This study reports on the effects of a cognitive-behavioral treatment program for two pre-adolescent children with chronic headaches. The program involved a combination of training the child in self-management skills (e.g. relaxation training, attention training, cognitive self-statements), and training for parents in how to prompt and reinforce children's self-help behaviors. Self-report assessment utilized a headache diary, a general activity measure, and a depression measure, whilst parental report measures were taken of the child's headache behavior and contingent parental care-giving behavior. Child headache behavior at school was also recorded by the child's teacher. The results indicated that by six months follow-up the subjects had improved in headache intensity 100% and 61% respectively, and in headache frequency 100% and 84% respectively. Both subjects also showed decreases in headache behaviors and reductions in contingent care-giving behavior by parents. Overall, the results suggest the potential usefulness of systematic involvement of parents in cognitive-behavioral treatment of children's chronic headaches.

547 patients admitted to the medical wards of a general hospital in South West England completed a computer-administered health behaviour screening questionnaire. This included a retrospective week's drinking diary and questions about alcohol-related problems. All patients were shown, via the computer, a summary of their own week's drinking in comparison with nationally recommended upper limits for safe drinking. In addition, all those who were considered to be risk drinkers on the basis of consumption or problems (23% of males, 7% of females) were advised via the computer to reduce their consumption and were given an approved self-help manual. All risk drinkers and a proportion of others were asked to complete the same questionnaire six months later. Seventy-five per cent of those asked, did so. The computer screening procedure was well accepted into ward routine and a simple before and after comparison showed a slight but significant reduction in drinking risk for the group as a whole. Regression discontinuity analysis showed that computer advice to reduce consumption plus provision of the self-help manual was of no additional benefit in helping patients reduce drinking risk.

Concern about body weight and shape is commonly allied with dysfunctional self-concepts and eating behaviour. When provided with group therapy structured around written handouts addressing these problems, women referred for weight control have improved in their self-esteem, assertiveness, attitudes to body size, control of emotional eating, self-efficacy about weight and susceptibility to cyclic dieting, improvements which were maintained to follow-up. The present study examined the effects of the handouts alone on 27 women who actively attempted to control their weight. Relative to a sample matched for initial scores on the target variables, reported incidences of emotional eating and vigour of dieting were significantly reduced over a period of one year in the sample who received the bibliotherapy. Also, perceived body size, weight assertiveness, self-efficacy about weight control and body mass index all moved in the predicted direction, relative to controls, but not to a statistically significant degree. Such bibliotherapy on eating and shape is recommended as an adjunct to group or individual psychotherapy or to initiate change in clients waiting for professional counsel.

Obessional-compulsive neurosis is quite a rare phenomenon with a prevalance of about 3% in all neurotics and 0.05% in the general population (de Silva, 1987). The form an obsessional-compulsive neurosis takes varies tremendously and its aetiology is not always easily identifiable. Salkovskis and Westbrook (1989) highlight the importance of a thorough assessment in distinguishing obsessional thoughts and “cognitive rituals”.

A chinese woman suffering from obsessional ruminations of harming herself and others was treated using an audio loop tape to facilitate exposure to these thoughts. The initial treatment using a tape of her ruminations in English produced little anxiety or improvement. Subsequent recording of her ruminations in Cantonese evoked considerable distress which habituated over treatment. The importance of cultural factors in assessment and treatment is emphasized.

Two patients with florid symptoms and severely disturbed behaviours were treated with a cognitive-behavioural programme. The programme aimed to facilitate the patients' and their carers' ability to adaptively cope with the distress generated by the patients' florid symptoms. Both patients actively co-operated and responded with a marked reduction in symptoms and behavioural disturbance.

This paper reports an exacerabation of health fears in response to cognitive modification in a patient with Somatoform Disorder (NOS). The results of the intervention present interesting theoretical implications for the conceptualization of cognitive events in clinical disorders and those characteristics that may contribute to treatment failure.

Using an ABA design, the impact of the unexpected delivery of Irn Bru to an out-patient clinic for depressed men was investigated using the Montgomery-Åsberg scale for depression. A significant improvement in both behaviour and affect was seen immediately, some benefit still showing at one month follow-up. The effect of the procedure on the multidisciplinary team is also discussed. Some methodological issues, including small sample size are explored. Despite the methodological problems the serious element of the study points to the important impact of unexpected, non-therapeutic elements on clinical behaviour, possibly as a result of the challenge to the therapist-patient relationship.

A 68-year old female with a phobia of choking on fluids was treated first with exposure in vivo and then with cognitive therapy. The exposure increased her water drinking to some extent, but the cognitive change was negligible. However, the cognitive therapy led to a dramatic change in the catastrophical misinterpretations and a fourfold increase in her water consumption. The effects of treatment were maintained at a 1-year follow-up.

A cognitive-behavioral treatment package aimed at alleviating trichotillomania, or hair-pulling, is presented. It consists of habit reversal and stimulus control to control hair-pulling, and relaxation, cognitive techniques, and role-play to manage the stress that often exacerbates pulling. Relapse prevention is addressed. This program has been applied successfully with several clients.