The growing “family” of cognitive-behavioural interventions has made impressive strides in the management of schizophrenia over the last decade. This paper critically reviews the advances that have been made and examines some of the controversies and difficulties encountered in the application of this approach and suggests areas for future growth and research. Future developments in family interventions, early intervention, the management of hallucinations and the potential utility of a form of psychotherapy to treat secondary depression and prevent suicide, are covered in depth. Service structures to integrate these interventions, their timing and duration are considered. It is suggested that the marriage of case management and psychosocial interventions in particular is now overdue.

Growing interest in the form and function of “social support” led to three small studies involving comparisons between behaviour therapists and social supporters (hair stylists) in terms of the help they provided with clients' emotional problems. The first compared observations of both groups in interaction with their routine clients, finding some overlap in their speech form (e.g. “reassurance”) but that overall the groups provided significantly different forms of help. The second study, based on a questionnaire survey, yielded similar results on the form of interactions between these groups and suggested in addition that their functions were distinctive. Together, these studies indicated that therapists and stylists differed in the form and the function of their helping work with clients. The final study went on to examine how behaviour therapists could help stylists to develop their social support role, finding a significant training effect and evidence of its generalization to clients. Implications drawn include enhancing the distinctive role of behaviour therapists in such “community care” interventions.

Research into the operant determinants of self-injurious behaviour (SIB) in people with learning difficulties has largely concentrated on the reinforcing effects that the behaviour of others may exert on the occurrence of SIB. In this single case study, the effects of SIB of differential severity on the behaviour of others are considered. The results of continuous, direct natural observations show social contact to be more likely to follow long bursts of SIB than short bursts and to be presented intermittently during and following long bursts of SIB. The implications of this finding for the functional analysis of SIB and the long term maintenance and development of severe SIB are discussed and related to the establishing operations and contingencies which govern the behaviour of the participants in the interaction.

The main aim of this study was to evaluate pet therapy in terms of increased interaction with two groups of elderly psychiatric patients. These patients were different in respect of their diagnosis, but their environments were similar in layout, decor and facilities. Each group of patients was observed by an independent observer, and further rated by the ward nurses on a scale which recorded change in their behaviour over the three conditions: baseline, dog intervention and photographic intervention. The total time of observing was four weeks where the baseline (i.e. “normal” amount of interaction) and the two intervening stimuli were introduced, and compared with one another. Time sampling was used throughout the study. The results indicate that the dog intervention was the most effective in increasing interaction when comparisons were made with other conditions.

In the past, aggressive behaviour shown by people with learning difficulties has often been reduced by means of punishment. A non-punitive alternative to punishment is Differential Reinforcement of Other Behaviours (DRO). However, there is no evidence that DRO can be used to reduce target behaviours that are less frequent than once or twice a day. A case study is presented in which DRO is used to reduce aggression in a lady who was aggressive once or twice a month. The factors that may have led to the effectiveness of DRO in this case are discussed.