Health anxiety (HA) is common in psychiatric and medical settings. Cognitive models of HA highlight the role of misinterpreting physical sensations as dangerous. This report presents the case of a 31-year-old man and the use of a cognitive-behavioural approach to treat his HA which also considers the role of misinterpreting intrusions as abnormal, by drawing on theoretical accounts of obsessive-compulsive disorder (OCD). A single-case experimental design demonstrated reliable improvements in symptom measures of HA and general distress. Distinguishing sensation-based versus intrusion-based appraisals in HA has implications for interventions in health settings and for refining cognitive theory.

Clinical practice offers the opportunity for the clinician to be a scientist-practitioner in the workplace. This, in turn, facilitates building practice-based evidence. But this can only occur if the effects of the interventions are objectively and systematically evaluated. To this end, single-case methodology is a valuable tool to implement an intervention in a scientifically rigorous manner and gather data on treatment effectiveness. It is possible to incorporate single-case methods into routine clinical practice by using a few simple strategies. This paper examines the ways in which single-case methodology departs from (a) routine clinical practice and (b) the familiar between-groups research design, such as the randomised controlled trial. It presents five practical strategies that will bridge the gap between routine clinical practice and single-case methodology. The Model for Assessing Treatment Effect is described as providing context for and a framework to self-evaluate the scientific rigour in clinical practice and benchmark service delivery.

This paper presents a unilevel and multilevel approach for the analysis and meta-analysis of single-case experiments (SCEs). We propose a definition of SCEs and derive the specific features of SCEs’ data that have to be taken into account when analysing and meta-analysing SCEs. We discuss multilevel models of increasing complexity and propose alternative and complementary techniques based on probability combining and randomisation test wrapping. The proposed techniques are demonstrated with real-life data and corresponding R code.

Comorbid anxiety and mood disorders are common but the majority of treatments tend to focus on a particular diagnosis. Previous research has found that cognitive behavioural therapy (CBT) targeted at a specific diagnosis can lead to improvements in comorbidities, especially in the case of CBT for panic. However, there is an emerging evidence base that transdiagnostic CBT, which addresses common underlying processes across presenting problems, may be effective at treating comorbidities simultaneously. Given the simple nature of the cognitive formulation of panic it is arguable that a panic-specific CBT intervention could help socialize patients to CBT before progressing to a transdiagnostic approach. This paper uses a single-case experimental design to illustrate an example of using diagnosis-specific CBT as a springboard to transdiagnostic CBT with a patient presenting with panic and agoraphobia, social anxiety, depression, uncontrollable worry, suicidality, self-harming behaviours and a history of bulimia. Results suggest that this was a well-received and effective intervention. Clinical implications are discussed as well as limitations and directions for future research

The use of a mnemonic cueing system (NeuroPage®) and a paper and pencil checklist in the rehabilitation of executive problems in a 50-year-old woman are described. Following a CVA 7 years earlier, the patient, despite intact general intellectual and memory functioning, had specific executive impairments of attention, planning, realizing intended actions, and also exhibited behavioral routines similar in form to obsessive–compulsive rituals. In a series of ABAB single-case experimental designs, the efficacy of 2 external cueing systems in prompting appropriately timed action is demonstrated. It is argued that the combination of external control and increased sustained attention to action were critical to the success of NeuroPage with this patient. Furthermore it is hypothesized that the checklist was effective in facilitating the patient's ability to foresee and recognize the consequences of her actions, which in turn had an impact on the probability of her changing those same actions. (JINS, 1998, 4, 399–408.)