Chronic illnesses in children and adolescents present difficulties for the individual and family. A family systems perspective can provide directions for assessment and intervention with these children and their families. A review is made of research on family interventions for children with juvenile rheumatoid arthritis, cancer, and insulin-dependent diabetes mellitus (IDDM), and the influence of intervention on health outcomes is discussed. Few family interventions, particularly behavioural family interventions, have been rigorously evaluated, but multisystemic models show promise for improving children's health outcomes and family adaptation to chronic illnesses.

Cancer patients undergoing chemotherapy frequently experience anticipatory distress before treatment sessions. Eighty-six cancer patients (ovarian, lymphoma and breast) were assessed to determine the prevalence of anticipatory nausea and vomiting (ANV). Approximately one patient in three reported anticipatory nausea (AN), and of these 6 also experienced anticipatory vomiting (AV). Several patients reported anticipatory anxiety without any sensation of nausea. Clinically the notion of anticipatory distress may be more fruitful so that the problem of pretreatment anxiety is also addressed. Generally, AN was rated as moderate or worse in severity, occurred fairly consistently, and often began well before arrival at hospital on treatment day. It is suggested that future research should endeavour to link more closely the topography of the problem and the intervention techniques employed, as well as evaluating a broader range of possible interventions.

The treatment of persons with mental disorders is advancing rapidly. New epidemiological information has allowed the magnitude of the task to be specified. A census of mental health professionals has allowed the workloads to be determined and organisational models which focus on treatment in the community established. As diagnosis is the first step in treatment it is timely that new, computerised structured diagnosis interviews are available. Treatment evaluation likewise is able to suggest that medication and cognitive behaviour therapy backed by good clinical care are the keys to good patient treatment. The two major problems that follow mainstreaming of the treatment of persons with mental disorders are the reallocation of money to treatment in the community, and the education of mental health staff to diagnose and deliver the proven effective treatments.

The object of this paper is to provide a brief review of current knowledge of childhood autism. A sketch of the most recent knowledge concerning diagnosis, aetiology, patterns of cognitive disability, and treatment approaches is provided. In the second part of the paper, areas of research needing further development to enhance our understanding of the syndrome are identified, along with some suggested strategies for future work.

This paper reports on the reliability, validity, and factor analysis of the subscales of the Thoughts and Real-Life Experiences Scale (THARL Scale). Two hundred and twenty-three subjects completed the THARL Scale. Of these, 86 subjects also completed anxiety, stress, depressive cognitions, well-being, and general psychological health scales. Six weeks later, 174 subjects completed the THARL Scale again. The four subscales of the THARL Scale were found to be reliable. Thought-related distress and real life related distress correlated positively with anxiety, stress, and depressive cognitions, and the thought-related positive affect and real life related positive affect correlated negatively with anxiety, stress, and depressive cognitions. High distress was associated with low well-being and low psychological health, and high positive affect was associated with high well-being and high psychological health. Results of multiple regression analyses showed that positive affect due to thoughts was the best predictor of anxiety, while positive affect due to day-to-day experiences was the best predictor of stress and depressive cognitions. Positive and negative affect caused by thoughts were the two significant predictors of well-being while negative affect caused by thoughts and positive affect caused by day-to-day experiences were the two significant predictors of general psychological health. It was concluded that the THARL Scale may be employed as an instrument for the diagnosis of psychological problems and emotional health.

Anxiety and fear are among the most common and distressing problems reported by children and adolescents. However, these problems have received little attention from behavioural family theorists and therapists. In this paper, we argue that more attention needs to be paid to evaluating the role of family interaction processes in the development and treatment of child anxiety disorders. A program of research is described including a treatment outcome study in which family processes and behavioural family intervention are evaluated with 7- to 14-year-old children with overanxious, separation anxiety, and avoidant disorders. The family treatment focuses on how parents interact with their child during displays of anxiety, their management of emotional upsets, and family communication and problem-solving skills. Preliminary results of the family treatment are presented.

Are Australian behaviourists compassionate and caring? Do we bother to find out what our consumers want? Do our consumers find our approach acceptable or are we running the risk of becoming an endangered species? These questions are considered along with how we might approach the problems the species of Australian behaviourists face so that our heart can beat steadily well in to the nineties.

An identical procedure to that of Pianta and Hudson (1990) was employed to reduce inappropriate sucking of fingers, hair, and clothes by a 7-year-old girl. The subject's mother utilised a simple response-cost procedure, which was faded over time, and social reinforcement to achieve substantial success. Follow-up observations conducted 6 months after the program terminated revealed a high degree of maintenance.

