The literature supports the existence of the phenomenon termed cognitive dissonance, and one can distil the principles underlying its production, maintenance and reduction. This body of literature may provide insights into the conduct of therapy generally, as well as into the mechanisms of specific therapies which may guide modifications or development of alternative interventions.

The concept of cognitive dissonance can clearly be seen to be of use in understanding the mechanism of action of MI. It can further be of use in guiding modifications to this existing intervention. This concept, and others available through the experimental psychological literature, can be of use in all branches of clinical psychology.

A clinical study was carried out to determine if parental presence during dental treatment alters the child's behaviour when compared with parental absence. Thirty-two children who attended with a parent for a dental recall visit were randomly assigned to a parent present or a parent absent group. The age of the children ranged from 4 to 12 years. Twenty-three mothers and nine fathers attended during the study. Those parents absent during the visit viewed proceedings from behind a one-way mirror. Each visit was standardised in procedure and recorded on video tape. The results showed that 4 to 8-year-old children exhibited significantly more negative behaviour, regardless of parental presence, than the 9 to 12-year-olds. The presence of the parent did not lead to significantly greater negative behaviour. The parent's need to see what happened during the visit and the child's need to have a parent present were the most important reasons for having a parent present. Parents viewing from behind a one-way mirror were as satisfied with their position as parents who had been actually present in the surgery.

The psychological well-being and job satisfaction of nursing staff working on long stay wards for the elderly confused were examined in one health district. Feelings of well-being were not related to job satisfaction. However, feelings of unhappiness were found to be related to job dissatisfaction, this relationship was found in the ward managers (predominantly males) and not other qualified or unqualified staff. The implications of this finding are discussed.

The effect of Community Care Policies upon staffing levels within institutions is potentially problematic; wider job opportunities becoming available to nurses as community provision increases. The job satisfaction of nurses still working within institutions must, therefore, be an issue of importance in the maintenance of suitably qualified and experienced staff. This study examines the differing amounts of job satisfaction reported by a sample of 59 nurses all working on long-stay wards for the elderly, mentally ill; located within three different institutions. The results show that the measures selected for use have high content and face validity for this population. The effects of institutional and staff management are highlighted as being major influences upon the degree of job satisfaction.