This study describes, and examines the initial efficacy of, a sleep therapy programme developed for cancer patients with insomnia. The six-session group programme included stimulus control therapy, relaxation training, and other strategies aimed at consolidating sleep and reducing cognitive-emotional arousal. The 12 final participants were patients of a regional cancer centre; mean age was 54.7 years (S.D. 10.4); median time from cancer diagnosis was 33.6 months; all had high performance status. Participants kept sleep diaries and rated their sleep quality, mood and functioning at baseline, week 4 and week 8. Significant improvement over baseline was observed at weeks 4 and 8 in the number of awakenings, time awake after sleep onset, sleep efficiency, sleep quality ratings, and scores on European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30 role functioning and insomnia. Total sleep time and fatigue were significantly improved at week 8. The sleep therapy programme was associated with improved sleep, reduced fatigue and enhanced ability to perform activities in relatively well individuals attending a cancer centre. This is preliminary evidence of the efficacy of the programme. Further research is required to examine the programme's effectiveness and suitability for a wider range of people with cancer. Options for providing cancer patients with access to nonpharmacologic treatments for insomnia are discussed.

A number of studies have linked the development of substance abuse problems to a lack of purpose or meaning in life, and a few studies have demonstrated an increase in sense of life purpose through substance abuse treatment programmes. The present study extended past research by examining the relationship of purpose in life to treatment outcome assessed three months after completion of treatment. The subject sample comprised 131 people in in-patient treatment programmes or awaiting treatment for alcoholism (in some cases in addition to other drug addictions). Consistent with previous research, the mean Purpose in Life Test (PIL) score before treatment was significantly below the normal range and the mean PIL score at the end of in-patient treatment was within the normal range. Furthermore, the PIL score at the end of treatment was predictive of changes in intimate relationships and health at follow-up. It was also predictive of follow-up drinking/drug use status. However, the pattern of prediction differed in the two treatment groups. Post-treatment PIL score was a positive predictor of improvement in a skill-based treatment centre, and a negative predictor in a more authoritarian, confrontation-based programme. The distinction between internally and externally derived senses of meaning is presented as one possible explanation of these findings.

This article reviews the literature on relationships between patient characteristics and outcome of inpatient treatment for alcoholism. The article is organized according to categories of patient variables which have been studied. These include psychological characteristics, demographic variables, degree of alcohol dependence, motivation for treatment, coping styles, and beliefs about abstinence from alcohol. Conclusions based on the studies reviewed are presented, along with a discussion of why definitive conclusions are rare in the field of alcoholism treatment research. Conceptual and methodological issues in this research area are highlighted in attempting to come to some coherent and integrated conclusions regarding the current state of knowledge, and directions for current and future research are discussed.

The hypothesis that clinicians' perceptions of psychological maladjustment are related to the deviation of symptoms from prevailing gender role stereotypes was explored. Case history descriptions were sent to a random sample of practicing psychologists. These clinicians viewed female patients with "masculine" symptoms (e.g., alcoholism or antisocial behavior) as more psychologically disturbed than males with the same symptoms; they also perceived male patients with "feminine" symptoms (e.g., depression and anxiety) as more psychologically disturbed than their female counterparts. Significant main effects for psychologists' sex were found for both the perceived usefulness of drug treatment and prognostic outlook ratings.

A pilot outpatient group for patients with anorexia nervosa was developed and co-led by a dietitian and a psychologist on a general hospital eating disorders team. The main goal of the short-term nutrition and behaviour change group was weight gain through normalization of eating. The first three groups conducted in the clinic were evaluated by monitoring group members' weights, collecting pre-treatment and post-treatment scores on the Eating Attitudes Test-26, and comparing earlier and later food records. The mean (+/- standard deviation) patient weight gain per eight-week group cycle was 1.6 (+/- 1.9) kg (p<0.05) and the Eating Attitudes Test-26 score change was -17.1 (+/- 11.5) points (p<0.01). Statistically significant changes were found in consumption of calories (p<0.01), fat (p<0.005), and protein (p<0.02). This treatment approach warrants further refinement and investigation.