In a hospital training unit for severely mentally handicapped adults, alternative methods of staff organization, Room Management (RM) and Small Groups (SG) were experimentally evaluated. Both procedures were found to be equivalent in ensuring that trainees had materials available to them, in promoting on-task behaviour and staff trainee interaction and minimizing staff–staff interaction. Group engagement was significantly higher during the SG condition. Room Management was nevertheless significantly more successful in facilitating individual training than the SG arrangement, trainees receiving four times more individual training during RM than SG.

The implications of these results for the appropriate use of training staff are discussed. The use of group engagement as a dependent variable is critically evaluated.

The present study was designed to investigate further the possible interactive role of both depression and headache type on the outcome of a standard E.M.G. biofeedback therapy for muscle-contraction headache. Forty-eight patients applying for treatment at a headache treatment center were given forehead/posterior neck E.M.G. biofeedback therapy for 20 weeks. Twelve subjects in each of four groups had either depression with or without a history of head trauma, or were not depressed, with or without a history of head trauma. Results showed that headache activity was lowered more for non-depressed subjects and more for non-trauma subjects, although there was no interaction. However, post-hoc examination also showed that the possibility of monetary gain from legal action might have confounded the data for some of the trauma subjects. The study supports the need for separation of depressed and non-depressed patients in headache treatment and the probable need for treatment for the depression itself, aside from the headache.

In treating anxiety and phobic disorders it is helpful to be aware of physical illnesses that can present with anxiety-type features. This paper discusses a number of organic conditions whose presenting features could be mistaken for an anxiety state, viz. hyperthyroidism, Cushing's syndrome, hypoparathyroidism, phaeochromocytoma, hypoglycaemia, mitral valve prolapse, paroxysmal tachycardia, temporal lobe epilepsy, caffeinism, and food and chemical allergy. Hyperventilation is also discussed since it is an important but frequently neglected mechanism in many cases of anxiety and phobia.

Long recognized as an important modifier in the relationship between stress and illness, social support appears in the light of recent research to include emotional, informational and practical components available from a variety of lay and professional sources. Health and mental health disturbances are more closely associated with inadequate than with unavailable social support. Individuals who report inadequate social support may lack skills in support-elicitation, of which this paper specifies several based on what is known of interpersonal style in depression and loneliness. The implications of this analysis for the helping professions refer to both therapeutic practice and the helper's work satisfaction.

Alongside the view that “nothing works” in correctional rehabilitation, the behavioural technique of social skills training (S.S.T.) has been singled out for use with offenders. The present paper critically reviews empirical evidence regarding the long-term effects of S.S.T. on young offenders with a view to examining the conceptual and methodological issues linking S.S.T. with criminal behaviour. It is concluded that S.S.T. has been shown to have only very limited effects on the future criminal behaviour of young offenders. Several explanations for this finding are considered, and it is concluded that re-offending is an inadequate measure of the efficacy of S.S.T. programmes as reported in the extant literature. Following criticism of research designs which produce false expectations by including unrealistic measures, several proposals for future research are made.

A 50-year-old married woman who had had a radical mastectomy was on the threshold of ceasing to take adjuvant chemotherapy because of a longstanding needle and blood phobia and a recently acquired conditioned nausea response to hospital and medical situations. A cognitive-behavioural therapy programme incorporating relaxation training, imaginal systematic densitization and video modelling, allowed her to complete the chemotherapy course and to feel less anxious in hospital and medical settings.

This paper describes the successful application of a behavioural intervention to the inappropriate behaviour of a severely mentally handicapped hospital resident. The intervention was based on the Constructional approach and at sixth week follow-up the effects had been maintained. Furthermore, there was evidence that these had generalised to other behaviours. Significant changes were noted in the attitudes of direct care staff and it is suggested that these may have been attributable to the nature of the approach used. The Constructional approach was considered ethically and practically superior to alternatives which would have concentrated alone on reducing or removing behaviour in the client's limited repertoire.

This study assessed the effects of training the parents of children displaying problematic eating behaviors in child management skills. Specifically, parents were taught to apply a range of management procedures, e.g. differential reinforcement, behavior correction routines, extinction and time out, to their child's behavior during mealtimes. Subjects were four families, each of which contained a child displaying high rates of disruptive behavior, e.g. non-compliance, complaining, leaving the table during mealtimes, and low rates of food consumption. Each family underwent baseline, mealtime management training (M.M.T.), follow-up conditions within a multiple baseline across families' design. Home observations were conducted four nights each week, during the families' evening meal, and the dependent measures recorded were child behaviour, eating responses, and weight of food eaten. The results showed that M.M.T. was effective in decreasing disruptive behaviour for three of the four families. The fourth family also required home feedback training which resulted in a marked decrease in disruptive behavior. Changes in eating responses were less marked and highly variable among individual families. Follow-up results and the implications for clinical practice are discussed.