“I'd warned her that intellectuals didn't count for much in the scheme of things: but academics are like the clergy in their blind conviction that their vocation has relevance to the rest of the world.” (McCauley, 1990).

In the beginning, the founders of behaviour therapy were quite explicit about the link between basic laboratory research and their new therapies (Eysenck, 1960; Wolpe, 1958). Their claim that behaviour therapy was based on “modern learning theory” was not, however, without controversy (e.g., Breger & McGaugh, 1965; London, 1972); but while the logical necessity for appeal to laboratory research on learning might have been questioned (Breger & McGaugh, 1965), the historical contingencies linking Pavlov's dogs, Masserman's cats, and Wolpe's first systematic desensitisation patients can scarcely be questioned (American Psychological Association, 1980; Kazdin, 1978).

It is equally clear that there was a similar close historical link between laboratory studies of operant behaviour, especially by Skinner and his students, and the development of behaviour modification applications such as reinforcement therapy and the token economy (Kazdin, 1978; Krasner 1971; Skinner, 1953). Again, the continuing necessity for behaviour modification to be linked to basic research in operant behaviour has been challenged (Azrin, 1977; cf. Deitz, 1978) but the historic fact of the relationship is well established (Krasner, 1971).

This paper reviews studies of the application of self-control procedures to the symptoms of schizophrenia. The authors argue that, while there are few well-controlled studies on their effectiveness, there are many cognitive-behavioural techniques which show promise for assisting clients to develop greater mastery over a number of symptoms. Surveys also show that many persons with schizophrenia spontaneously use their own methods to gain some control over their symptoms. While much further research is needed in this area, clinicians need to empower clients with schizophrenia to explore and enhance their self-control skills.

Individuals with intellectual disabilities commonly engage in a variety of problematic behaviours such as aggression and self-injury. This paper discusses the value of using a communicative model to study these behaviour problems. First, the reciprocal nature of behaviour problems is outlined. Next, research on the use of functional communication training as a treatment for behaviour problems is reviewed in terms of its initial effectiveness, generalisation, and maintenance, as well as the mechanisms responsible for behaviour change. Finally, recommendations are made for future research and training efforts aimed at reducing severe behaviour problems.

Constructions of the experiential sources of anger, both in ordinary language accounts and in scientific studies, are characterised by a proximity bias. Anger is commonly represented as being due to acute, proximate occurrences. However, anger can be alternatively understood to be a product of contextual conditions, which may involve distal or ambient determinants. The themes of embeddedness, interrelatedness, and transformationality, derived from the contextual perspective of Stokols in environmental psychology, are presented for the understanding of anger as pertinent to clinical concerns and as heuristics for anger management interventions.

The goal of the Murdoch Early Intervention Program (MEIP) was to replicate the intensive early intervention program designed by Lovaas for children with severe developmental disability and autism. This paper describes the objectives, methods, and the results as of 24 months. Although MEIP differs from Lovaas's model in several respects, and the children have been generally less capable at the outset, results are interpreted tentatively as being as predicted. Four of 9 experimental children have shown signs of approaching normal levels of functioning whereas 1 of 5 control children has made significant progress. Improvements in the remainder of the children are rated as moderate to minimal. These preliminary results are presented to encourage others working with children with autism and other difficult-to-teach children to publish their methods and results. The small number of children in any one locality, and the high cost of controlled studies indicates the necessity for accumulating findings across service providers.

In his address to the Annual Conference of the Australian Behaviour Modification Association in 1986, Dr. Robin Winkler chose the topic “The social history of behaviour modification in Australia” (Winkler & Krasner, 1987). Dr. Winkler was concerned to recognise the contributions of a number of individuals who were prominent in the new movement in the 50s, 60s and 70s. My aim is rather different. I want to try to capture what the early workers were trying to achieve, what they saw as the problems, and how they viewed the early developments. I will then look at more recent developments in Australian behaviour therapy, and try to characterise its current status. Finally, I'll discuss what seem to me the major current problems, and suggest some possible solutions. Where I feel able to do so, and it seems to me appropriate, I'll make some comparisons with the situation in the USA. Many of the more general points, of course, will be relevant to behaviour therapy in any country.

