This edition has a special focus on cognitive and behavioural work with older people. Many of the papers have been written by national and international experts in their respective fields and demonstrate the variety and breadth of work undertaken within the specialty. Older people bring heterogeneity to the therapeutic context, with unrivalled opportunity for challenge, versatility and creativity. For example, during a single working day one could find oneself treating a centenarian with depression, a 60-year-old patient with early onset dementia, a person with pseudo-dementia whose anxiety mimics a Parkinson's presentation, a depressed person with chronic heart failure, and a depressed family carer. Alternatively, one could find oneself working with nursing home staff who are struggling to deal with a resident with challenging behaviour. Practitioners require knowledge and skills in neuropsychology, chronic disease management, standard 1:1 therapy, family and systems work. They must also be able to apply a wide ranging set of conceptual frameworks and associated interventions to people with varying degrees of cognitive impairment as well as undertake activities such as supervision, consultation and training of carers, staff and colleagues. Thus therapists working with older people are often acutely aware of the importance of extending treatment to the individual's supporting social context and the system within which treatment is offered.

Acute stress disorder (ASD) is purportedly characterized by impaired encoding of aversive material. In this study ASD, trauma-exposed non-ASD, and non-traumatized control participants (N = 45) were administered intermixed presentations of either distressing (i.e. disfigured) or neutral faces. For each presentation, two words were presented centrally to the image and two were presented peripherally. Participants were subsequently administered recall and recognition tests for the presented words. Participants recalled more words presented centrally to neutral images than those presented centrally to trauma images. Dissociative tendencies were negatively correlated with recognition of words centrally presented with distressing stimuli. These findings are consistent with the proposal that dissociative reactions are associated with impaired memory for distress-related information.

This project reports on the effective delivery of a behavioural coping skills programme with a repetitive deliberately self-harming young woman. A simple single case A-B design was employed to evaluate the intervention due to the applied nature of the project and ethical considerations. An assessment period prior to the intervention phase constituted an extended baseline. Data concerning the primary dependent variable, deliberate self-harm, were collected for a 3-month follow-up period.

Self-control is a difficult concept for behaviourists. The implication that we are exercising control over ourselves, rather than being controlled by our environment, appears to run counter to strict behaviourist doctrine. The spectre of mind-body dualism with homunculi sitting inside our head looms large on the horizon. The concept of the self as initiator and controller of our behaviour appears to break all the rules in the behaviourist book. Self-control, in this sense, is not only ‘mentalistic’ and ‘inferential’, it is also in danger of becoming ‘explanatory fiction’. Like the man who gives up smoking because of willpower, we can only infer his willpower from the behaviour it is designed to explain. Skinner (1953) has pointed out the dangers of using inferential concepts such as willpower and self-control. He and many other ‘radical behaviourists’ have strongly argued that there is no place for these concepts in scientific psychology.

A 7-year-old hyperactive boy with multiple problems was treated using a combination of interventions, applied sequentially over 14 months. The first phase of treatment was participation in a drug trial (placebo, then drug) and this was followed by cognitive-behavioural training designed to teach strategies with which to approach academic work. Teacher and parent behaviour ratings showed improvement over the drug trial period and educational gains were made during the cognitive-behavioural training, both in the area specifically taught and other academic subjects. The problems choosing appropriate targets and of disentangling the effects of different treatment components are discussed.

The co-editor of the first BABP Newsletter in 1973 reminisces on the excitement of early behavioural therapy in the UK but is disappointed at the pace of change at service delivery level.

Behavioural psychotherapy is being applied to an ever increasing range of children's problems. Well established techniques continue to be used by an increasing range of people from different professions. There is a slight danger that the techniques are so widely used that they are outstripping their data base and some thought needs to be given about the level of training necessary to ensure that new approaches are encouraged and critically evaluated.

The introduction of sex therapy two decades ago was accompanied by largely uncritical enthusiasm, with the result that too few careful evaluative studies were conducted. Those that were indicated that a weekly or twice weekly schedule of treatment sessions was best and that treatment by individual therapists was as effective as co-therapy. Some of the major prognostic factors and the long-term results of sex therapy have now been elucidated. Low sexual desire has emerged as a problem for which our now traditional methods of treatment are often inadequate and new therapeutic approaches are required. Current efforts to explore the beliefs and cognitive processes associated with erectile dysfunction are proving rewarding and are likely to enrich therapeutic interventions in the future. Attention should now be paid to the beliefs and cognitions associated with other sexual dysfunctions, both male and female.

Some aspects of the literature on the aetiology and classification of faecal soiling are reviewed briefly, and behavioural treatment approaches described. A case study—a 4-year-old girl with faecal soiling—is presented using a behavioural strategy. The case highlights the clinical importance of systematic fading of treatment contingencies, and a detailed analysis of the presenting problem in more recalcitrant cases.

A senior nurse with a 10-year history of hospitalization phobia was treated with a combined cognitive therapy, imaginal and in vivo exposure therapy package. All previous medical admissions for the subject had resulted in her being transferred to a psychiatric ward and being treated with neuroleptics. The cognitive therapy provided an explanation for the phobia and a rationale for the treatment, which secured compliance to the exposure therapy. Pre- and post-treatment fear ratings showed a large reduction. Follow-up data showed the subject to be free of all psychiatric symptoms in two subsequent medical admissions. It is suggested that an initial few sessions of cognitive therapy with intransigent phobics may be a pre-requisite for an exposure programme.