The Self-Regulatory Executive Function (S-REF) model of affective dysfunction (Wells & Matthews, 1994) suggests that metacognitive beliefs are important for initiating and maintaining repetitive thought processes in emotional disorders. Rumination is reported by socially anxious individuals, yet it is not known whether this group endorse positive beliefs about the utility of rumination. We predicted that higher levels of social anxiety would be positively associated with stronger positive metacognitive beliefs about rumination. In Study 1 (N = 250 undergraduates), a measure of social anxiety was positively correlated with a measure of positive metacognitive beliefs about rumination, even when controlling for gender and level of depression. Given this result, we then attempted to replicate the finding in another sample, as well as test whether positive metacognitive beliefs about rumination would mediate the relationship between social anxiety and trait rumination. In Study 2 (N = 124 undergraduates), a social anxiety composite measure was positively correlated with a measure of positive metacognitive beliefs about rumination, even when controlling for gender, level of depression and level of rumination. Positive metacognitive beliefs about rumination were also shown to partially mediate the relationship between social anxiety and trait rumination. These results support the S-REF model and provide a potential account of why socially anxious individuals engage in rumination. Implications for the treatment of social anxiety are discussed.

This article presents a panel discussion on the integration of homework assignments into cognitive behaviour therapy sessions. The panel comprised experts in research and practice who had been invited as keynote presenters for the 32nd National Conference for the Australian Association of Cognitive and Behaviour Therapy. Experts responded to questions about the definition of homework, the mechanism by which homework produces its effects, and the relative importance of homework adherence for effective therapy. Interwoven through the discussion was an emphasis on a collaborative approach to homework, as well as specific recommendations for the integration of homework into sessions. Selected case illustrations were also discussed.

This research aimed to investigate habituation to spider images during an online exposure treatment (www.feardrop.com) among participants with a high fear of spiders. Participants (N = 392) undertook a 10-stage online exposure treatment with a stage length of either 180 or 360 seconds. Four Subjective Units of Distress Scale (SUDS) ratings were taken throughout each stage. Treatment completion was found to be a significant challenge, with less than one-third (30%) completing at least one stage of the program. Those in the shorter stage length condition were significantly more likely to complete the first stage relative to those in the longer stage length condition (43% vs. 16%). SUDS ratings decreased significantly across time at Stage 1, suggesting habituation of self-reported anxiety and there was an overall reduction in SUDS ratings at the second relative to the first stage, suggesting generalisation of habituation. The greatest habituation was observed among those with high anticipatory anxiety (pre-exposure SUDS rating), high total exposure time, and younger age. There was preliminary evidence for improvement in symptoms of spider fear at post-treatment. Directions for future research include strategies to facilitate treatment completion, evaluation of treatment outcomes, and expansion to include a range of specific fears.

The objective of this review is to summarise the evidence for mindfulness and acceptance approaches in the treatment of adolescent depression. The article begins by summarising the outcomes of three broad approaches to the treatment of adolescent depression — primary prevention, pharmacotherapy, and psychotherapy — in order to advocate for advances in treatment. With regard to psychotherapy, we restrict this to comparisons of meta-analytic studies, in order to cover the breadth of the outcome literature. In the second half of this article, we introduce the reader to mindfulness and acceptance-based psychotherapy, with a particular focus on Acceptance and Commitment Therapy (ACT) and the applicability with adolescents. We provide an overview of the philosophical arguments that underlie this approach to psychotherapy and consider how each of these might contribute to treatment approaches for adolescents with depression.

Forty-three youth aged 7–17 years old who fulfilled DSM-IV criteria for assorted specific phobias, were randomised to a one-session exposure treatment, a psycho-education package or a waitlist control conditions. Participants were assessed using semi-structured interviews, self-report measures and an individualised behavioural avoidance test (BAT). Assessments were completed pre- and posttest. At the 1-year follow-up, self-report measures along with a generalised version of the individualised BAT were re-administered. Results exhibited that both active treatment conditions were superior to the waitlist control on the BAT, self-efficacy ratings; however, no significant differences were found on functioning levels and other self-report measures with the exception of the Fear Survey Schedule — Revised. Additionally, no significant differences were found between the two active conditions at posttest or the 1-year follow-up. Implications and future research strategies are discussed.

