It can be argued that an individual’s subjective experience and beliefs about a substance are important. Motives and expectancies regarding the use of alcohol and drugs are often that they are going to modify a cognitive state or help them cope with a particular situation. However, there are growing concerns in the U.S.A. and in the U.K. regarding individuals who experience psychosis and concurrently use substances. Correctly diagnosing individuals with dual presentation is said to be difficult, engagement in treatment is problematic, and medication adherence and prognosis poor. In this paper a cognitive-developmental model is proposed. I suggest that for individuals who experience psychosis and also use drugs or alcohol, the ability to identify the relationship between the substance use and the psychotic illness in terms of a case formulation/conceptualization would provide a good starting point for developing strategies and interventions that are most likely to succeed in treatment. Such an approach would explicitly address key cognitions. Unless the dysfunctional substance-related beliefs are addressed, adherence to medication and engagement with treatment services will be hindered and the possibility of relapsing to problematic substance use and acute psychosis remains. A cognitive treatment component, to target these beliefs, based on the cognitive model of substance misuse and the motivational interviewing approach will also be briefly outlined.

Psychological treatment that reduces anxiety has been found to be beneficial to benzodiazepine withdrawal. High drop-out and relapse rates, however, have also been reported. They might be due to a heightened anxiety level maintaining the drug-taking habit or to the addictive potency of the drug, which is not addressed by the intervention strategies. In the present study, initial assessment data were compared among treatment refusers, drop-outs and completers – successful as well as unsuccessful ones – of a psychological treatment programme in support of benzodiazepine withdrawal. Treatment refusers showed a more negative current mood state than those consenting to treatment. Internal locus of control was predictive of premature termination and unsuccessful completion of the treatment trial. Neither medication-related variables nor anxiety or depression were found to influence the success of treatment. Perceived control over medication intake is thought to reduce compliance with the treatment regimen – a pattern that may be consistent with the addiction hypothesis.

This study investigates whether large-scale, day-long stress management workshops open to the general public can work as well as small, weekly groups run for referred clients. It is suggested that the self-referral route may enable some people who might otherwise have been ‘‘filtered out’’ from the traditional health services to get help for their stress-related problems. Analysis showed that the large-scale format was just as effective with a more distressed subgroup as was the small weekly format for formally referred clients, which suggests that the effectiveness of this approach is not only related to a restricted client group. It would appear that the low drop-out rate, the effectiveness of the workshops and the severity of problem handled within this format indicates potential value in this type of approach.

While treatments for Generalized Anxiety Disorder have considerably improved recently, they remain less effective than similar treatments for other anxiety disorders. This paper reports on a comparative outcome study of a large group didactic therapy specifically designed to teach patients to “become their own therapists” in an attempt to counter the relapse problems commonly associated with this condition. The data suggest that improvements noted at six month follow-up are maintained at two years. Suggestions are forwarded to explain the lack of differential responding found among different therapy approaches.

The French version of the Social Interaction Self-Statement Test (SISST) was studied in 95 social phobia and 87 non-clinical subjects. Total scores on both positive and negative scales significantly discriminated social phobics from non-clinical control subjects. Social phobics had higher scores than controls on negative statements and lower scores on positive statements. The positive and negative subscales of the SISST for social phobic patients were correlated with anxiety, depression and avoidant behaviours. The negative subscale was significantly sensitive to change in patients with social phobia receiving cognitive behavioural therapy. Our findings showed good convergent and discriminant validity of the SISST and the sensitivity of the negative sub-scale to improvement after cognitive behavioural therapy.

A 34-year old woman with Generalized Anxiety Disorder and recently diagnosed multiple sclerosis was treated in a single case design. The case formulation approach was used to assess and integrate the various difficulties reported by the participant. Treatment interventions targeted intolerance of uncertainty, overestimation of the utility of worrying, problem orientation, and problem solving. Results indicated a decrease in the tendency to worry. Difficulties in the application of typical interventions for Generalized Anxiety Disorder to people with multiple sclerosis are discussed and suggestions are provided.

The present study used two single case studies to evaluate clinical improvement as a result of cognitive behavior therapy in panic disorder with or without agoraphobia (PDA). A special emphasis was placed on assessing the reduction in catastrophic cognitions, which are considered to be of prime importance in PDA. Multiple measures were employed, during pre and post treatment and at a six month follow-up. Data from self-report questionnaires, physiological measures and cognitive sampling during in vivo exposure were used. Convergent results demonstrated clinical improvement and supported the importance of catastrophic cognitions in the process of change for treatment outcome of PDA.