conjunction with treatment studies and in independent laboratory investigations. Methodology for investigating cue reactivity varies widely, providing little guideline for the optimal assessment parameters. The present pilot study describes the evolution of a methodology for assessing cue reactivity in response to in vivo cues in women with bulimia nervosa. Patients' responses are compared with those of health controls. Recommendations for the standardisation of the procedure are given. The guidelines proposed have equal applicability to research on cue reactivity in the fields of substance abuse and anxiety disorders.

The potential efficacy of recently developed cognitive and behavioural treatments (CBT) for residual hallucinations raises practical questions about the extent of applicability of such treatments and the possible need for programmatic responses by mental health services. This pilot study, conducted in a 355-bed acute and rehabilitation psychiatric hospital, explored the prevalence of persisting auditory hallucinations, patients' coping strategies, and indicators for cognitive and behavioural treatments. A census identified 123 patients with persisting hallucinations. Information about practical impediments to CBT was obtained from structured interviews with staff. Detailed interviews with a subsample of 35 hallucinators identified natural coping strategies and indicators for treatment. High rates of natural coping strategies were reported by this very disabled sample. Fifty-three per cent of hallucinators were considered “potential” candidates, and 20% “good” candidates for CBT for voices.

There has been extensive debate over the last three decades about which professional groups should receive government-funded rebates in the mental health field. Cognitive-behaviour therapists appear to be in the best position to demonstrate clinical efficacy, but have failed to demonstrate cost-effectiveness of cognitive-behaviour therapy. There is a need to demonstrate the cost of behaviour therapy as the first step in determining the cost-effectiveness of behaviour therapy compared to the traditional (medical-based) interventions. Using archival data from a university-based psychology clinic specialising in cognitive-behavioural interventions with child and adolescent problems, the present research determined the cost of successful treatment programs with the clinic's major referral areas: nocturnal enuresis, behaviour management, and education-based problems. Analysing 77 cases, it was found that there were significant between group differences in the number and total duration of face-to-face interviews, in the number of other contacts between therapist and client, in total therapist time, and in the estimated average cost of cases. There emerged different treatment patterns for each clinical problem, and these were reflected in costing. A number of research and methodological issues are explored. Implications for future research on cost-effectiveness and the subsequent collection of comparative data across clinics and a variety of clinical problem areas are discussed.