The current article describes the psychometric properties of the Thought Control Questionnaire (TCQ; Wells & Davies, 1994) in 176 psychiatric inpatients at admission and discharge (352 completed TCQs). Factor analysis revealed four factors; Reappraisal/Distraction, Social Control, Punishment, and Worry. Scale descriptive statistics, reliabilities and correlations with psychiatric symptoms, self esteem, and quality of life supported the use of the TCQ in this setting. TCQ factors were then used as predictors of improvement from admission to discharge. The strategy of Punishment appeared to be unhelpful, with smaller reductions in the use of this strategy from admission to discharge predicting less improvement. Worry appeared to be an unhelpful strategy although the results were less consistent. The strategy of Reappraisal/Distraction appeared to be helpful, and greater increases in the use of this strategy from admission to discharge predicted greater improvement. Social Control also tended to be a helpful strategy although the results were less consistent. Overall, the results support the psychometric properties of the TCQ and are consistent with the notion that the use of certain thought control strategies may contribute to the maintenance of psychopathology while the use of others may contribute positively to treatment outcome.

A variety of cues have been proven to elicit reactivity in nicotine-dependent individuals. Since such reactivity has been shown to form a source of relapse, treatments aim at extinguishing this reactivity. Yet, typically, in cue-exposure treatments a very limited range of relevant stimuli is used, usually focusing only on proximal stimuli (e.g., a cigarette) rather than on contextual cues that trigger craving (e.g., a bar). The restriction to proximal cues may be one of the reasons for the low efficacy of cue-exposure treatments. In the current pilot study (N = 88), we aimed to evaluate the effect on relapse rates of exposure to contextual cues prior to quitting smoking, by varying the degree of exposure/extinction to habitual smoking contexts prior to quitting between groups. Results suggest that context exposure prior to smoking cessation indeed reduces relapse. However, since dropout rates were high, this finding needs replication with a larger sample.

Based on findings from subclinical OCD checking samples (Cuttler & Graf, 2007; 2008), Cuttler and Graf (2009) suggested that checking may develop to compensate for prospective memory failures. The present study provides the first evidence of prospective memory problems in a clinical sample of OCD checkers (n = 26) compared to a group of healthy controls (n = 26). Consistent with earlier work with subclinical samples, the OCD checkers performed more poorly on an event-based, but not a time-based, prospective memory task. However, the OCD checkers did not report more subjective prospective memory failures than controls and their confidence in prospective memory accuracy was higher than that of controls. An explanation of the inconsistent findings with regard to metamemory in clinical and subclinical OCD checking is provided. Further research assessing both subjective memory performance and the strategies understood to support memory is needed to clarify the contribution of prospective memory to OCD checking.

Background: The pervasive tendency to avoid perceived risks has been recently implicated in the maintenance of anxiety pathology, and more specifically, social phobia. Social anxiety symptoms are thus hypothesised to be associated with a global risk-avoidant decision-making bias. Aim: This study investigated: (1) the relationship between risk-avoidance and social anxiety symptoms using both self-report and behavioural measures of risk-taking; and (2) whether risk-avoidance mediates the relationship between a dispositional vulnerability to anxiety (Behavioural Inhibition System [BIS] sensitivity) and social anxiety symptoms. Method: Fifty-five undergraduate students completed self-report measures assessing for social anxiety symptoms, risk-taking across various domains, and BIS sensitivity. Risk-avoidance was also assessed using a behavioural computer task. Results: As hypothesised, risk-avoidance correlated significantly with both social anxiety and BIS. Multiple regression analyses revealed that risk-avoidance served as a partial mediator between BIS and social anxiety. Conclusion: These results confirm the hypothesised relationship between BIS, risk-avoidance, and social anxiety symptoms. Risk-avoidance is one possible mechanism by which personality characteristics may be linked to anxiety pathology.

