The treatment of depression in an older person with Alzheimer's dementia using cognitive behavioural therapy (CBT) is described. Treatment focused on identifying beliefs associated with dementia, behavioural experimenting to test the validity of these beliefs, and increasing pleasurable activities. Results were promising, suggesting that it may be possible to treat depression in people with cognitive impairment.

A number of studies have shown that patients with obsessive-compulsive disorder do not universally regard their obsessions as either senseless or unlikely to happen. This is of particular significance for the current cognitive-behavioural model of OCD, which is based on the notion that obsessions are ego-dystonic. This study examined the appraisal of obsessions by a group of OCD patients (n=63). Participants completed a paper and pencil task in which they had to appraise a range of intrusive thoughts and contamination fears on two variables: senselessness and likelihood to happen. The results suggest that the appraisals may vary according to the content of the obsessive thought. Contamination obsessions were judged less senseless and more likely to happen than obsessions concerning aggressive and sexual themes. A number of variables, which may play a role in these appraisals, are discussed and the methodological limitations of the study are examined.

Behavioural and Cognitive Psychotherapy is an international multidisciplinary journal for the publication of original research, of an experimental or clinical nature, that contributes to the theory, practice and evaluation of behaviour therapy. As such, the scope of the journal is very broad and articles relevant to most areas of human behaviour and human experience, which would be of interest to members of the helping and teaching professions, will be considered for publication.

Exercise is generally accepted as means of improving mental health yet few studies have examined its use in specific disorders. This study examines delivery and efficacy of cognitive behaviour therapy (CBT) for panic and agoraphobia combined with a gym-based exercise programme in a Healthy Living Centre. Preliminary evidence for this novel service has shown Group CBT followed by exercise targeting safety behaviours to be clinically successful and acceptable to clients. Details of the pilot service and some of the clinical issues are discussed

Carers' beliefs about the controllability of challenging behaviour have been shown to be related to their emotional and behavioural responses to such behaviour. This paper describes the psychometric properties of a new 15-item scale that assesses such beliefs. The scale has good internal reliability and a two-factor structure representing positive and negative beliefs about controllability. The negative beliefs about controllability sub-scale correlate highly with a wishful-thinking coping style but not with a practical problem-solving coping style. The clinical use of this scale is discussed.

We present the case of a 31-year-old man with comorbid schizophrenia and obsessive compulsive disorder (OCD) distinct from delusional beliefs. The OCD was successfully treated to 6-month follow-up with Exposure and Response Prevention (ERP) without leading to significant deterioration of psychotic phenomena. Considerations for clinicians are discussed.

Trauma within psychosis is often undiagnosed or untreated. There is a wide body of literature on the efficacy of cognitive behaviour therapy (CBT) for post-traumatic stress disorder (PTSD), but there has been no report of combining CBT for psychosis and CBT for PTSD in modular form. The authors discuss a combined treatment for two patients with psychosis and a history of trauma. The clinical features, process of therapy, and outcome are all described in relation to cognitive therapy models developed for use in PTSD. The implications for therapy, service development, and training are discussed.

We assessed the use of a microswitch cluster to improve assisted ambulation in a man with multiple disabilities. The cluster included two optic microswitches at the man's heels to detect his steps and a pressure microswitch under his right arm to detect his body posture (i.e. whether he had an upright, appropriate posture or was leaning forward). The man received 2.5 seconds of favourite stimulation at each step provided that his posture was appropriate. The results showed that there was a large increase in the man's appropriate posture during walking throughout the intervention phases and the 3-month follow-up.

Supervision of therapy has received a lot of attention, but it has only recently begun to be examined in a systematic and empirical manner. This exploratory project employed a new type of methodology for examining the process of change occurring over four sessions of supervision. Video recordings of four clinical psychology supervision sessions were made, and after each session the supervisor and trainee independently provided commentaries of their experiences of supervision. Based on these commentaries, and further post-hoc reflections, the trainee was asked to choose an aspect of supervision to explore further. She chose to investigate her emotional reactions within the sessions. Hence, she was asked to provide further details about her emotions in each of the four sessions. The focus of supervision was a patient with neuropsychological problems following a stroke. The process analysis revealed that the trainee experienced a wide range of emotions in all of the supervision sessions, with anxiety being the most frequent. These emotions appeared to be responsive to the supervisor's conscious attempts to ensure appropriate affective arousal. Subsequent reflections on the processes highlighted via this methodology suggested that the dynamics observed were consistent with Vygotsky's theory of the Zone of Proximal Development.