In recent years an impressive body of research has accumulated indicating that behavioural management strategies can promote the levels of on-task behaviour of classes of disruptive secondary school pupils. These successes have led to the explicit, self-evident claim that levels of off-task behaviour have concomitantly been reduced—and the implicit claim that levels of disruptive behaviour have also been reduced: for disruptive behaviour constitutes a subset of off-task behaviour. However the promotion of on-task behaviour with a corresponding reduction in off-task behaviour is a necessary but not sufficient outcome to claim that disruptive behaviour has diminished. It may be the case that innocuous off-task behaviours have been reduced but disruptive off-task behaviours remain. From a further data analysis of a previous study (McNamara and Jolly, 1990) it is claimed that when disruptive classroom behaviour is dealt with by the promotion of on-task behaviours the total amount of all types of off-task behaviours, from innocuous to grossly disruptive, is reduced. Analysis of data for individual pupils reveals that the whole class aggregated data conceal considerable inter-pupil variability for low incidence off-task behaviours.

The effectiveness of instructional training and response cost procedures in reducing the frequency of performance of a range of inappropriate behaviours in a group of nine long-term schizophrenic patients was examined in three distinct settings. Instructional training was found to be generally effective in controlling inappropriate behaviour. The effects of a combined instructional training and response cost procedure in further reducing the level of performance of inappropriate behaviour were confined to a small sub-group of patients and were only demonstrated in one specific setting.

Issues relating to the systematic nature of the instructional training procedure, to maintenance of change and to the role of response cost are discussed.

It is accepted that for reasons of economy and efficacy the behavioural approach needs to be “given away” to those in day-to-day contact with clients. These new behaviourists may need special help if they are to use their skills to best advantage but can make a valuable contribution both to their clients and to practical knowledge in the area.

When I was asked by Professor Aubrey Lewis (later Sir Aubrey Lewis) to undertake the establishment of the first school of clinical psychology in this country, and to establish a profession of clinical psychology, I went to the United States of America in order to study how this profession was organised (Eysenck, 1980a). The very hospitable reception I received did not lead me to advocate the establishment of a similar system in this country. It seemed to me that there were three major faults inherent in the American system.

This paper describes the successful application of a behavioural intervention to the inappropriate behaviour of a severely mentally handicapped hospital resident. The intervention was based on the Constructional approach and at sixth week follow-up the effects had been maintained. Furthermore, there was evidence that these had generalised to other behaviours. Significant changes were noted in the attitudes of direct care staff and it is suggested that these may have been attributable to the nature of the approach used. The Constructional approach was considered ethically and practically superior to alternatives which would have concentrated alone on reducing or removing behaviour in the client's limited repertoire.

In reply to Jones and Baldwin's paper, the current practice of electroconvulsive therapy (ECT) is described with a retrospective case study. Particular reference is made to: indications, consent, immediate and longer term outcome. It is argued that the treatment is beneficial, but systematic audit is necessary.

In the past, aggressive behaviour shown by people with learning difficulties has often been reduced by means of punishment. A non-punitive alternative to punishment is Differential Reinforcement of Other Behaviours (DRO). However, there is no evidence that DRO can be used to reduce target behaviours that are less frequent than once or twice a day. A case study is presented in which DRO is used to reduce aggression in a lady who was aggressive once or twice a month. The factors that may have led to the effectiveness of DRO in this case are discussed.

The following discussion relates our experience of teaching behavioural techniques of child management to single-parent mothers. We found that these mothers were able to conceptualize the theories of child behaviour and apply them successfully to their own children through the use of behavioural programmes.

In teaching behavioural techniques to parents we had the following aims in mind:

1. To initiate behavioural change

2. To maintain behavioural change

3. To foster the group members' ability to anticipate future problems and to deal with these with the minimum of professional advice. Firmer control of their children would result in greater feelings of self confidence for the mothers.

ECT has been administered to infants, children and teenagers between the ages of two and eighteen, in Europe, North America and Australasia. There are several alternate forms of effective behavioural and cognitive interventions for the range of problems experienced by minors. In this paper, some of the reasons for the contemporary popularity of ECT administration with children and teenagers are explored, via a critical evaluation of the published literature.

