Research in cognitive-behaviour modification (CBM; Meichenbaum, 1978) continues apace, and a particularly important area is the study of the “crucial ingredients” of successful CBM programmes. However, findings reported to date are not unequivocal. For example, in a recent article, Glogower, Fremouw and McCroskey (1978) report that the rehearsal of coping self-statements was a more effective component of cognitive restructuring than imparting insight into unhelpful self-statements in reducing performance anxiety about speaking in a group. A treatment condition which combined both procedures was most successful in general, but was not significantly better than rehearsal alone. The study was well-designed and implemented, and the authors were able to support their conclusions by referring to both self-report and behavioural data. The results directly contrast with those of Thorpe, Amatu, Blakey and Burns (1976), who sought to test similar hypothesis in a similar experiment in Britain. Glogower et al. correctly point out the differences between the studies include the relative youth of subjects, brevity of treatment, and few kinds of coping self-statement used in the Thorpe et al. study. They further indicate that a combination group has fared well in studies other than their own (e.g. Fremouw & Zitter, 1978), but that in the Thorpe et al. study the combination procedure, similar to the instructional rehearsal procedure, was significantly less effective than “insight” on self-report measures.

A child's ability to attend selectively to stimuli is central to the learning process. The length of time for which a child will attend (the child's attention span) is of equal importance. In general, mentally handicapped children have exteremly short attention spans. This study reviews the relevant literature and describes in detail an operant procedure designed to increase the attention spans of five mentally handicapped children, using parents as agents of change.

All parents were successful and the resulting increase was statistically significant. Short term follow up indicated that any increase in attention span may well be reduced if the procedure is discontinued, thought subsequent attendances at a nursery school appeared to maintain the gains achieved by the intervention process.

Self-controlled relaxation training was combined with assertion training to treat a 22-year-old woman with a 2-year history of chronic headaches following a traumatic injury to her head and neck. There was a substantial drop in the frequency of headaches and medication use with the introduction of both components of treatment. Gains were maintained at a 6-month follow-up. The case is presented in the context of a general treatment plan for modification of traumatic headaches. The plan combines a focus on both antecedent (i.e. environmental stress) and consequent (i.e. pain behavior reinforcers) events as possible factors influencing chronic post-traumatic head pain.

The growing body of research indicating that classroom behavioural management strategies can successfully modify the behaviour of mainstream classes of disruptive adolescent pupils is referred to. These “successes” are qualified by the observation that they could make the pupil teacher dependent, whereas pupil self-control is the ideal control state. Feedback strategies have the potential to encourage internalization of control (Van Houton, 1984). An intervention package involving the feedback of level of on-task behaviour as a major component is described. The effect on the individual and the group's level of on-task behaviour in two settings (Religious Education and French lessons) is reported. Claims are made that (1) the intervention promoted levels of on-task behaviour and (2) the group data generally reflected the data of individual pupils. The conclusions are drawn that while it remains to be demonstrated that the behavioural attributional tendencies of the pupils were moved in the direction of “internalization” nonetheless the research can serve as a starting point for further research in this area.

In vivo exposure techniques have been applied to problems of urinary inhibition (or retention) in public on a number of occasions with considerable success (Lamontagne and Marks, 1973; Anderson, 1977; Ascher, 1979). In the present case-study in vivo exposure was combined with self-monitoring in the management of such a urinary difficulty.

Mahoney's recent book, Cognition and Behaviour Modification (1974), has produced some fierce interchanges in the pages of this journal. To me, the surprising feature of the controversy is that it has frowned on Mahoney's arguments about the adequacy of radical behaviourism. I had imagined that the philosophical assumptions of radical behaviourism had long ago been shown to be untenable. However, I do not wish to join in this discussion, or to try and improve on the arguments of Mahoney and Marzillier's (1976) defence of them.

Biofeedback by means of an anorectal probe or balloon linked to a manometric apparatus can be an effective treatment for childhood faecal retention associated with inappropriate external anal sphincter coordination (obstipation). We report an alternative biofeedback approach in a child with long-standing obstipation. Sphincter tone was detected by digitization instead of manometrically and information on the state of the muscle relayed orally, the child's mother acting as trainer and working at home. Five years of dependency on purgatives for bowel evacuation was reversed in three weeks of this regime. Carer-mediated biofeedback by digitization may prove a low-technology alternative to manometric methods where suitable equipment is unavailable.

This study was carried out in a residential school for 46 junior boys ascertained as maladjusted. Some of the dissatisfactions with the more conventional classroom based economies are expressed and the “Levelled Economy” is put forward as an alternative model. The levelled system is described in detail and the economy evaluated over a 3-month period. The results showed a dramatic reduction of inappropriate behaviour and also a large increase in the acquisition of skills.

A behaviour-therapeutic approach in a case of chronic insomnia is illustrated. Based on research reported in the literature the treatment programme consists of sleep-related interventions as well as of training in coping with conditions which influence sleep negatively. Data on the short- and long-term effects of therapy, especially during the follow-up period of two years, are discussed.

Preliminary findings are reported from a specialist unit for difficult to manage patients (those patients who have severe behavioural problems in addition to a mental illness). Staff attitudes and residents' psychiatric and social needs were assessed after the unit had been open for just over a year. The effect on residents' behaviour and symptoms over the course of that year was also evaluated. Findings showed that staff attitudes were resident orientated and that interactions between staff and residents and of staff with each other were almost always positive. These findings compared favourably with data collected on three other continuing care units in the same Trust and with data from previously published studies. The Cardinal Needs Schedule, a recent adaptation of the MRC Needs for Care Assessment Schedule, appeared to be a useful way of identifying unmet needs of the residents and gaps in service provision. Over the course of the year, behaviour in one third of the residents improved sufficiently for them to be considered suitable for potential discharge into community based accommodation. Implications of the findings for specialist units for difficult to manage patients are discussed, together with suggestions for further research.

Background: The integrative cognitive model of mood swings proposes that mood symptoms are driven by extreme, self-referent appraisals. For example, if activated mood is appraised positively, this prompts selection of mood regulation strategies that act to up-regulate mood. Appraisals are driven by fast and automatic Type 1 cognitive processes, which, left unchecked, can cause activated mood to escalate. Aims: It was hypothesized that greater propensity to override these automatic processes by engaging in reflective (Type 2) thinking would be negatively associated with extreme appraisals of activation and activation. Method: Study 1 (n = 150) was a cross-sectional survey consisting of measures of activation, extreme appraisals, and an objective performance-based measure of the propensity to engage in reflective thought (cognitive reflection test; CRT). In Study 2 (n = 241) participants completed these measures plus three alternative measures of effortful cognitive engagement (CRT-2, Need for Cognition and Actively Open-Minded Thinking). Results: In Study 1, propensity to engage in reflective thought (higher CRT scores) was not significantly associated with activated mood or extreme appraisals, but activated mood and extreme appraisals were positively correlated. In study 2, the association between activation and extreme appraisals was replicated. Predicted associations between alternative measures of reflective thinking, activated mood, and extreme appraisals were not found. Conclusions: Extreme appraisals of internal states may be a psychological mechanism underlying activated mood. Propensity to reflect on and override default cognitions was unrelated to these extreme appraisals and activated mood. Further research in a clinical sample using mood-relevant measures of reflective thinking is warranted.