When behaviour therapy was developed in the 1950s and 1960s, it was based firmly on the experimental psychology of the time, principally learning theory. Since that time effective verbal therapies have been developed, and clinicians are faced with the difficult task of selecting among so-called behavioural and cognitive interventions based on radically different philosophies. This paper reviews developments in learning theory, particularly human learning, which suggest that conditioning is a complex cognitive process giving rise to verbally accessible expectancies and beliefs. Such a perspective provides a common theoretical framework (cf. Bandura, 1977) that allows behavioural and cognitive strategies to be coordinated to modify a particular cognitive target, such as biased expectancy of harm in anxiety. It is argued that the terms behavioural and cognitive carry unwanted connotations, and that it is preferable to specify independently the content of information to be conveyed in therapy (e.g., reduction in expectancy), and the mode by which it is conveyed — experience, observation, or language. Learning theory, in conjunction with other areas of experimental psychology, continues to provide a conceptual basis for the understanding of psychopathology and the development of new psychological interventions.

The traumatic stress field has expanded dramatically over the last 10 years. This paper provides a review of progress in three areas from the domain of posttraumatic stress responses. First, recent developments in diagnosis are discussed, with particular reference to the proposed diagnostic criteria for DSM-IV (Diagnostic and Statistical Manual of Mental Disorders, 4th Edition; American Psychiatric Association, in press). Second, a theoretical formulation based on cognitive processing principles is presented and, where available, empirical support for such a conceptualisation is provided. Third, the implications of a cognitive processing paradigm for treatment are discussed briefly, with reference to recent research findings. Suggestions for future development of the field are provided.

Five tutor-tutee pairs of 13-year-old students who were below average in reading participated in a program of remediated reading using the Pause, Prompt, and Praise procedures. Whereas previous research has shown that these procedures can be learned concurrently by peer tutors, this study showed that the procedures can also be learned successively. Data indicate that the five tutors readily learned to implement all components of the procedure, and that both tutors and tutees made major gains in reading accuracy and comprehension.

This paper describes a two-component conditioning model of anxiety disorders whose two main components are an associative process and a process which determines the evaluation of the unconditioned stimulus (UCS). It is argued that the inclusion of UCS revaluation processes enables conditioning models to explain a variety of anxiety-related phenomena that hitherto had been difficult to explain solely in associative terms. In particular, (a) experiments are described which suggest that incubation of the conditioned response (CR) can be explained in terms of processes contributing to UCS inflation, (b) the experimental evidence on UCS revaluation is assessed in relation to cognitive processes that might lead to trauma revaluation within specific anxiety disorders, and (c) the role of personality factors in effecting UCS and trauma revaluation is discussed.

Lovibond (1993), weaves an exciting first person narrative of the development of behaviour therapy in Australia. His paper, derived from his years of experience and leadership, provides rare insight into the people and programs which have shaped behavioural practice today. In chronicling these early years, he well and fully elucidates the historic shortcomings of the larger field of Australian clinical psychology to provide minimal standards for science or practice, to effectively evaluate its practitioners, or to be a potent, united voice for the scientist/practitioner model. To remedy these shortcomings, he proposes the development of a new entity, largely independent of traditional clinical psychology or behaviour therapy, to simultaneously address issues of science, standards, and practice.

In the remainder of this article I should like to address what I consider to be primary issues in the advancement of an experimentally based psychology applied to human problems; to frame the current issues within professional psychology in the US which are germane to Lovibond's notions; and to lobby strongly for the maintenance of a separate and independent behaviour therapy community as the basis for the practice of scientific psychology.

This paper falls into three distinct sections. In the first, the attempt is made to discuss those aspects of emotion theory, particularly with respect to the links between emotion and cognition, that have been considered by cognitive-behaviour therapists. In the second, the aim is to describe recent emotion theory which has, in part, been directed towards cognitive-behaviour therapists and others who are concerned with emotional dysfunction, but which has not yet been taken up. In the final section, the goal is more speculative, arrived at through a description of some of the less obvious excursions made by emotion theorists. Although they mostly do not have emotional dysfunction in mind when addressing their theories, their views are, in the belief of the present author, particularly pertinent to the future directions of cognitive-behaviour therapy.

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.

Difficulties can arise in correctly diagnosing clients who present with mood and anxiety disturbances. Unless a detailed history is taken and a comprehensive interview performed, errors of diagnosis are likely to occur which may result in aversive consequences. To illustrate this likelihood, two cases of persons exhibiting anxiety and mood disturbance are briefly reported. The first case involved a prior diagnosis of psychogenic disorder (Mood Disorder). However, further investigation of the client's symptoms revealed that the anxiety and depression were secondary and caused by an underlying organic disorder. The second case involved a prior diagnosis of a physically based disorder presenting with anxiety and depression (Multiple Sclerosis). However, further investigation of the client's symptoms revealed that the somatic symptoms were secondary and the mood and anxiety disturbance were primary symptoms. A model is presented as a guide to better understand the diagnostic process, comments upon the need for a detailed history and interview are offered, and problems arising from incorrect diagnoses are discussed.