Relapse prevention (RP) plays a significant role in current treatments and post-treatment approaches to substance abuse problems. It is also widely used in a number of other problem areas, including other addictive behaviours and sexual offending. The widespread use of RP in various fields is due to both its clearly articulated theoretical basis, which has significant face validity, and its transferability into clinical practice. Also, there is a growing (though arguably still modest) body of empirical evidence that demonstrates its efficacy in a range of therapeutic contexts. However, arguably, in terms of both the theoretical underpinnings and the practical application of RP there is room for improvement. This article hypothesises that one of the key weaknesses of RP is that it takes a generally unconstructive approach to the therapeutic process through the use of negative concepts and avoidance goals. It is suggested that a ‘good lives’ framework of psychological wellbeing can provide a means of remedying these weaknesses of the traditional RP model. It is argued that a good lives framework can lead to a more optimistic approach to the prevention of relapse among individuals with substance use problems.

This study investigated the relationship between attachment, mood and deliberate self-harm (DSH) in a nonclinical population (n = 114). In addition to a range of risky behaviours, the most commonly reported DSH behaviours were Head-banging (47%), Hitting (46%), Scratching (38%) and Cutting (34%). Those who engaged in DSH had poorer quality of attachment to both parents but not peers, and higher levels of depression, anxiety and stress. Path analysis was then used to examine the interaction between attachment, mood and DSH. The impact of the quality of attachment on DSH was found to be mediated by stress, which suggests that DSH may be a maladaptive coping mechanism. Attachment to father and peers was found to be more influential than attachment to mother. Our findings suggest that DSH may be more prevalent in the community than previously recognised, and that attachment, which is currently neglected in DSH research, warrants further investigation in both clinical and nonclinical populations.

Sexual offending is frequently seen by the lay person as being a result of an innate abnormality that is relatively fixed and unchangeable. Accordingly, sexual offenders are seen as more likely to recidivate than other types of offenders. In fact, this is not the case, and most sexual offenders do not re-offend. Also, contemporary research has shown that treatment programs driven by cognitive behaviour therapy significantly reduce rates of sexual offender recidivism. Nevertheless, while there has been a great deal of research on the treatment of child sexual offenders, the treatment of rapists has received comparatively less attention. Thus, the main aim of this article is to summarise current knowledge of sexual offender treatment, paying specific attention to the needs of rapists. In particular, we pay attention to the content of sexual offender treatment programs, and the relevance of this content to rape. We also discuss therapeutic issues of relevance for rapist treatment that are typically ignored or underestimated in the research literature. Finally, based upon our analysis of the literature, we present a schematic overview of rape treatment and identify important areas for further research.

In a pilot evaluation study, effectiveness of a 20-week dialectical behavioural therapy (DBT) skills training group program was explored for adult clients with borderline personality disorder (BPD; N = 140). Subjective ratings of depression, anxiety and BPD symptomatology were obtained pre and post group therapy. Objective measures of service utilisation levels were obtained for the 6 months prior to group therapy, the duration of therapy, and the 6 months following therapy. Group completers (n = 68) showed reductions in depression, anxiety and BPD symptomatology, as well as in the number of emergency department attendances. Completers with previous high service utilisation had decreases in telephone counselling calls and inpatient days during therapy, and fewer emergency department attendances post therapy. Completers had larger decreases in service utilisation than noncompleters (n = 72). Simultaneous engagement in individual DBT was related to higher group completion than was individual therapy as usual, but it did not impact on level of service utilisation or psychological functioning. This quasi-experimental pilot study suggests that DBT groups may improve psychological functioning and decrease service utilisation for BPD clients, particularly those with high service utilisation. The treatment warrants systematic evaluation.

