This paper reviews the effects of maternal distress on several aspects of parent—child interactions that were identified in the course of a parent training program for child non-compliance. Distress was measured by a number of self-report questionnaires examining depression, anxiety, marital relations, and extrafamilial relationships. The parent training program is initially reviewed. Subsequently, pretreatment relationships between maternal distress and parent—child interactions were examined. Distress appears to be related primarily to measures of parent perceptions of child maladjustment. Several relationships between distress and treatment outcome also were noted. A recent study designed to enhance parent training by modifying maternal distress factors is presented. Finally, implications and limitations of the data are discussed.

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 purpose of the present study was to examine some trends in child behavior therapy over the past 12 years and to suggest some future directions. Four behavioral journals that have been in existence since at least 1970 were examined for type of behavior treated and type of treatment technique utilized. Beginning with 1970 every other year of each journal was examined and 410 articles dealing with the treatment of children were identified. There was no systematic trend across years in the number of articles published in this area. Furthermore, only a few trends across years were noted for behaviors treated or treatment technique utilized. Negative behaviors, particularly acting out ones, had been targeted for treatment most often. Consequences, particularly of a positive nature, had been utilized most often as the treatment technique of choice. The need to expand our models by treating new behaviors and utilizing new techniques was discussed.

Eighteen young adult out-patients with social interaction difficulties were treated using a multifaceted group approach, which incorporated skills training, anxiety reduction and cognitive restructuring techniques. They were assessed before and after treatment, and at 2-year follow-up. A non-clinical comparison group was assessed using the same measures. The treatment group showed significant improvement on measures of social performance, social anxiety and self-esteem, which was maintained at 2-year follow-up. Individual results are reported, which show differing patterns of change. The implications of using anxiety reduction and cognitive restructuring techniques with social skills training are discussed.

The sparse empirical research on maintenance of treatment effects in behavior therapy is reviewed and a practical maintenance program for phobic clients is presented. Preliminary results with the program for 32 agoraphobic patients showed that the treatment effects had been maintained 6 months after conclusion of treatment.

When I was asked by Professor Aubrey Lewis (later Sir Aubrey Lewis) to undertake the establishment of the first school of clinical psychology in this country, and to establish a profession of clinical psychology, I went to the United States of America in order to study how this profession was organised (Eysenck, 1980a). The very hospitable reception I received did not lead me to advocate the establishment of a similar system in this country. It seemed to me that there were three major faults inherent in the American system.

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.

Self report instruments for assessing social competence are briefly reviewed. The amount of assistance available from the literature to those wishing to apply the scales psychometrically seems scarce, and construct infrastructure of many such scales is limited and insufficiently explicit. A new inventory was investigated, using three male samples (controls = 100; alcohol abusers = 160; other psychiatric = 58) from an Armed Services population. Results indicate an underlying factorial framework which comprises five separate scales, and data are presented which indicate the scale's potential usefulness in such ways as identifying candidates for social competence training, and for inter-group analyses of social competence.

I have subtitled this address An Autobiographic View; it is also anecdotal and subjective. I find it fascinating to realize that my own autobiography coincides with, and indeed is part of, the history of behaviour therapy and, indeed, of much of clinical psychology as a profession in Britain. Clinical psychology scarcely existed before the Second World War. Even in 1945 the British Psychological Society listed it among terms not entirely meaningless, but too ambiguous for use by the Society. Between the Wars, there had been great resistance to lay encroachment upon medical territory, although there had been a little intellectual testing in mental hospitals by interested academic researchers. At the end of the war, Hans Eysenck came to the Maudsley having done his pioneer factor analytic work on dimensions of personality at Mill Hill. He was keen to establish a clinical psychology course, but was appalled by the existing main models along psychoanalytic lines, both in the United States of America and in the Tavistock Clinic in London. His most important initial recruit was Monte Shapiro, who became head of the clinical course of which I was an early student member and a relatively early staff member. The early emphasis was on assessment mainly by objective standardized tests. Indeed, much of our early intellectual effort went into disputations about the lack of validity of projective tests, such as the Rorschach. We had no real involvement in treatment. Aubrey Lewis, who was the Professor of Psychiatry at the Institute and the dominant figure at the Maudsley Hospital was very much against non-medical participation in therapy.

Developments in behavioural group therapy over the past decade are described, with particular reference to a change in focus from administering individual treatment techniques to teaching coping skills for the management of anxiety. In spite of this growing interest there has been little empirical research reported. The current study was an attempt to develop a coping skills package and to evaluate it against the more traditional approach of group relaxation training. Three experiments were conducted, comprising a total of seven groups and they were run in either an N.H.S. psychiatric hospital outpatient setting or in General Practice.