It was with great interest that I read Professor Lovibond's paper, not the least because of the fact that before returning to the UK in 1991 I had spent approximately 2½ years working in Australia. In his article Professor Lovibond charts the history of behaviour therapy in Australia and comments on the current academic and professional situation there. He raises issues concerning scientific rigour, clinical practice, service delivery, and professional organisation. Some of these are general issues and many readers from many places around the world will find sympathy with these. Others are relevant to the local circumstances within Australia and are less pertinent to other countries. My first reaction to the article was surprise that problems within clinical psychology were being aired at a World Congress of Behaviour Therapy and within a behaviour therapy journal. This is perhaps explained by Professor Lovibond's view that behaviour therapy is too narrow a term for what is really clinical psychology and should be so entitled. But from a UK perspective there is here a confounding between the theory and practice of behaviour therapy (I will use the term cognitive-behaviour therapy as being more reflective of current thinking) and the profession of clinical psychology. I will devote most of this short article to outlining the situation in the UK so that it can be seen why Professor Lovibond's suggestion that behaviour therapy and clinical psychology are synonymous would not be readily acceptable in the UK. Firstly, I would like to comment on the situation regarding behaviour therapy before briefly describing that of the profession of clinical psychology.

The long-term outcome (mean follow-up period 5.7 years) for 20 patients with anorexia nervosa was assessed on a comprehensive battery of self-report inventories and a structured clinical interview. Two thirds of the cohort were improved to a clinically significant degree at follow-up, but the majority still showed higher than normal scores on inventories of anorexic symptomatology, social maladjustment, anxiety, and hostility. The remaining one third were unimproved and demonstrated a broad range of impairment including distorted attitudes toward eating, overconcern about body shape, poor social functioning, high levels of anxiety, hostility, depression, and external locus of control. Moderate to strong correlations were found across outcome measures. Longer duration of eating difficulties before presentation was a strong predictor of poor long-term outcome, suggesting a chronic relapsing form of the disorder occurred in a subgroup of patients.

The fourth World Congress of Behaviour Therapy held at the Gold Coast was a great success as the first worldwide congress on behaviour therapy in South East Asia and Oceania countries. The fact that an academic association can sponsor a world congress is a good index of the level of development of a host academic association as a leader in that field. We can say that the ABMA has come to play a leading and important role in behaviour therapy in the world.

Lovibond's paper (Lovibond, 1993), based on his keynote address at the Fourth World Congress of Behaviour Therapy, is interesting for an understanding of not only the current status of behaviour therapy in Australia, but also for typical courses of the development of behaviour therapy in many countries where behaviour therapy has not been a major clinical approach, having been “imported” from countries where behaviour therapy has been highly developed from early times.

The courses of the development of behaviour therapy in Australia and Japan are considerably similar, that is, clinical psychologists in both countries have tried to develop a scientific clinical psychology since the dawning of behaviour therapy, as Lovibond (1993) has pointed out. However, there are some differences between these countries on the current status of behaviour therapy. In order to compare the courses of the development and the current status of behaviour therapy in both countries, an introduction to a brief history of behaviour therapy in Japan might be helpful.

This study examines the efficacy of a cognitive-behavioural program for recurrent headaches which was first implemented with an 8-year-old boy suffering from headaches. The child was subsequently trained to implement the same intervention with his father who also suffered from headaches. The treatment involved pain management skills, such as relaxation training, imagery, positive self-talk, and distraction techniques. In addition, a parent contingency management component involving the mother was employed. The treatment intervention was sequentially introduced to the child and father in a nonconcurrent multiple-baseline across-subjects design. Headache diaries and self-report measures were completed by both clients. From pre- to posttreatment there was respectively a 92.5% and 86.7% improvement in headache frequency, a 67% and 85% improvement in mean headache intensity and a 89.44% and 28% improvement in headache duration. Three-month follow-up data showed that both subjects had 100% improvement rates on all headache measures. The results highlight that some children can successfully teach their parents pain management skills. Possible implications of the results for the treatment of families, where multiple family members suffer from pain, are discussed.

The purpose of this article is to emphasise the importance of basic research in the advancement of theory and clinical technique. To illustrate the power of such a strategy the theory and imagery technique of Implosive (Flooding) Therapy will be briefly described along with a recent modification that has resulted in the development of a new technique which is capable of reactivating all past traumatic memories responsible for the development and maintenance of psychopathology. This new approach has resulted in a number of important discoveries that challenge many currently held beliefs.