The Fear Questionnaire (FQ) has been widely used both nationally and internationally in the anxiety disorder literature. Research from a variety of centres advocating its psychometric properties and clinical utility is now available; however a critical and integrated review has been lacking. This paper offers an integration of empirical research for cross-cultural comparison and as a testament of the FQ itself. A refined FQ is also proposed to enhance its utility.

In addition to vomiting, clinicians and researchers have outlined several means by which women with bulimia nervosa purge, including fasting, exercise, laxatives, emetics, diuretics, thyroid hormone, fluoxetine, sorbitol, enemas, heroin, and tobacco (Bulik, 1992; Mitchell, Hatsukami, Eckert, & Pyle, 1985; Pyle, Mitchell, & Eckert, 1981). The following report presents an additional method of purging, namely with excessive dietary fibre, which was particularly reinforcing as it satisfied the need to binge and purge simultaneously.

Ms. A was a 27-year-old single white female who presented for outpatient treatment with a 1-year history of “out of control” binge-eating. She reported no prior history of any eating or weight disturbance. At the beginning of treatment she was 172.7 cm and weighed 64.5 kg (BMI = 21.6). She reported her desired weight to be 59 kg. The onset of her eating disorder was 1 year prior to treatment after moving, taking a new job, and beginning a relationship with a man whose diet consisted mainly of junk food.

During the first few months of the relationship, she gained (4–4.5 kg) and became quite concerned. She was distraught at not fitting into her clothes and disliked her body at that weight. She began a very restrictive diet, losing 6 kg in 2 weeks. Following that 2-week period, she “lost control” and began to binge-eat. This pattern of alternating binge and fast periods and 5 kg weight fluctuations continued for 1 year. With every subsequent binge period, she reported feeling more out of control.

This paper examines some of the policy issues arising from behavioural approaches to involving parents in improving their children's learning at school. Issues raised include (a) the researcher's role in establishing equitable partnerships between parents and teachers, (b) reducing educational inequalities, and (c) designing research to examine generalisation of children's learning across home and school settings, and the effects of implementing components of intervention at home and at school. The paper discusses particular challenges for applied behavioural research presented by each of these issues.

The Fourth World Congress of Behaviour Therapy, held on the Gold Coast of Queensland, Australia between July 4–8, 1992 was an important event in the professional calendars of many behaviour therapists internationally. It was hosted by the Australian Behaviour Modification Association, in association with the Association for the Advancement of Behavior Therapy, and the European Association of Behavior Therapy. This 3-yearly event provides an important opportunity for behaviour therapists from around the world to meet, socialise, exchange information, perspectives and ideas, and establish or extend colleague networks in a multicultural context. As the first World Congress on Behaviour Therapy to be held in the southern hemisphere, it achieved the same high standard of previous congresses in Israel, Washington, and Edinburgh, producing a balanced and stimulating program addressing most of the major areas of contemporary behaviour therapy research and clinical practice.

The aim of this clinical note is to describe a cost effective method of collecting parent reports of their children's behaviour, and to stimulate research and discussion about its application.

The method was developed in a community based children's mental health clinic which saw many parents who sought help to improve the noncompliant behaviour of their children. Behavioural methods were used extensively because they often lead to lasting changes, are cost effective, and are accepted by parents.

An 8-week group program taught parents to observe and record their children's behaviour, and to use these records with behaviour management skills and problem-solving techniques to develop their own approach to discipline. Behaviour management skills included reinforcement, time-out, extinction, effective use of commands, house rules, and contracts.

Therapists wanted to collect data frequently to assess problems, tailor an intervention program for the family's needs, and to evaluate the extent and maintenance of change. In addition, therapists wished to monitor the client's progress and involvement with the program and take early steps to correct any problems. The research component required regular data to evaluate the overall outcome and to analyse the effect of particular components of the program.

Unfortunately, the methodological standard of using independent observers to rate changes in the behaviour of families was judged to be inappropriate in the clinic. With a small number of staff facing a high demand for services, it was argued that the expense of independent observers was difficult to justify. Staff favouring nonbehavioural approaches and those less enthusiastic about research perceived the use of independent observers as intrusive and unwieldy. There was no easy access to researchers, grant funds, or tertiary institutions who could assist.

The prevention of severe psychopathology has long been held as a goal of psychological intervention with children. This paper examines the role of behavioural family intervention in the prevention of conduct problems in children. Components of a prevention model and their conceptual and empirical justification are outlined as well as some practical obstacles to the development of comprehensive, preventively oriented, mental health services for children and families. Possible directions for future research with high risk groups are discussed.