Motivational interviewing is an approach based upon principles of experimental social psychology, applying processes such as attribution, cognitive dissonance, and self-efficacy. Motivation is conceptualized not as a personality trait but as an interpersonal process. The model deemphasizes labeling and places heavy emphasis on individual responsibility and internal attribution of change. Cognitive dissonance is created by contrasting the ongoing problem behavior with salient awareness of the behavior's negative consequences. Empathic processes from the methods of Carl Rogers, social psychological principles of motivation, and objective assessment feedback are employed to channel this dissonance toward a behavior change solution, avoiding the “short circuits” of low self-esteem, low self-efficacy, and denial. This motivational process is understood within a larger developmental model of change in which contemplation and determination are important early steps which can be influenced by therapist interventions. A schematic diagram of the motivational process and a six-step sequence for implementing motivational interviewing are suggested.

Several psychopathological conditions include delusional beliefs as central symptoms. A conceptual model highlighting the importance of cognitive factors in regulating the bizarre internal contingencies which characterize delusional systems is presented. Cognitive–behavioral treatment emphasizes the direct modification of expectations and beliefs as well as the disordered behavior patterns they support. The efficacy of neuroleptics in treating delusional states has also been reported. Two patients with predominate delusional beliefs were treated in a cross-over design by the sequential use of cognitive–behavior therapy and pimozide. A third patient received cognitive–behavioral training alone. The delusions as well as the anxiety associated with them diminished and behavioral functioning improved significantly following cognitive therapy. The relationship between delusional symptoms, perceptions of self, and social functioning, as well as the optimal application of cognitive–behavioral and psychopharmacological interventions are discussed.

Exposure and response prevention has recently been reported as a successful treatment for binge eating in obesity (Smith, 1981). This present paper further extends this treatment to modification of binge eating in a single case study of a young anorexic woman. Binge eating decreased during treatment and this improvement was maintained at 9 months follow-up. Satisfactory weight was also attained during treatment and maintained at follow-up.

The successful treatment of a client with a handicapping fear of other people vomiting is described. This involved exposure to “vomiting”, using a simulation procedure. It is suggested that the appropriate stimulus in such cases may be someone vomiting rather than vomit itself.

The memory functioning of a 31-year-old Korsakoff syndrome patient was assessed in his everyday environment and in the laboratory and a programme devised to support residual memory capacity. The patient's wife was used as a monitor of input and retrieval conditions and taught how to seek situations in which her husband would be least impaired. Prompt cards and leaflets were provided for acquaintances in order to reduce the memory demands of the patient's environment.

Follow-up at 1 year showed that although tested memory functioning deteriorated, the patient's memory support system had continued. Additionally, an experiment demonstrated that retrieval could be boosted significantly by presentation of associative cues at storage and retrieval. These findings were used to guide further change in the way the patient's wife managed his memory impairments.

Seven patients with angina pectoris were treated with relaxation training, electromyographic feedback and feedback of heart rate, pulse transit time or the product of these measures. Six showed a decreased frequency of anginal attacks, of trinitrin usage and an increased exercise tolerance.

A pilot controlled study was designed to evaluate the efficacy of the thought-stopping technique (T.S.) as a treatment for persecutory delusions and auditory hallucinations with chronic schizophrenics already treated with neuroleptics and to compare this combination with patients only treated with antipsychotic drugs. Medication was standardized for each patient and psychological measurements were recorded before and after treatment and during a 6-month follow-up. Results show significant differences in favor of the T.S. group mainly after treatment. Although T.S. was beneficial for chronic psychotics, other studies should be conducted with patients whose illness would be less severe and less chronic. The length of treatment as well as the cues that would serve to stop delusions and hallucinations also merit further investigation.

A case is described of an 11-year-old schoolgirl with both obsessive-compulsive rituals and tics of sudden onset following a traumatic event at the age of five. Treatment consisted of exposure in vivo and response prevention directed mainly towards her obsessive-compulsive rituals as they were considered the primary problem. Following the initial therapist–patient out-patient session and home treatment with her mother, the obsessive-compulsive rituals disappeared and the tics decreased. Three weeks later the tics disappeared without specific treatment and the patient has maintained her improvement at follow-up, 52 weeks later. The actual therapist–patient time was about an hour.