Background: Whilst effective psychological treatments such as CBT-I have been developed for insomnia, few services provide CBT-I and awareness of CBT-I is low among referrers. In addition, men tend to seek help less frequently for their insomnia than women. This paper describes the development and evaluation of psycho-educational CBT-I workshops, each for up to 25 people, and designed to be acceptable to men. Method: The CBT-I programme was based on Morin and Espie (2003), and adapted into a self-referral one-day workshop format designed specifically to improve access. Workshops were held on Saturdays in leisure centres. A one group pretest-posttest design was used and assessments were collected before and 6 weeks after each workshop. Over a 6-month period, 74 men self-referred, and attended the Introductory Talks preceding the workshops. Of these, 49.3% had never sought help from their GP, 66.2% suffered from clinical insomnia (ISI) and 61.6% were experiencing elevated depression symptoms (BDI over 10). Results: At follow-up, the workshops were found to be effective in reducing insomnia and depression. Satisfaction ratings with the workshops were very high. Conclusions: Given these promising results, further work is now proposed for a larger controlled study with a longer-term follow-up.

Background: Accumulating research indicates posttraumatic stress disorder (PTSD) is a universal phenomenon. However, it remains substantially unknown as to whether the processes implicated in the aetiology and maintenance of PTSD are culturally similar. Aims: This study investigated the impact of cultural differences in self on negative cognitive appraisals in those with and without PTSD. Method: Trauma survivors with PTSD and without PTSD from independent and interdependent cultures (N = 106) provided trauma narratives. Narratives were coded for negative cognitive appraisals (mental defeat, control strategies, alienation and permanent change) as in Ehlers and colleagues' previous work. Results: Replicating Ehlers and colleagues' work, trauma survivors with PTSD from independent cultures reported more mental defeat, alienation, permanent change and less control strategies than non-PTSD trauma survivors from independent cultures. In contrast, for those from interdependent cultures, only alienation appraisals differentiated between trauma survivors with and without PTSD. Those with PTSD had more alienation appraisals than those without PTSD. Conclusions: The findings suggest cultural differences in self impact on the relationship between appraisals and posttraumatic psychological adjustment. Theoretical and clinical implications are discussed.

Background: Factors that distinguish depressed individuals who become hopeless from those who do not are poorly understood. Method: In this study, predictors of hopelessness were examined in a sample of 439 clinically depressed adolescents participating in the Treatment for Adolescents with Depression Study (TADS). The total score of the Beck Hopelessness Scale (BHS) was used to assess hopelessness at baseline. Multiple regression and logistic regression analyses were conducted to evaluate the extent to which variables were associated with hopelessness and determine which cluster of measures best predicted clinically significantly hopelessness. Results: Hopelessness was associated with greater depression severity, poor social problem-solving, cognitive distortions, and family conflict. View of self, view of the world, internal attributional style, need for social approval, positive problem-solving orientation, and family problems consistently emerged as the best predictors of hopelessness in depressed youth. Conclusions: Cognitive and familial factors predict those depressed youth who have high levels of hopelessness.

Background: This paper investigates the relationship between care staff perceptions' of self-harm behaviours presented by adult and adolescent inpatients and the emotional responses and helping behaviours of the staff. Method: Seventy-six nursing staff participated, including qualified and unqualified staff, who worked in either adolescent or adult secure inpatient settings within a single organization. Participants completed vignette, knowledge, and attitudes questionnaires, related to working with patients who display deliberate self-harm. Results: Further support was found for attributional theories suggesting that views on deliberate self-harm are linked to propensity to help, and that emotional responses can be a mediating factor. Staff who reported feeling more negative about patients who self-harm reported more worry about working with this patient group. Unqualified nursing staff reported more negativity and worry than qualified staff. Neither gender nor length of work experience was found to be significant factors. Conclusions: These findings indicate that training and support should be aimed at helping nursing staff, particularly unqualified staff working in inpatient settings where self-harm is frequent, feel more positive and less concerned about working with patients who self-harm. Such needs of unqualified nursing staff have not been highlighted in previous research.

Background: Perceptual Control Theory (PCT) suggests that psychological distress can be conceptualized as the by-product of conflicted control systems. Method: Using a program of psychotherapy based on the principles of PCT called the Method of Levels (MOL), a 12-month study was conducted with 120 patient participants and 4 clinicians. In this study, analyses of statistical significance were conducted. Qualitative data were also analysed to understand psychotherapy from patients' perspectives. Data were collected on the attendance patterns of patients, their ages, referral problem, and socio-economic background. A standardized questionnaire measured pre and post treatment effects. The null hypothesis of no difference between pre and post treatment scores was examined by the derivation of p values and the construction of 95% confidence intervals. Results: In all cases the null hypothesis was rejected. Conclusions: Results suggest that MOL is a useful form of psychotherapy that warrants further investigation.

Background: This paper draws on cognitive psychology research and clinical observation to propose a model for the formation of auditory hallucinations that are located externally, and experienced in noisy environments. Method: This model highlights a series of cognitive processes that may make an individual prone to detecting false positives, i.e. believing they have heard something that is absent. A case study is used to illustrate the model. Results: It is suggested that the false positives may be a by-product of a perceptual system that has evolved to reduce false negatives in conditions of threat. The term hypervigilance hallucination is proposed for this type of experience. Conclusion: The clinical implications of the model are discussed.

Aims: The present study aims to determine whether cognitive-behavioural minimal contact bibliotherapy is acceptable to participants suffering from DSM-IV-TR hypochondriasis, and whether this intervention is able to reduce hypochondriacal complaints, as well as comorbid depressive complaints and trait anxiety. Method: Participants were assigned to either an immediate treatment condition, or subsequently to a waiting list condition. Participants were sent a book, Doctor, I Hope it's Nothing Serious?, containing cognitive behavioural theory and exercises. Measures were taken pre, post and at follow-up (after 3 months). Those in the waiting list group received a second pre-assessment, and were then enrolled in the bibliotherapy. Results: Results showed that participants were accepting of the cognitive-behavioural theory. Furthermore, results showed beneficial effects of the intervention: all effect measures decreased significantly over time, with the largest effect at post-assessment. However, a large amount of questionnaires were not returned. Conclusion: It is concluded that bibliotherapy may be an efficient aid in reducing hypochondriacal and comorbid complaints, but due to data attrition and methodological flaws should first be studied further.

Background: The term “socialization to the model” is frequently used in the Cognitive Behavioural Therapy (CBT) literature, but it is unclear exactly what constitutes socialization to the model and there is a paucity of research in this area. Aims: This study aimed to develop a working definition of “socialization to the model”. Method: A three-round electronic Delphi technique was used to generate data and to achieve a consensus agreement amongst a panel of experts (N = 9) in response to two questions pertaining to what constitutes “socialization to the model”. Results: All elements generated in response to the primary question at the first round were retained throughout and scored an IQR of ≤1 at the final round, indicating a consensus that all elements were either essential or important to accurately defining socialization to the model. The panel also reached a consensus on five elements considered to be “indicators” of socialization to the model, the secondary question. Conclusions: A working definition of socialization to the model is presented and discussed. This definition has implications for both clinical practice and research.

Behavioural and Cognitive Psychotherapy is an international multidisciplinary journal for the publication of original research, of an experimental or clinical nature, that contributes to the theory, practice and evaluation of behaviour therapy. As such, the scope of the journal is very broad and articles relevant to most areas of human behaviour and human experience, which would be of interest to members of the helping and teaching professions, will be considered for publication.