The present study investigates the prediction of treatment outcome in the early stages of therapy by examining the quality of the therapeutic relationship. Furthering our understanding of the critical relationship variables may be useful for intervening in unsuccessful treatment outcomes. Two self-report instruments are used to assess the client-therapist interaction: the EPIN and the TCRS. Results show the client's assessment of the quality of the therapeutic relationship, as assessed with the EPIN, is related to treatment outcome. None of the subscales of the TCRS showed significant correlations. We conclude that in the early stage of treatment, the establishment of an accepting, empathic and supportive relationship with the client (as perceived by the client), is important for the progress of directive behaviour therapy.

I remember quite well my first exposure to an international conference of behaviour therapists, albeit through a haze of Irish hospitality. As a trainee clinical psychologist in the early 1970s, at a time when training budgets could stretch to the occasional foreign conference, I was fortunate enough to attend one of the early, and now infamous, Wexford Congresses on Behaviour Modification, organized by the now defunct Behavioural Engineering Association of Ireland.

Substitution of a happy ending to a recurrent stereotypic nightmare and subsequent assisted rehearsal produced immediate cessation of a previously frequent nightmare and consequent removal of associated fear and distress.

The philosophy of radical behaviourism continues to be misunderstood and the ways in which it influences therapy are still not widely appreciated. This paper shows that radical behaviourists do not ignore peoples' thoughts and feelings; that we consider people and their behaviour as part of the context in which they live; and that clinical problems are as much our concern as broader social problems. To illustrate the influence of radical behaviourism on clinical therapies Goldiamond's constructional approach and Hayes' comprehensive distancing are described.

Space phobia is a rare syndrome characterized by a fear of absent visuospatial support and of falling, which is noted to be quite unresponsive to treatment. We report a case of space phobia which was successfully treated using behavioural methods and remained much improved at nine months follow-up.

On a cold and dull Autumn Friday in 1972, I was among hordes of Behaviour Changers/Modifiers/Engineers/Therapists (all to become Psychotherapists) making their way from the four corners of Britain to the Middlesex Hospital in London. We were all going to a meeting to discuss the setting up of a National Association for those interested in Behavioural … whatever. When I arrived, I was refused entry unless I paid £3 annual membership fee to the very smartly dressed bouncer on the door who claimed to be the Treasurer. “But I thought the meeting was to decide if we are going to form an Association and, if so, to elect the officers!” My protests were in vain, as would have been my 460 mile day trip if I had not parted with my £3 — I have never really mastered contingency management!

This paper summarizes developments in the field of classical conditioning. Attention is paid to four common misconceptions of what is classical conditioning. First, classical conditioning does not ensue as a simple result of temporal pairing of conditioned and unconditioned stimuli. Rather, conditioned reacting occurs if and to the degree that the subject is able to predict the occurrence of one stimulus from the presence of another one. Second, what is learned during classical conditioning is not necessarily a response to a cue, but rather a probabilistic relationship between various stimuli. Third, classical conditioning is not only manifested in responses mediated by the autonomic nervous system, but also in immunological parameters, in motoric behaviour and in evaluative judgments. Fourth, the nature of the conditioned and the unconditioned stimulus is (often) not a matter of indifference: particular combinations of CS and US produce more powerful conditioning effects than do other combinations. In the second part of the paper, the potential relevance of these developments is illustrated. Discussions are included about anxiety, addictions and food aversions/conditioned nausea.

Six patients meeting DSM-III criteria for dysthymic disorder completed fifteen weekly sessions of one hour of individual cognitive therapy. Pre-, post- and six months follow-up assessments were carried out by an independent assessor. A significant improvement in depression was observed after treatment and maintained at six months follow-up. Clinically, improvements were meaningful and wide ranging and four of the patients no longer met DSM-III criteria for dysthymic disorders. Cognitive treatment acted specifically as it reduced significantly the frequency of negative automatic thoughts during treatment and follow-up.

A multi-component intervention programme comprising 12 sessions is described which successfully enabled an Olympic archer to overcome performance related anxiety.

The co-editor of the first BABP Newsletter in 1973 reminisces on the excitement of early behavioural therapy in the UK but is disappointed at the pace of change at service delivery level.

Preliminary work in assessing the competency of trainees attending a cognitive behaviour therapy course is presented. Inter-rater reliability of the Cognitive Therapy Scale to assess competency in therapy is considered satisfactory at the overall competency level. Item reliabilities are promising. Although the power of this pilot design is weak, the competency scale showed a trend towards improvement over the course of training.

Social learning theory has provided the field of substance misuse with a solid base from which to generate hyotheses and develop treatments. The emphasis during the last decade has been upon outcome and efficacy expectancies, relapse prevention and stages of change. Helping people to move through these stages of change (motivational interviewing) has been a particularly strong focus. The literature on alcohol dependence provides reasonable evidence to support the effectiveness of the following treatment approaches: antidepressant medication, behavioural contracting, brief interventions, behavioural marital therapy, behavioural self-control training, community reinforcement approach, covert sensitization, Disulfiram (Antabuse), social skills training and stress management training. It is also suggested that interest in cue exposure will develop in the future. During the next decade self-regulation theory will turn out to be a rich source of ideas as well as a useful conceptual framework that integrates a range of treatment approaches.

Seven experienced clinicians were asked to judge how many sessions patients in a clinical psychology out-patient clinic would take to complete treatment, using patient referral letters as their only data. Results showed the clinicians were very poor at making this judgement and generally did no better than chance. Their clinical predictions were compared with statistical data using a regression analysis of initial questionnaire measures. The regression equation did a little better on some judgements, but still failed to predict long-term treatment.

Behavioural psychotherapy is being applied to an ever increasing range of children's problems. Well established techniques continue to be used by an increasing range of people from different professions. There is a slight danger that the techniques are so widely used that they are outstripping their data base and some thought needs to be given about the level of training necessary to ensure that new approaches are encouraged and critically evaluated.

Over the past few years, there has been increasing availability of effective behavioural psychotherapies for use with elderly people. Notably, procedures developed with younger adults have been found effective with elderly clients. However, the needs of people with dementia are still only partially met. Some therapies are used that are of questionable benefit, while possibilities based on sound theoretical bases have been largely ignored. Given that the targets of intervention for people with dementia are likely to be wide ranging, and certainly include the needs of families and of other caring systems, and of their effective functioning, behavioural interventions must address these wider issues, which may well include behavioural methods applied to systemic change.