Data on the results of cognitive therapies and theoretical models to explain them are proliferating. Yet from the current state of the evidence it is clear that we have as yet been furnished far more richly with questions than answers. Watts (1977) has indicated some of the issues remaining. What relationship has cognitive behaviour therapy to cognitive psychology as a whole? What kind of cognitive processes is it concerned with? How should these be formulated and investigated? Can covert stimuli and behaviours be equated with overt, both functionally and formally? How far must the individual be aware of (able explicitly to discriminate and describe) covert processes? What is the use of imaginal stimuli in cognitive behaviour therapy? What kind of changes take place during it? The achievement of answers to these and related questions is more than likely to have been hindered than helped by the vituperative nature of the arguments raging between the radical behaviourist and cognitive fields.

Mahoney's recent book, Cognition and Behaviour Modification (1974), has produced some fierce interchanges in the pages of this journal. To me, the surprising feature of the controversy is that it has frowned on Mahoney's arguments about the adequacy of radical behaviourism. I had imagined that the philosophical assumptions of radical behaviourism had long ago been shown to be untenable. However, I do not wish to join in this discussion, or to try and improve on the arguments of Mahoney and Marzillier's (1976) defence of them.

Since 1969, there has been a slow, but steady, increase in the number of studies which have attempted to apply behavioural methods within the British school setting. The variety of papers reported in this volume attest to the wide level of current interest. Many reviewers of American experience (e.g. Sherman and Bushell, 1975;O'Leary and O'Leary, 1972) show that both academic and classroom behaviours have been investigated, and there is a general agreement that the aim of behavioural intervention is not necessarily to make children “be still, be quiet and be good” (Winnett and Winkler, 1972). Rather, the aim is to help the classroom teacher to use the ongoing teacher-child interaction in a deliberate, positive way so as to foster the optimum level of personal development and academic attainment in her pupils. This paper draws on our experiences of the past four years of training groups of teachers in behavioural management, and concentrates on some of the important issues involved in ensuring that behavioural intervention of the highest quality can be offered to teachers in schools.

In 1958 Stunkard and McLaren-Hume concluded that “Most obese persons will not remain in treatment, of those that remain in treatment, most will not lose weight, of those that do lose weight, most will regain it.” Since then great advances have been claimed for behavioural, specifically self-control, treatments of obesity, (i.e. Stunkard, 1972). This had been witnessed in a great proliferation of research papers on group studies purporting to demonstrate the superiority of this approach and to verify its theoretical basis.

The present paper aims to describe the work of a behaviourally oriented psychologist in the treatment of agoraphobia, the most common single problem referred in two years' work in primary care. Apart from its high frequency, agoraphobia has a particular relevance to the general practice settings as it is a problem which relates very specifically to the patient's home environment. A recent study by Mathews et al., (in press) found that a home-based treatment of agoraphobia produced at least as much improvement as clinic based treatments and required less therapist time. One might expect that a psychologist operating from the local health centre might achieve many of the advantages of such a program with a possible decrease in therapist time as travelling is reduced.

Information collected from approximately one hundred males with sex disorders was analysed in order to attempt to identify some of the causes of the more important sex dysfunctions in men. Those conditions receiving special attention were erectile dysfunction, premature ejaculation and heterophobia. The information gathered comprised those parameters thought to be relevant from the patients' social, sexual and medical histories. Some thirty independent parameters were recorded including a limited psychometric assessment. Information on social class, education, family structure, parent-child relationships, traumatic experiences were quantified as far as possible and to this were added data from the patients sexual history; masturbation patterns, the frequency, pattern and variety of sexual outlet, the nature of his fantasies and so on. Information was also collected on somatotype, relevant medical indices, and smoking and alcohol consumption.

In 1975, the Board of Directors of the AABT appointed a committee to conisder the development of a statement on ethical practice for the organization. The committee consisted of Nathan H. Azrin, (Anna Mental Health and Development Center, Anna, Illinois) and Richard B. Stuart (University of Utah), co-chairpersons; Todd R. Risley (University of Kansas, Lawrence); and Stephanie B. Stolz (National Institute of Mental Health, Rockville, Maryland).

Early studies of the application of behaviour modification techniques in both special and normal classroom settings indicated that teachers could incorporate the more systematic management procedures without highly specialised training (Clazarioand Yelon, 1967: Becker, Madsen, et al., 1967). However, some of the earliest studies were closer to the laboratory than the real-life classroom setting in that they required elaborate recording procedures and used material reinforcers which are often unacceptable to teachers. Reversal designs, commonly used in early studies, proved impractical in wider settings. Problems such as these led the present author to place greater emphasis on extinguishing appropriate behaviours, using natural reinforcers identified by the Premack principle, using simplified recording procedures and using multiple baseline design.

With limited therapeutic resources, increasing demands for behavioural psychotherapy impose rationing by long waiting lists. Every patient taken on for treatment denies it to another who has to wait. Given this constraint, therapists can help many more patients by concentrating their scarce time on sufferers likely to show tangible improvement with brief treatment. This policy was applied to the treatment of 42 neurotics (mainly phobics and obsessive-compulsives) who completed exposure treatment with nurse-therapists in a mean of 9 sessions (16 hours). A cost-effectiveness study was mounted of the year before and after treatment.

The applications of behaviour modification techniques in schools have undergone many changes in recent years. The original model of one or two disruptive pupils in a class being treated by the teacher, whilst independent observers recorded the changes in behaviour, has been considerably widened. The kinds of behaviour selected for treatment, the number of pupils involved, the types of contingencies managed, and the methods of recording have all become diversified; and this diversification has been facilitated by the emergence of more complex designs, which complement the original design of BASELINE, TREATMENT and REVERSAL.

Entering the betting shop environment may be influenced not only by economic motives (Hess and Diller, 1969) but also by early learning within the family (Bergler, 1957) and by the contingencies operative in the wider social environment (Newman, 1972).

In England over the last ten years Behaviour Modification has become increasingly more known, accepted and utilised in the education sector; but only in the last half decade or so has Behaviour Modification been utilised with any generality and regularity.

One of the major conclusions of the Foster Report was that there was a strong case for legislation in the United Kingdom to control the practice of psychological medicine. Following the publication of that Report in December 1971, the Department of Health & Social Security invited comments. At a meeting, held on 24th May 1974, at the initiative of the British Psycho-Analytical Society, between officials of the DHSS and representatives of seven organisations representing practitioners of psychotherapy, Sir John Foster's recommendations were further discussed. Following that meeting, the Department in a letter dated 22nd January 1975 suggested that the organisations concerned might wish to consider establishing a joint Working Party which could develop the proposals in more detail in consultation with others.