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.

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.

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.

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.

Sleeping difficulties are relatively common amongst normal young children at some stage in their development. It is estimated, for example, that approximately 20% of normal 1–2 year olds and 14% of 3 year olds wake regularly during the night (Bernal, 1973; Jenkins, Bax and Hart and Land-sown, 1980). Amongst handicapped children rates of sleeping disturbance tend to be even higher (Richman, Stevenson and Graham, 1975; Richman, Douglas, Hunt, Levere, 1982) and in autistic children, in particular sleeping difficulties are frequently severe and persistent. Thus, De Meyer (1979) found that almost all autistic children had shown sleeping problems at some stage in their development and at an average age of 5½ years, 49% still showed severe sleeping difficulties (as compared with only 3% of normal controls). This additional strain on parents, who already have to cope with many behavioural problems throughout the day, can be considerable, and frequently has a deleterious effect on many aspects of family and marital relationships.

A treatment approach to severe, refractory obesity involving combining therapeutic starvation with behavioural management techniques was advocated. The potential of the approach was illustrated by the description of a patient who lost 53 lb in weight over a 14-month-period.