Background: In the 26 years since it was first introduced in this journal, motivational interviewing (MI) has become confused with various other ideas and approaches, owing in part to its rapid international diffusion. Methods: Based on confusions that have arisen in publications and presentations regarding MI, the authors compiled a list of 10 concepts and procedures with which MI should not be addled. Results: This article discusses 10 things that MI is not: (1) the transtheoretical model of change; (2) a way of tricking people into doing what you want them to do; (3) a technique; (4) decisional balance; (5) assessment feedback; (6) cognitive-behavior therapy; (7) client-centered therapy; (8) easy to learn; (9) practice as usual; and (10) a panacea. Conclusion: Clarity about what does (and does not) constitute MI promotes quality assurance in scientific research, clinical practice, and training.

Background: Audio recording of cognitive behavioural therapy (CBT) sessions has been recommended but not yet widely adopted. It is believed to have positive effects on later recall and reflection by the patient and on supervisory quality and accuracy for therapists. Aims: To evaluate self-reported attitudes and behaviour regarding audio recording of therapy sessions in both patients and therapists in a setting where such recording is routinely carried out. Method: In a centre specializing in CBT for anxiety disorders, 72 patients completed a questionnaire at the start of therapy and 31 patients completed a questionnaire at the end of therapy. Fifteen therapists also completed a similar questionnaire. Results: Ninety percent of patients reported listening to recordings between therapy sessions to some extent. The majority reported discussing the recordings with their therapist. Patients typically planned to keep the recordings after therapy ended. Most patients and therapists endorsed positive attitudes towards the use of recordings. Similar advantages (e.g. improving memory for sessions) and disadvantages (e.g. practical issues and feeling self-conscious) of recordings were generated by patients and therapists. Therapists were more likely than patients to express concern about recordings being distressing for patients to listen to. Both patients and therapists regarded the use of recordings for therapist peer supervision purposes favourably. Conclusion: The use of audio recording of sessions as an adjunct to therapy (where patients listen to recordings between sessions) and for therapist supervision is rated as both highly acceptable and useful by both therapists and patients.

Background: “Stressbusters” is an interactive computer software programme based on a clinically effective face-to-face CBT protocol for young people with depression. It was designed for teenagers with mild to moderate depression, and comprises eight 45-minute sessions. Method: Twenty-three young people (aged 12–16; mean age 14.87 years) with symptoms of depression were recruited from CAMHS teams in Manchester and London, and received the Stressbusters treatment (range 1 – 8 sessions, mode 8 sessions). Results: On the K-SADS at initial assessment, 95% met diagnostic criteria for a depressive disorder, with a high group mean score of 35.48 (SD 9.84) on the MFQ. Post-treatment, 22% of young people met criteria for a depressive disorder, with the group mean score on the MFQ falling significantly below clinical cut-off to 20.32 (SD 11.75). These gains were maintained at 3-month follow-up. Significant improvements were also found in the adolescents' global functioning (CGAS), self-reported anxiety (RCMAS), depressive cognitions and attributions (ATQ and CTI-C), and in adolescent- and parent-reported emotional and behavioural difficulties (SDQ). Conclusions: Taken together, these results provide promising preliminary data for the clinical efficacy of Stressbusters as a valid form of CCBT for adolescents with depression.

Background: It has been suggested that socially anxious individuals often engage in a wide range of safety behaviours in social situations that are intended to reduce the risk of social failure and humiliation. Method: This study explored the interpretations that people make for behaviours considered to be safety seeking. High and low socially anxious individuals completed one version of a questionnaire that assessed how the safety behaviours that they may exhibit are interpreted by others, and then completed a second version of the same questionnaire that assessed how they typically interpret safety behaviours in other people. Participants rated the extent to which each of eight interpretations was viewed as a likely interpretation of the behaviour. Results: Individuals high in social anxiety were more likely than low socially anxious participants to think that being arrogant, suffering from a psychological problem, or experiencing a normal level of anxiety, nervousness or fear are likely explanations for safety behaviours, regardless of who exhibits them. Additionally, high socially anxious participants were more likely than those low in social anxiety to think that others interpreted these behaviours as being indicative of intense anxiety or other negative emotional condition. Conclusions: The results suggested that socially anxious people are, at least, aware of the negative effects of certain behaviours characterized as safety seeking.