Background: The effective treatment of Borderline Personality Disorder (BPD) presents healthcare providers with a significant challenge. The evidence base remains limited partially due to a lack of professional consensus and service user involvement regarding ways of measuring change. As a result, the limited evidence that is available draws on such a wide range of outcome measures, that comparison across treatment types is hindered, maintaining a lack of clarity regarding the clinical needs of this group. Aims: This investigation aimed to follow the National Institute of Clinical Excellence (NICE, 2009) research recommendations by asking service users about meaningful change within their recovery. This forms a starting point for the future development of a tailored outcome measure. Method: Fifteen service users with a diagnosis of BPD participated in three focus groups across two specialist Personality Disorder services. The focus groups were analysed using Thematic Analysis. Results: Two superordinate themes were synthesized from the data: (1) recovery to what?: ‘How do you rewrite who you are?’; and (2) conditions for change. Each superordinate theme further consisted of three subordinate themes which elucidated the over-arching themes. Conclusion: This investigation highlights the complex nature of measuring change in people who have received a BPD diagnosis. Further research is needed to develop meaningful ways of measuring change according to the needs and priorities of people with BPD.

To increase levels of activity of patients and residents in institutions is seen as an important aim. Work in old people's homes shows that this can be achieved by supplying residents with simple recreational activities. It has also been shown with profoundly mentally handicapped adults that training staff to pay attention to working residents and largely ignore non-active ones leads to increases in resident activity. This study replicates both these results with adult psychiatric day patients. Implications for staff training are discussed.

Effecting change in any organisation is a difficult process (Watson, 1972; Georgiades & Phillimore, 1975), but this is particularly so in hospitals for the mentally handicapped. These are under considerable public pressure to change the aims of the organisation away from simply a caring role, and towards a teaching role aimed at the maximum development of each individual's abilities. Translating these demands into tangible changes presents enormous problems. Very often projects which demonstrate what can be done for the handicapped remain isolated examples of excellence, and do not translate into general service provision effecting the lives of large numbers of handicapped people. The gap between current knowledge and actual practice remains enormous. The particular programmes to be described here arose out of just a small scale “demonstration” project with a group of children on one ward in a mental handicap hospital (Clements, 1976). This programme which was highly staffed aimed at encouraging the all round development of a group of young profoundly, and multiply handicapped children. These children were part of a 30 bedded-ward for multiply handicapped children and young adults. The ages ranged from 12–23 years, no child was fully ambulant, none had any speech, none were continent, and only a few were able to feed themselves. After the success of the demonstration programme, it became necessary to find ways of applying the findings to the ordinary ward situation, where staff ratios were far less favourable. And if a method of sustaining a whole-ward programme were found, this would be of relevance to other wards within the hospital complex.

Samson and McDonnell (1990) proposed a definition of the term functional analysis. In a reply to that article, Jones and Owens maintained that Samson and McDonnell had failed to address sufficiently the complexities of this approach, particularly in the use of unobservables in functional analysis and the contextual nature of challenging behaviours. This paper attempts to provide a short reply to these contentions.

This paper will describe a program whose framework is based on our research of the general characteristics of rapists, and on the results of individual behavioral analyses of over thirty five such individuals. Treatment is aimed at:

(1)reducing the incidence of habitual patterns of unacceptable sexual behavior using aversive therapy and covert sensitization where these two procedures attempt to modify the attractiveness of deviant fantasies.

(2)increasing the incidence of appropriate sexual behavior using various techniques such as: (a) orgasmic reconditioning to enhance the attractiveness of appropriate fantasies; desensitization to reduce heterosexual fearj social skill training involving modeling, videotaped role rehersal, and cue discrimination to reduce aggressiveness and inappropriate assertiveness; thought stopping to eliminate hostile thoughts; converant control to enhance self-esteemj and sex education. The specific content of each program is tailored to the individual's particular problems as revealed by a thorough analysis.

Psychological treatments of headache are becoming increasingly influenced by cognitive therapy. This paper addresses three issues relevant to the development and evaluation of cognitive therapy. 1. It is argued that current assessment measures for evaluating treatment are founded on a theory of pain which is inadequate and as a result they are not sufficient for the evaluation of cognitive therapy. 2. The assumptions on which cognitive therapy for headache is based have not been verified. Recent research indicates a degree of complexity in the relationships between cognition, emotion and pain which has yet to be assimilated. 3. It is noted that cognitive therapy for headache lacks an explicit model of pain which would facilitate the precise formulation and testing of interventions.