The experience of paediatric asthma is associated with increased stress and emotional difficulties for both the child and family. The current study aimed to qualitatively explore parents’ views of their child's asthma experience, from initial diagnosis onwards, to enhance our understanding of how families emotionally adjust and adapt to the diagnosis and management of asthma. Semi-structured interviews were conducted with 17 parents of children (<18 years) with physician-diagnosed asthma. Questionnaires were used to capture demographic information and anxiety symptom status of parents (State Trait Anxiety Inventory — Form Y [STAI-Y1/Y2]) and children (Spence Children's Anxiety Scale — Parent reported [SCAS-P]). Grounded theory was used to analyse the results. Analysis saw three themes emerge as important in understanding the impact of asthma on the family: (1) the experience of obtaining an asthma diagnosis, (2) parents’ belief in their competence to manage asthma, and (3) parents’ behaviour in response to the asthma. A model was developed that posits adaptive parental adjustment to asthma is determined in part by the circumstances around the time of diagnosis, the level of knowledge and skills, and the controllability of the asthma. This model can guide medical and allied health professionals to specific areas where intervention may reduce stress and emotional difficulties associated with asthma and its management for affected families.

An extension of the Home Situations Questionnaire is described (HSQ-M), and normative data for an Australian clinical sample are reported. Reports were obtained from both female (339) and male (143) informants on 403 children aged between 3 and 12 (287 boys, 116 girls) from nine centres in Sydney. Clinicians from these centres predicted the likely findings on the HSQ-M, and their expectations were not wholly supported by the data. Boys were reported to have more problem situations than girls by fathers but not by mothers, and boys were reported as having greater situation severity than girls by mothers but not by fathers. While these differences were statistically significant, they were not clinically significant. Contrary to expectations, fathers reported similar levels of home situation difficulty to mothers. The data provide useful information for targeting situations that would meet the need of parents in parenting groups, and for supplementing the assessment tools used by clinicians working with families.

The COVID-19 pandemic presents challenges to the provision of community programs and access to mental health services for young people. We examined the feasibility, reach, and acceptability of multi-technology delivery of an integrated system that assesses and provides feedback on youth mental health and wellbeing and connects them to care within the context of a youth sports development program. The system was delivered via computer, telephone, and teleconference with 66 adolescent boys participating in a rugby league development program in three communities in Australia. Young people completed online wellbeing and mental health measures (Assess step), parents were provided with telephone feedback on results, support, and referral options (Reflect step), and youth received teleconferenced workshops and online resources (Connect step). The multi-technology delivery was feasible to implement, and reach was high, with barriers experienced at the Assess step but minimally experienced at the Reflect and Connect steps. Delivering the system via multiple forms of technology was rated as highly beneficial and enjoyable by young people. Players improved in self-reported prosocial behaviour, gratitude, and anxiety symptoms from pre- to post-program. Strong collaboration between researchers, organisational personnel, and community members is important for achieving these outcomes.

Following on from the American Psychological Association's (1993) findings regarding empirically validated treatments, a British task force (Roth & Fonagy, 1996) arrived at similar conclusions. Both publications strongly endorsed the superior efficacy of cognitive-behaviour therapy (CBT) over placebos, waiting list controls and other psychological treatments. These findings, although not new, are becoming increasingly important as new ways of funding health care become more likely. With these probable changes in health system funding, organisations such as the Australian Association for Cognitive and Behaviour Therapy will almost certainly be asked to provide evidence supporting the efficacy of certain interventions for certain problems, but also to decide who can implement such treatments. This article attempts to present the well known findings within the current framework, and poses an important question: Who can ethically and competently practice CBT?

Little is known about the prevalence of having been bullied in adults with versus adults without an anxiety disorder, so a pilot comparison was undertaken. A questionnaire on recall of having been bullied was completed by 81 attenders of a behavioural psychotherapy unit for anxiety disorders and by 81 attenders of a dental clinic who had no psychiatric problems but who were similar to the anxiety disorder group in gender, marital and employment characteristics. Recall of being bullied was significantly more common in the anxiety disorder referrals than in the dental patients. Results warrant testing of whether being bullied as a child increases the likelihood of developing an anxiety disorder in later life, controlling for demographic, personality and ethnic variables.

Many individuals seeking treatment for social anxiety disorder (SAD) also meet criteria for a comorbid depressive disorder. Little is known, however, about how a comorbid depressive disorder affects social anxiety treatment. This study examined 61 participants with SAD and 72 with SAD and a comorbid depressive disorder (SAD+D) before and after 12 weeks of cognitive behavioural group therapy (CBGT) for social anxiety. Although patients with SAD+D reported more severe symptoms of social anxiety and depression at pretreatment, treatment was similarly effective for individuals with SAD and SAD+D. However, individuals with SAD+D continued to report higher symptom severity at post-treatment. Interestingly, CBGT for social anxiety also led to improvements in depressive symptoms despite the fact that depression was not targeted during treatment. Improvement in social anxiety symptoms predicted 26.8% of the variance in improvement in depressive symptoms. Results suggest that depressive symptoms need not be in remission for individuals to benefit from CBGT for social anxiety. However, more than 12 sessions of CBGT may be beneficial for individuals with comorbid depression.

