Cognitive behavioural therapy has been shown to be effective in reducing anxiety and depression in cancer patients when provided within the context of individual sessions. We describe the application of a cognitive behavioural model to a group therapy context. This represents a novel approach to the psychological treatment of cancer patients. Fourteen breast cancer patients attending the Royal Marsden Hospital were included in an assessment of treatment outcome pre-and post-group therapy. Outcome was assessed using the Hospital Anxiety and Depression (HAD) Scale and a study-specific visual analog measure relating to perceived efficacy of the therapeutic techniques. Rationale and organization of group therapy is described along with the preliminary pilot study results.

Seven mothers, identified by their health visitor as having conduct disordered pre-school children, participated in a behaviourally based parent training group. Two health visitors and a child care social worker also attended the group. The group members were taught skills in behaviour observation, reinforcement and goal setting. The results showed that the health visitors were able to identify children with conduct disorders and that the mothers of most of the children were themselves experiencing mental health difficulties. Participation in the group led to improvements for both the children and their mothers. The mothers found the group a satisfactory treatment method and the health visitors and social worker developed skills in the behavioural management of conduct disorders. The findings are considered in relation to the three components of the Welsh Strategic Intent and Direction for the NHS (health gain, people centred and resource effective).

A randomized controlled trial of a new intervention based on motivational interviewing and cognitive approaches to psychosis (Compliance Therapy) has shown improvements in insight, attitudes to medication and compliance in an unselected sample of consecutively admitted patients with acute psychotic disorders. In the introduction, previous research focusing on cognitive interventions in psychosis and systematically tested psychoeducational approaches to compliance are reviewed. The content of our intervention is described with examples of the principal techniques used, together with a description of the progress of therapy in two individual cases. We conclude that the intervention is eminently applicable in the typical clinical setting.

The marital satisfaction of sixteen maritally distressed couples who received three sessions of Brief Behavioural Couples Therapy (BBCT), and 24 couples who received 12 to 15 sessions of Traditional Behavioural Couples Therapy (TBCT), were compared before and after treatment in a quasi-experimental design. A 2 way ANOVA of treatment (BBCT versus TBCT) by time (pre- and post-treatment) showed both conditions produced significant increases in marital satisfaction, but there were no significant differences between the effects of the two treatments. The results need replication within a true experimental evaluation, but suggest that brief behavioural couples therapy may be a viable treatment option for some distressed couples.

This paper describes a case concentrating on the psychological conceptualization and treatment of phantom pain. A single session of cognitive work, teaching an “attention diversion’ strategy, was effectively utilized for the treatment of below knee phantom pain in an elderly lady. A follow-up, approximately one year later, revealed that the treatment gains had been maintained. Although a review of the literature (Sherman, Sherman and Gall, 1980) presents a rather murky picture as regards treatment prospects, the results nevertheless illustrate how a very simple cognitive strategy was successfully employed to alleviate a long standing debilitating phantom pain.

An eight year old boy who had prolonged faecal incontinence associated with surgery in infancy for Hirschsprung's disease was assessed and given biofeedback training for the purpose of achieving anal sphincter control. A computer-based apparatus was constructed to give feedback in the form of a graph and column of light. The child learned to produce tracings on the graph by contracting a small saline-filled balloon positioned at the anal sphincter. The child achieved voluntary defaecation, and eliminated soiling during follow-up periods of twelve and twenty four months.

A cognitive behavioural model for the development of chronic fatigue syndrome (CFS) is outlined. Six patients with CFS are described who were treated as in-patients using cognitive behaviour therapy. Treatment consisted of graded consistent exposure to activity and cognitive restructuring. Substantial improvements were made in all but one patient up to three months after discharge.

A randomized trial was conducted of cognitive-behavioural therapy and a non-focused intervention for children and adolescents aged 8–16 years with depression (N = 57) referred to four child and adolescent psychiatry units. Children in both groups showed similar rates of recovery from depression at the end of treatment (cognitive-behavioural therapy: 87% recovery rate; non-focused intervention: 75% recovery rate). This paper addresses the question of how cognitive-behavioural therapy was perceived and used by depressed young sters in clinical settings (N=29). Only seven children (24%) kept a diary for all nine sessions of the CBT programme. Children who had been rated as compliant with CBT tasks were more likely to recover at the end of treatment. Analysis of the content of each cognitive-behavioural session has shown that all children received advice on self-monitoring, positive self-statementing, and social problem-solving, but only 50% actually received advice on cognitive restructuring, since this was scheduled late in the treatment package and most children had recovered by this stage. Children, parents and therapists had a high degree of agreement on the helpfulness of CBT. Children identified several helpful CBT elements, the majority being related to social problem-solving. The treatment programme was explained to parents, who did not actively participate in treatment, but they helped to plan suitable rewards for their children. Recommendations are made for the future use of CBT with referred young people with depressive disorders.

This study compared the outcome of patients treated with behavioural psychotherapy by a nurse behavioural psychotherapist against the outcome of those treated by trainee psychiatrists under his supervision. The trainees were shown to produce improvement, but significantly less than the supervisor. It was shown that supervision of trainees was a cost effective use of the supervisor's time.

Psychological management is a crucial part of the overall treatment plan involving therapeutic amputations in children. Therapeutic work aims to facilitate the implementation of a coordinated treatment plan taking into account the patient's physical and psychological needs. Psychological contact at the early stage is advocated to minimize the patient's distress and to forestall potentially handicapping emotional disturbances. The paper highlights important issues at different phases of the patient's treatment, including coming to terms with the initial diagnosis, acceptance of the amputation plan, and the final process of rehabilitation and normal life adjustment. Psychological interventions with one adolescent girl treated with therapeutic amputation for osteosarcoma are used to illustrate the therapeutic process.

The wonder-rabbi of Kuzmir provided a troubled person with advice that was consonant with the Judaic tradition and also with behavioural therapy that led this person to overcoming his problems.

Stimulus modification procedures involve changes to the task materials that are intended to facilitate the response. Their application in teaching stimulus discriminations has been extensively investigated. Less attention has been given to their use in teaching response topography, and there is little evidence relating to their effectiveness in this context. Previous studies have failed specifically to target the response topography and/or to include an appropriate control condition. The present study compared the effectiveness of a physical guidance procedure with a combination of this procedure and stimulus modifications in teaching response topographies to three individuals with severe developmental disability. The combination proved more effective, suggesting that stimulus modification procedures can, indeed, facilitate the acquisition of response topography. They may be particularly useful when teaching those with a more severe developmental disability.