The magnitude of the problem of relapse and recurrence in depression is outlined and it is contended that this is now the major treatment issue facing clinicians. Studies demonstrating a longer term prophylactic effect of Cognitive Behaviour Therapy (CBT) are briefly reviewed and it is concluded that these methods have significantly impacted on relapse rates in unipolar depression. Nevertheless, it is argued that there is little cause for complacency due to the still significant rate of relapse which is found with CBT. While promising cognitive behavioural methods have been developed in the field of addictive disorders, there is a clear need for similar clinical advances in the area of recurrent depression. Some strategies which may have potential for promoting maintenance and preventing relapse are briefly outlined. The importance of developing a coherent model for assessing relapse risk and guiding decisions regarding treatment and after care strategies is emphasized. Lastly, future research directions in this important area are briefly considered.

The effect on psychological and immune function measures of a 6-week psychological intervention for anxiety states was evaluated in cancer patients who had already completed medical treatment for a tumor. Ten patients were treated with anxiety management and stress inoculation training while another ten served as a waiting list control group. The treated group showed a slight improvement in psychological variables but there were no group differences in immunological measures. Changes in the latter were, however, correlated with changes in psychological variables, notably, an increase in the T4/T8 ratio, with an improvement in the Quality of Life index.

This article reports on some psychometric features of the Therapist Client Rating Scale (TCRS), an instrument that claims to measure the therapeutic relationship in behaviour therapy sessions. A study is described in which the TCRS was completed after each therapy session by 28 obsessive-compulsive patients undergoing behaviour therapy, as well as by the therapists. The perception of patient behaviour correlated significantly with the treatment outcome. Further examination on the reliability and validity of the TCRS is recommended.

A new model of worry is presented, differing from previous work in which worry was set within a broader theory of anxiety. It is proposed that threat is initially evaluated in terms of imminence, likelihood, and cost set against perceived self-efficacy; this evaluation can produce worry as a relatively automatic response. Worry serves the functions of alarm, prompt, and preparation; in terms of processes, it leads to an unfocused attentional style, sensitivity to emotional information, and arousal (which produces self-absorption). Threat (and worry) are maintained if there are elevated evidence requirements or inappropriate problem solving. The therapeutic implications of the model are discussed briefly.

There is increasing interest in the use of psychological therapies for depressive disorder in primary care. This paper describes a pilot study using an abbreviated form of cognitive therapy as an adjunctive treatment for major depressive disorder in primary care. Seven primary care patients received an abbreviated cognitive intervention package in addition to their usual treatment. The patients were assessed before and after intervention using observer and self rating measures of depression and their subjective evaluation of the intervention was sought. Four of the subjects showed 50% change in depression ratings at the end of the intervention and only one of the group was taking antidepressant medication. The intervention was generally well accepted by patients and feasible within the time constraints. The initial results are encouraging and a randomized control trial of this brief intervention is now underway.

This paper addresses the question of how psychodynamic psychotherapists and behaviour therapists attempt to influence the cognitions of their patients. Two independent judges rated audioregistrations of therapy sessions of eight psychodynamic and eight behaviour therapists with regard to various distinct categories of cognitive restructuring. The validity of the system of categories was established in a previous study. The interrater reliability of the present ratings was investigated and found to be satisfactory. Although psychoanalytic therapists carried out fewer interventions altogether, no differences were found between the groups in the percentage of cognitive restructuring. However, there were differences in the way the two groups tried to achieve cognitive restructuring.

Strikingly diverse views have been expressed regarding the current status of behaviour therapy, with some concern that the field has lost its bearings. Two possible reasons for this diversity of views are the lack of data and the lack of a behavioural referenced instrument for gathering such data. In this paper we offer an instrument and illustrate its use in relation to a random sample of articles appearing in Behavioural Psychotherapy throughout the 1980s. The results suggest that the instrument is reliable and valid, but that behavioural research has not shown itself to be on course towards the standards set out in its own methodological literature. In addition, there is no evidence for the development of an environmental approach. Suggestions are made on aligning research with the aspirations of behavioural and cognitive psychotherapy.

In this paper a method to regain control over heroin addiction is described. The method is illustrated with a case example. A self-control guide book is used to help the client regain control. Motivational interviewing acts as a go between: a linking pin between client engaging in high risk behaviours and a method that could help him to become a responsible heroin user.

Momentary time sampling (MTS) is an unbiased method of estimating the duration of time for which a behaviour occurs, unlike partial interval recording (PIR) which introduces bias. This lack of bias does not, however, permit the researcher to make the further assumption that MTS allows multiple behaviours to be monitored accurately or in a way that is sensitive to behaviour change. Further considerations of the use of MTS and PIR are discussed.

The introduction of a period of non-contingent exercise was found to have a differential effect on two challenging behaviours shown by a man with a profound learning disability. His rate of purposeless wandering was reduced, but initially there was an increase in his rate of self-injury. The implication of these results are considered with regard to the uses of ecological interventions.