The successful resolution of a problem of school phobia using self-management strategies is reported. The clinical report is prefaced by the observation that differences of emphasis are apparent when authorative reviews of the field of self-management are considered—and the conclusion drawn is that the successful outcome could be used to lend support to Kanfer's two-stage model of self-regulation. The client, Anne, was a pupil in the first year of comprehensive schooling. She attended school on only four days during the first term. Problem analyses in terms of operant and classical learning theories are described, and intervention strategies were generated which were accommodated within Kanfer's two-stage model of self regulation. Anne self-recorded school attendance, lesson attendance and self-confidence. School attendance was immediately achieved and progress towards full lesson attendance was made over a seven-week period. Affective state (self-confidence) as assessed by self-report was observed to increase as lesson attendance improved but a temporal lag was observed. The report concludes with some observations of a theoretical nature and justification for the intervention to warrant the descriptor “self-management”.

A DRO approach was used to teach positive social behaviours in a young woman with mental handicap, and to decrease aggressive and disruptive behaviours. Reprimands were used on a few occasions for serious problem behaviours and did not result in an increase in these behaviours. As the problem behaviours receded the young woman became apparently happier and developed better relationships with her family, peers and Centre staff, and the improvement has been maintained over three years.

This paper presents a single case study of a patient with compulsive hairpulling (trichotillomania) of 16 years' duration, who was successfully treated using electric aversion therapy. All previous attempts at treatment and self-help had been unsuccessful. A behavioural self-control programme was tried initially with some success, but the progress was not maintained following an unplanned break in treatment and this treatment was ineffective when reinstated. Electric aversion therapy eliminated hair pulling almost immediately and the results were maintained on follow-up, with the exception of a minor relapse at a time of stress.

The 28 patients in the Linton et al. (1985) outcome study were contacted for a 20-month follow-up. The follow-up was superimposed on a three-group design consisting of a waiting-list control, a regular treatment group, and a “behavioural” group receiving the regular treatment plus applied relaxation and operant-activities training. Measures similar to the ones used in the original study were employed, in addition to a follow-up questionnaire concerning work, health status, activity level, pain ratings, medicine use, and sleep. Ninety-three per cent of the original patients participated in the follow-up. In general, improvements were maintained by the behavioural group. Specifically, results indicated that the group receiving applied relaxation and operant-activities training had significantly larger improvements with regard to pain and activity at follow-up than the control groups. Moreover, an overall analysis of variance showed that the behavioural group differed significantly from the other two groups. The results definitely suggest that the positive effects of the behavioural programme were maintained at follow-up.

A problem behaviour which had been maintained on a variable reinforcement schedule was first put onto a continuous schedule and subsequently treated by extinction. The rapid response to extinction was judged to have been due to the prior move to a CRF schedule. Reasons for the emergence and maintenance of problem behaviours in certain situations are discussed.

The effect of subvocalisation on reading speed and comprehension is briefly reviewed. Reading speed is slowed by subvocalisation but comprehension and retention of complex material is improved. In this single case study the activities of the laryngeal and mylohyoid muscles were recorded during reading and other activities. Through electromyographic biofeedback the patient learnt to reduce muscle tension and to discontinue the long term habit of subvocalisation.

The latency of the self-injurious behaviour of a severely handicapped, Down's-syndrome boy, aged 9 years, was increased by a factor greater than three. Vibration was presented as the reinforcer in a discrete-trial, DRI-schedule procedure in which the incompatible response was physically prompted. A single-subject, ABAB design was used. It is suggested that the DRI schedule used in this way is a valuable initial procedure for decreasing self-injurious behaviour to a level where other procedures may then be applied.

The dry bed approach, described by Azrin et al. (1973) as a highly successful way of bringing about night toilet-training in people with mental handicaps, is not always feasible. An alternative method, progressive lifting, was undertaken in a small group home to train a young man. Although very lengthy (lasting two years), the programme was successfully carried out by sleep-in staff who worked normal daytime shifts throughout.

A mother was taught to modify her interactional style with her language-delayed son, using direct feedback via a bug-in-the-ear and video recordings. Results showed that attending to and praising the child's behaviours and imitating vocalisations increased, while commands, questions and reprimands decreased. Methods of dealing with tantrums were taught but no occasion arose during the teaching for putting them into practice. Follow-up two years later showed Stephen making good progress, while neither his mother nor his school had needed any further outside help for him.

A case study is described which illustrates the use of behavioural techniques in a family intervention where the patient had been diagnosed as having schizophrenia. The relative merits of behavioural techniques and the difficulties encountered in applying them are noted.

A woman with moderate mental handicap was taught to use a public telephone. The project involved teaching, first, recognition of some numbers, using a stimulus-shaping procedure; and second, the steps involved in using a public call box. Such difficulties as were encountered in the project were not those anticipated, underlining the need for individually tailored programmes of teaching for people with mental handicaps.

Hand-laundering of tights and knickers was taught to a woman with moderate mental handicap. The 14-stage programme was taught over five sessions in a total of 90 minutes. At follow-up she was shown to have both maintained and generalised the skills.