Background: Overestimation of threat (OET) is ascribed a pathogenetic role in obsessive-compulsive disorder (OCD). Aims: We hypothesized that OCD patients overestimate their personal but not the average risk for OCD-related events. Specifically, an attenuation of the common “unrealistic optimism” bias (UO) was expected for OCD patients. UO refers to the phenomenon that the subjective likelihood to personally experience a positive event is enhanced compared to other persons and vice versa for negative events. Method: Fifty-three participants with OCD as well as 40 healthy and 23 psychiatric controls participated in an internet survey. They were asked several questions about different event types (positive, negative, and OCD-related): the probability that this event will happen to oneself (block 1), to another person (block 2), comparison between oneself versus another person (block 3), appraisal of consequences (block 4), and prior encounters with event (block 5). Results: No evidence was obtained in OCD to overestimate the overall probability of negative or OCD-related events. However, whereas healthy participants displayed an UO bias, OCD participants perceived themselves as more vulnerable to experience OCD-related events. Conclusions: Results indicate that OCD is associated with inflated personal vulnerability and that this bias is not fully available to the consciousness of OCD participants.

Background: Researchers have begun to scrutinize the assumption that active processing in response to a traumatic event is beneficial whereas avoidance of thoughts, emotions and reminders about the traumatic event is detrimental. Indications that avoidance is not always detrimental come from studies on grief and debriefing. Aims: In an analogue experimental study, the hypothesis was tested that conceptually-driven processing immediately after a distressing film is more successful in reducing analogue PTSD symptoms than suppression of thoughts and images related to the film. Method: Ninety students watched a distressing film after which they were instructed to either elaborate on the meaning of the film (conceptual processing) (n = 31), suppress all thoughts and images of the film by performing a task (n = 29), or were given no instruction (n = 30). Four hours later, analogue PTSD symptoms were assessed. Results: The results showed that conceptually-driven processing does not result in fewer analogue PTSD symptoms than suppression. Conclusions: It is speculated that suppression may only be dysfunctional when individuals interpret their symptoms negatively or when suppression is believed to be dysfunctional.

Background: The importance of supervision is increasingly recognized, yet it remains little understood, impairing research and practice. Specifically, the CBT supervision model provides a relatively “heartless” account of professional development, which may undermine its effectiveness. Method: A theoretical review of emotions in supervision and learning is provided, to summarize relevant theoretical and empirical literature. The objectives are to clarify the role of emotions in CBT supervision, and to use this understanding to outline an emotionally-attuned model, illustrating its application to two critical aspects of CBT supervision (the development of a learning alliance and enhancing professional competence). Conclusion: The reviewed literature (theory and research evidence) supports the explicit and systematic incorporation of emotions into CBT supervision. Conceptually, this can be achieved by integrating Lazarus's (1991) general theory of emotion with the CBT model. The illustrations of this augmented model indicate its value in understanding and managing both the “rupture-repair” cycle that can affect the supervisory alliance, and the “deskilling-development” pattern that appears to be necessary for the acquisition of competence. We propose that CBT supervision might usefully be guided by our expanded model, as this affords greater internal consistency and may be more effective educationally.

Background: Although psychosocial treatments for pain have been found to be effective in reducing self-reported pain, physician visits, and in improving mood, the research has largely focused on younger persons. As such, there is a paucity of related studies involving older adults. Method: We implemented and evaluated a 10-session psychosocial (i.e. cognitive behavioural orientation) pain management program that was specifically designed for older adults. The intervention was delivered either in the participants' homes or in bookable rooms in seniors' residence buildings. Ninety-five community dwelling seniors with at least one chronic pain condition were assigned to either a treatment or a wait-list control condition. An assessment battery was administered to treatment participants immediately before the program started, immediately post-treatment, and 3-months post-treatment. Comparable data were obtained from control group participants, although 3-month follow-up data were not available for the control group. Outcome variables included pain intensity, coping strategy usage, pain beliefs/appraisals, and perceived life stressors. Results: Although decreases in pain intensity were observed in both the treatment and wait-list control groups, the intervention was found to result in fewer maladaptive beliefs about pain and greater use of relaxation, which is considered to be an adaptive coping strategy. Conclusions: Although some treatment benefits were identified (e.g. change in pain-related beliefs), future research should test the effectiveness of a cognitive behavioural treatment program tailored for seniors with participants who are experiencing higher pain intensities than those reported by our sample (i.e. those who experience a higher level of pain at baseline may represent a more suitable sample for assessing the effectiveness of our intervention in reducing pain intensity).

Background: The Brief Core Schema Scales (BCSS) were developed to provide a theoretically coherent self-report assessment of schemata concerning self and others in psychosis. They provide a more useful measure of schemata about self and others than traditional measures of self-esteem. Aims: The aim of this study was to determine if these scales would be useful in a sample of individuals who are at clinical high risk of psychosis to help identify targets for intervention. Method: Thirty-eight individuals who are at high risk for psychosis were administered the Scale of Prodromal Symptoms, the Calgary Depression Scale, the Brief Core Schema Scales and the Young Schema Questionnaire–short version. Results: Results suggested that these scales are appropriate for this population and that negative evaluations of the self and others were significantly associated with attenuated psychotic symptoms and, in particular, suspiciousness.