Results were equivocal, both experimental and control groups showed treatment gains. These were superior in the coping skills group on one measure. Reasons for these findings are discussed in the light of the curriculum and the experimental design. And ways of making the coping skills package more potent are suggested.

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.

The purpose of this paper was to review the methodological rigor and clinical implications of behavior modification studies in which social skills have been taught to socially deficient children. Thirty two studies were reviewed. The following four treatment approaches were identified and reviewed: adult contingent attention; peer-mediated strategies; modeling; and treatment packages. The clinical merits and limitation of each approach are discussed. Identification and possible target behaviors for neglected and rejected children are outlined. It appears however that conclusions are not warranted at this time about the relative effectiveness of the four treatment strategies. Research issues such as subject selection and the need to document that skills acquired during training are associated with relevant outcome measures are discussed. Finally, suggestions for future social skills studies are offered.

The effectiveness of programmed instruction with operant training (P.I.O.T.) in the language rehabilitation of severe aphasics was evaluated by comparison with an attention-placebo control treatment (A.P.C.) in which non-verbal tasks were administered. Patients were divided into two groups and received first either 4 weeks of P.I.O.T. or of the A.P.C. condition. Both groups then received 4 weeks of the alternative treatment. Both groups also received some speech therapy throughout. Only two out of 24 assessments showed differences, both indicating that the A.P.C. with non-verbal practice improved abilities more than P.I.O.T. Over the total 8-week period, significant improvements in abilities occurred on more than one-half of the measures. It is concluded that rehabilitation therapy by means of programmed instruction with operant training failed to produce improvement in the course of recovery of language or related aspects of communication in severely aphasic patients.

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.

The present study examined the effect of a bedtime management programme which incorporated both stimulus control and contingency management procedures on the level of bedtime disruption in children. Using a multiple baseline across subjects design each of four children (ranging in age from 2–5 years) were sequentially introduced to the treatment program, which was implemented by the child's parents each night. In addition the study sought to determine whether direct treatment of bedtime disruption would be associated with any negative side effects. Systematic observational data revealed that the Bedtime Management Program was effective in reducing bedtime disruptions in all subjects and the improvements sustained during a 2-month follow-up. No evidence suggests that treatment resulted in negative side effects. The implications of the results for behavioural parent training are discussed.

Twenty-eight chronically phobic patients had therapist-aided exposure either rapidly or slowly. During therapist-aided exposure move to the next hierarchy item occurred after subjective anxiety had dropped, on a scale of 0–8 by two points (rapid) or by four points (slow). Exposure began with the lowest of eight hierarchy items. All patients had self-exposure homework between sessions. In a balanced design 12 patients were treated in London and 16 in Istanbul. Peak anxiety during sessions was comparable in both groups. Compared to slow exposure patients, rapid exposure patients completed treatment to criterion in fewer sessions and less time (4·7 vs. 5·8 sessions P< 0·01; 360 vs. 484 min P< 0·005). Criterion for termination of treatment was toleration of the highest hierarchy item with minimal discomfort, or a maximum of eight sessions. Both in London and in Istanbul rapid and slow groups improved substantially and similarly in phobias, social adjustment and mood; gains continued to 6 months follow-up. Compared to slower exposure, rapid exposure does not enhance final outcome but does shorten treatment time without increasing peak anxiety during sessions.

This paper describes five measures of behavioural skill that apply to the “generalist” level of therapy sophistication. This level was trained in a group of 65 qualified psychiatric nurses working in the rehabilitation sector of a large N.H.S. hospital. Three of the measures were administered before and after a 5 day in-service training course, followed by two measures of proficiency in using behaviour therapy on the ward. The results indicated that reliable and valid measurements could be made in this crucial domain. Also, a discriminant analysis showed that one test, a video-presented functional analysis task, accounted for most of the variance and predicted utilisation. It is therefore possible to use this brief assessment device to dependably gauge a vital area of behavioural skill.

Self-efficacy is normally measured by a pencil-and-paper test, and two separate studies involving snake phobics have indicated that this test does not have significant reactive effects on related behaviour. Two experiments are reported which examine the possibilities of measurement reactivity with a different type of behaviour, the social skill of assertiveness. In the first experiment, 46 non-assertive female students served as subjects. Measuring efficacy was shown to have reactive effects on later behaviour. These reactive effects showed consistent changes during the course of an assertiveness training programme, with the effect of measurement being initially to enhance performance and later to produce slight decrements. A second experiment examined the possibility that this change was related to differing levels of assertiveness. Sixty female students of varying levels of assertiveness participated in this study; again, reactive effects occurred, but they were not related to level of assertiveness. The question of possible therapeutic advantages and disadvantages of using efficacy measures at various points during therapy was raised.

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.