Obsessional thoughts or “pure” obsessions and overvalued ideation represent two salient phenomena within obsessive-compulsive disorder (OCD) that remain somewhat treatment-resistant. Treatment issues regarding these phenomena are discussed in the context of two clients attending a state health community psychiatry clinic. Both clients displayed significant improvement over the course of treatment on measures of OCD and depression. Pertinent issues are raised concerning the timing of specific treatment components, measurement processes, and the general direction of treatment research in this area.

The present study investigated the effectiveness of a cognitive-behavioural approach to the management of chronic work-related upper limb pain. Clients included three females who had experienced severe upper limb pain for 7, 3.5 and 1.5 years respectively and whose condition had been labelled by medical specialists as occupational overuse syndrome. Clients commenced treatment in a sequential manner, following a staggered baseline monitoring phase in order to produce a multiple baseline design across cases. Treatment involved 8 sessions over a 4-week period, covering pain management procedures, cognitive restructuring of maladaptive cognitions, relaxation training and EMG biofeedback. All cases showed some improvement in pain, distress and interference caused by pain. In addition, changes in depression, anxiety, coping strategies and sleep disturbance were reported. Therapy gains were maintained at the 6-month follow-up assessment for 2 of the 3 cases.

The potential application of behaviour therapy to cross-cultural situations is explored as societies move to recognise their bicultural or multicultural composition. First reviewed are the moral and epistemological underpinnings of behaviour therapy and questions involving the universality of behaviour principles and technologies. Expected competencies of cross-cultural therapists are next raised. The basic message, told through examples from Australia, North American, and elsewhere, is that cultural norms and values penetrate every facet of client–therapist interaction and clinical decision-making. Competently performed functional analyses can produce culturally accommodating interventions that respond to culture-specific definitions of deviancy, accepted norms of role behaviour, expectations of change techniques, and approved behaviour change practitioners.

Despite the very significant proportion of people with panic disorder who have accompanying agoraphobia, there is considerable controversy about the variables that influence the development of this avoidance behaviour. This study investigated whether degree of avoidance is a function of extent of fear and prevalence of negative cognitions about autonomic arousal symptoms and whether the use of, and confidence in, behavioural strategies to cope with panic sensations also influences agoraphobic avoidance. Thirty-nine people who met DSM-IV criteria for panic disorder completed questionnaires measuring fear and negative cognitions about autonomic arousal and panic sensations, and a questionnaire measuring their use of largely behavioural strategies to cope with panic attacks. Fear of autonomic arousal and negative cognitions in response to the occurrence of these arousal symptoms were jointly related to situational avoidance. There was little relationship between the use of, and confidence in, panic coping strategies and less agoraphobic avoidance, although simply allowing panic symptoms to develop and pass predicted less avoidance. The results were interpreted as providing an empirical basis for treatment that reduces fear of panic sensations and allows their experience to be tolerated while preventing escape and avoidance of situations in which panic occurs. There was little evidence that additional teaching of behavioural coping strategies would be useful in reducing agoraphobic avoidance.

This paper falls into three distinct sections. In the first, the attempt is made to discuss those aspects of emotion theory, particularly with respect to the links between emotion and cognition, that have been considered by cognitive-behaviour therapists. In the second, the aim is to describe recent emotion theory which has, in part, been directed towards cognitive-behaviour therapists and others who are concerned with emotional dysfunction, but which has not yet been taken up. In the final section, the goal is more speculative, arrived at through a description of some of the less obvious excursions made by emotion theorists. Although they mostly do not have emotional dysfunction in mind when addressing their theories, their views are, in the belief of the present author, particularly pertinent to the future directions of cognitive-behaviour therapy.

Anxiety sensitivity (AS) is a common vulnerability in emotional disorders. Due to the pathological role of AS, individuals with high AS are faced with emotional problems. Thus, cognitive behavioural interventions try to reduce these problems by targeting AS. The present study aimed to compare the efficacy of transdiagnostic cognitive behavioural therapy (T-CBT) and construct-specific CBT (CS-CBT) on AS, anxiety, depression, and positive and negative affect in these patients. To this end, 40 patients with high AS were randomly assigned to one of the three groups of T-CBT, CS-CBT, and wait list. Participants were assessed using the Anxiety and Related Disorders Interview Schedule for the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Anxiety Sensitivity Index-3, Beck Anxiety Inventory, Beck Depression Inventory-II, and Positive and Negative Affect Schedule at baseline, post-treatment, 3-month follow-up, and 6-month follow-up. The findings showed that T-CBT and CS-CBT have a significant effect on AS, anxiety, and negative affect; however, contrary to T-CBT, CS-CBT is not effective for reducing depression and positive affect. T-CBT had a more promising efficacy than CS-CBT in all treatment outcomes. The results show better and more stable efficacy of T-CBT among patients with high AS. It is essential to consider AS as a target for cognitive behavioural intervention for the spectrum of emotional disorders.

