Historically people with intellectual disabilities have not been offered or received cognitive behavioural interventions that have been shown to be effective for mental health and emotional problems experienced by those without such disabilities. This is despite many people with intellectual disabilities having life experiences that potentially result in them having an increased risk to such problems. This paper discusses whether such therapeutic disdain is justified based on the evidence that is available and emerging concerning the application of cognitive behavioural interventions for this population. Issues concerning access to services, the ability of people with intellectual disabilities to engage in and benefit from the cognitive components of CBT, and the effect of cognitive abilities and IQ level on treatment effectiveness are explored in relation to this question.

An increasing body of research in support of cognitive-behavioural therapy (CBT) for adolescent depression has emerged during the last two decades. However, it has been suggested that empirically supported treatments are seldom carried out in clinical practice. Although the reasons for this are likely to be diverse, it is argued that mental health services have an ethical responsibility to offer evidence-based interventions. Whether empirically supported interventions, such as CBT, are consistently offered to depressed adolescents attending Child and Adolescent Mental Health Services (CAMHS) is currently unknown. A primary aim of this study was to survey the use of CBT for depression in a number of United Kingdom (UK) CAMHS settings. A postal questionnaire was sent to 117 members of the BABCP Children, Adolescents and Families Special Interest Branch, of which 44 completed questionnaires were returned. Descriptive statistics indicate that just over half of the organizations represented routinely offered CBT to depressed adolescents. CBT practice and the transportation of evidence-based research findings to CAMHS settings are discussed.

Anxiety symptoms and panic disorder are common sequelae of chronic obstructive pulmonary disease, an illness that primarily affects older adults. The aim of this paper is to describe the application of cognitive behavioural treatment for two patients with chronic obstructive pulmonary disease and co-morbid panic disorder. The patients attended for eight to twelve sessions of cognitive behaviour therapy. Both improved on a range of indices of anxiety and quality of life. Neither patient met criteria for panic disorder at the end of treatment or over the following year. These two cases provide evidence that interventions of proven efficacy for treating panic disorder in healthy individuals can be adapted to treat patients with chronic obstructive pulmonary disease.

Over-involved parenting is commonly hypothesized to be a risk factor for the development of anxiety disorders in childhood. This parenting style may result from parental attempts to prevent child distress based on expectations that the child will be unable to cope in a challenging situation. Naturalistic studies are limited in their ability to disentangle the overlapping contribution of child and parent factors in driving parental behaviours. To overcome this difficulty, an experimental study was conducted in which parental expectations of child distress were manipulated and the effects on parent behaviour and child mood were assessed. Fifty-two children (aged 7 – 11 years) and their primary caregiver participated. Parents were allocated to either a “positive” or a “negative” expectation group. Observations were made of the children and their parents interacting whilst completing a difficult anagram task. Parents given negative expectations of their child's response displayed higher levels of involvement. No differences were found on indices of child mood and behaviour and possible explanations for this are considered. The findings are consistent with suggestions that increased parental involvement may be a “natural” reaction to enhanced perceptions of child vulnerability and an attempt to avoid child distress.

Recent research has shown that the verbal information and vicarious learning pathways to fear create long term fear cognitions and can create cognitive biases and avoidance in children. However, it is unlikely that these pathways operate in isolation in the aetiology of childhood fear and the interaction between these pathways is untested. Three preliminary experiments are reported that explore the combined effect of verbal threat information and vicarious learning on self-reported fear beliefs in 7–9-year-old children. Results showed that prior negative information significantly facilitated the effect of negative vicarious learning on children's fear beliefs (Experiment 1); however, there was not a significant combined effect of verbal threat information and vicarious learning when they the information was presented during (Experiment 2) or after (Experiment 3) vicarious learning. These results support the idea that verbal information can affect CS-US associations formed in subsequent vicarious learning events, but contradict the proposal that it can change fear beliefs already acquired through vicarious learning by changing how a person evaluates the vicarious learning episode.

There is a lot of nonsense talked about how to adapt therapy for older people. This is because often authors fail to define the types of populations they are tailoring their therapy for. Such definitions are important with such a diverse patient group, some of whom were “in-service” during the first world war, while others were “doing drugs and dropping out” in the 1960s. To guide our thinking regarding specific adaptations, this paper presents a framework for clarifying therapeutic need. The second section of the paper illustrates ways in which working psychotherapeutically with older patients has helped inform mainstream CBT theory and practice, with particular reference to competence and schema work.

Internalizing disorders of childhood and adolescence are common conditions, but until the past decade, had received little scientific scrutiny. This paper overviews the new knowledge that the past decade of research has given us. The early research began by adopting adult models of disorders, and adult-based modes of treatment. This met with moderate success, but the focus now is on testing whether these models are appropriate for younger clients. The good news is that, for adolescents at least, the adult models do seem to be appropriate. The bad news is that, even in well-resourced treatment trials, barely half of all cases remit. In very recent years, there has been a focus on generating developmentally appropriate models of childhood internalizing disorders, and correspondingly, an increasing interest in developing treatment approaches that are appropriate for young people and their families. The paper concludes with our thoughts on the most important questions for research in the next decade.