This study examined the relationships between obsessive-compulsive symptoms (OCs) and encoding style in a subclinical sample, by using a questionnaire that evaluates the extent to which preexisting schemata (versus cues from the outside world) affect encoding processes (Lewicki, 2005). Research on encoding style has revealed on one hand the existence of individual differences in the tendency to impose interpretive schemata in the process of encoding, and on the other hand the fact that an extremely internal mode of encoding has been found to be related to an increased propensity to self-perpetuate preexisting schemata. Furthermore, internal encoding may contribute to the development of psychopathological symptoms, through the self-perpetuation of dysfunctional schemata. The results confirmed that OCs are connected with an internal encoding style; specific relationships between obsessive-compulsive disorder (OCD) dimensions and internal encoding style were also found. These results are discussed in terms of the role of encoding style in the perpetuation of OCs, and its relationship to the dysfunctional beliefs characterising OCD.

The study investigated if the degree of personality pathology among people with clinical levels of social anxiety disorder was similar to those with personality disorders more generally, if the degree of avoidant personality pathology was correlated positively with Neuroticism and negatively with Extraversion and facets of Agreeableness (particularly Trust), and finally if scores on the relevant personality dimensions improve from pre- to post-treatment. Changes in Neuroticism, Extraversion, and Agreeableness were examined following group treatment for social anxiety disorder. The current study employed a within-subjects repeated-measures design (N = 25) to investigate whether these traits can be changed by group treatment for social anxiety disorder. A measure of personality disorder pathology was found to correlate positively with Neuroticism and negatively with Agreeableness in the absence of significant relationships with other Five-Factor Model traits. Treatment was associated with significant reductions in Neuroticism and there was significant improvement of the Trust facet of Agreeableness. These results are discussed in terms of the way that group treatment for Social Anxiety Disorder may be enhanced.

The presence of psychotic-like experiences in the general population has been amply reported. Nevertheless, the degree of concern or anxiety that such experiences may generate is an aspect that has not received as much appraisal. In this sense, mindfulness is an approach to intervention based on the modification of the individual's relationship with the symptoms, instead of their elimination. The goal of the present study is to compare the effect of mindfulness training on distressing hallucination-like experiences. Eighteen participants were assigned to the experimental group, and they received 8 sessions of mindfulness training; 20 participants were assigned to a control group that viewed 8 sessions of a video forum. The results showed that upon completing the mindfulness training, there was a significant and large effect on the decrease of anxiety caused by hallucination-like experiences. These results were maintained at the 16-week follow-up. The repercussions of these results are underlined.

Obsessive–compulsive disorder (OCD) is an important mental health problem. The Australian National Survey of Mental Health and Wellbeing estimates the 12-month prevalence of OCD is 1.9% (Australian Bureau of Statistics, 2007). Individuals with OCD experience considerable impairment in daily functioning. Cognitive and behavioural therapy for OCD has been shown to be effective, however, accessibility to evidence based treatments is limited in Australia, especially for those living in rural and remote communities. Treatment delivered in a remote fashion may improve accessibility to such treatments. The present review aimed to evaluate the current status of evidence based treatments for OCD delivered remotely.

This study examined, first, effectiveness of a brief behavioural activation treatment for depression, in which participants engaged concurrently in activities of various difficulty instead of a standard least-to-most difficult sequence; and second, the relationship between behavioural self-observations of changes in activity levels and depressive symptomatology. Two adults with mild to moderate BDI-II depressive symptoms participated in a with-in participant multiple baseline study that contained 8 weekly conjoint sessions. Results showed that depression decreased to minimal levels at posttreatment and 1-month follow-up as a function of increases in activities of various difficulty. Results suggest early initiation of more difficult activities, and corroborate the relationship between increased activities and decreased depressive symptoms.

The general aim of this study was to examine the predictive value of both teachers' causal attributions for behavior problems and perceived efficacy for class management for forms of intervention used in the classroom and cooperations preferred in order to get help for students' problem behaviour. Primary school teachers (N = 249) were asked to rate 12 factors as the possible cause of the behaviour problem described in a vignette, and evaluate 19 statements referring to the intervention strategies they would use, as well as the cooperations they would prefer in order to respond effectively to the problem in the vignette. They also completed an 8-item questionnaire measuring perceived efficacy for class management. The teachers' responses were found to be associated with their teaching experience. Both causal attributions for behaviour problems and perceived efficacy for class management predicted specific interventions. Results are discussed in terms of their implications for future research and teacher education.