Understanding the psychosocial experiences of women as hospital patients is an important step in assessing the relationship to healthy outcomes of patients' perceived experiences of power and control in hospital. Accordingly, the aims of this study of 124 adult women were (a) to document women's psychosocial experiences during a hospital stay, and (b) to develop and psychometrically evaluate a scale to measure perceived control over treatment, management and daily routine during a hospital stay (Perceived Control in Hospital Scale; PCHS). Women who had experienced a hospital stay of at least one night were surveyed. The qualitative section of the study involved thematic analysis of the written or oral comments of 10 women concerning psychosocial aspects of their hospital experience. Results indicated that the PCHS comprised three factors describing patients' perceptions of their hospital stay: Respect/Communication, Lack of Dignity, and Day-to-Day Control. The survey results showed that although the majority of the women were satisfied with the psychosocial aspects of being an in-patient, there was a substantial core of perceived powerlessness. A significant proportion of women indicated that they either felt “not listened to”, experienced loss of dignity, or experienced unnecessary loss of day-to-day control.

Many constructs used in various areas of psychology often represent some behavioural reality not yet analysed as such. Analyses of behaviours associated with these constructs might profit both behaviour analysis and the other disciplines. This paper provides a behavioural analysis of the construct of ‘empowerment’ found in community psychology. We discuss the implications for researchers attempting to combine behaviour analysis and social action.

The acceptability of three treatments for the maladaptive, but not injurious, repetitive stereotyped behaviour of a mentally retarded child was evaluated. Evaluation was conducted by questionnaires to two groups of staff (nurses and teachers) at two New Zealand institutions for mentally retarded people. A differential reinforcement procedure was found to be most acceptable. A visual screening procedure was judged as being more than moderately acceptable by nurses but less than moderately acceptable by teachers. When visual screening and reinforcement were combined in a treatment package and a rationale for so doing was provided, acceptability was increased significantly for both groups of staff. Teachers rated visual screening, when explicitly prescribed with differential reinforcement, as more than moderately acceptable. The implications of the finding of differential rating of acceptability across and within occupational groups was discussed.

Social anxiety disorder (SAD) is a prevalent chronic condition with a large demand for treatment. This community outpatient study examined the effectiveness of a group intervention version of the established one-to-one cognitive therapy derived from the Clark and Wells model for SAD. Questionnaires were completed pre-treatment and post-treatment for SAD symptoms (Social Phobia Scale, Social Interaction Anxiety Scale), depressive symptoms (BDI-II), self-focused attention, safety behaviours (Social Phobia Weekly Summary Scale and Subtle Avoidance Frequency Examination), and impaired functioning (Work and Social Adjustment Scale). From an initial sample of 159 participants, 101 completed at least seven of the nine weekly group sessions (Mage = 34.1 years, SDage = 10.8 years, 53% female). Significant improvements were demonstrated on all measures. Large effect sizes were found for social anxiety symptoms and safety behaviour use. Self-focused attention, depressive symptoms, and impaired functioning had moderate effect sizes. Effect sizes for anxiety (d = 1.00 and 1.32) and mood measures (d = 0.71) were as high, or in some cases, higher than previous group treatment studies. Results suggest group cognitive therapy for SAD based on the Clark and Wells model is effective in a clinical setting for individuals with moderate/severe and treatment-resistant social anxiety.

Different and evolving conceptualisations of perfectionism have led to the development of numerous perfectionism measures in an attempt to capture the true representations of the construct. It is, therefore, important to ensure that these instruments are valid and reliable. The present systematic review examined the literature for the psychometric properties of the most commonly used general multidimensional trait perfectionism self-report measures. Relevant studies were identified by a systematic electronic search of academic databases. A total of 349 studies were identified, with 38 of these meeting inclusion criteria. The psychometric properties presented in each of these studies were subjected to assessment using a standardised protocol. All studies were evaluated by two reviewers independently. Results indicated that while none of the included measures demonstrated adequacy across all of the nine psychometric properties assessed, most were found to possess adequate internal consistency and construct validity. The absence of evidence to support adequate measurement properties over a number of domains for the measures included in this review may be attributed to the criteria of adequacy used, with some appearing overly strict and less relevant to perfectionism measures. Clinical and research relevance of the present findings and directions for future research are discussed.

Forty-five university students were assigned on a sequential basis to either a face-to-face or a self-help exercise program for 12 weeks. Pretests and posttests included anthropometric and physiological variables, field tests of aerobic capacity, and psychological variables which had previously been identified as predictors of adherence to exercise. Both groups showed significant increases in aerobic capacity and reported increases in general well-being, suggesting that self-help programs may be as effective as more structured interventions in facilitating exercise. However, self-reports 12 weeks later suggested that maintenance was quite poor for both groups. Measures of body composition showed few changes over 12 weeks. Psychological variables generally failed to predict success with either program. It is suggested that variables derived from narrowly social-cognitive approaches to health-related behaviour change may fail to take account of social and environmental constraints which may be important in understanding and predicting maintenance with health-related exercise.