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The purpose of this paper is to critique the current manner in which cognitive behavioural therapy (CBT) is delivered, with a focus on the impact of evidence-based practice.

This paper is based upon the experiences, ideas and clinical practice of the authors.

The reductionist approach based on psychiatric diagnosis is put forward as the mechanism by which CBT has gradually lost its status as a form of psychotherapy.

An alternative framework based on revitalising CBT as a client centred, problem-based and formulation driven form of therapy is put forward.

Research demonstrates that non-attendance at healthcare appointments is a waste of scarce resources; leading to reduced productivity, increased costs, disadvantaged patients through increased waiting times and demoralised staff. The purpose of this paper is to investigate non-attendance and implemented interventions to improve practice.

A mixed methods service audit took place in a primary care psychological therapies service. Existing service guidelines and reporting systems were reviewed. A cross-sectional design was used to compare a year’s cohort of completers of cognitive behavioural therapy (CBT) (n=140) and drop-outs (n=61).

Findings suggested contrasting guidelines and clinically inaccurate reporting systems. The overall service did not attend (DNA) rate was 8.9 per cent; well below rates suggested in the literature. The drop-out rate from CBT was 17 per cent. The most influential factor associated with CBT drop-out was the level of depression. The level of anxiety, risk ratings and deprivation scores were also different between completers and drop-outs. The main reasons given for non-attendance were forgetting, being too unwell to attend, having other priorities, or dissatisfaction with the service; again these findings were consistent with prior research.

A range of recommendations for practice are made, many of which were implemented with an associated reduction in the DNA rate.

This paper aims to explore the experience of living with scars from self-injury; how people who self-injure (SI) make meaning of their scars and how these scars are a part of the identity construction process.

It is observed that 60 entries, from 25 online narrative blogs detailing the experience of living with self-injury scars, were analyzed using a contextualized thematic analysis informed by an embodied perspective.

The analysis generated two dominant themes: temporal aspects of identity; and social stigma and scars.

Far-reaching consequences of self-injury scars on the daily lives of people who SI was found. This included a person’s posture, clothing, choices of career, inclusion in family life, leisure activities and relationships; all of which have corollaries in emotional and psychological well-being. Scars were found to be self-narrative with particular salience given to how scars represented healing. Novel findings included the central role scars played in the resistance of self-injury stigma.

The IAPT programme has been rolled out across England in the last ten years. Although undoubtedly many people have benefited from having greater access to psychological therapy there are several issues with the practicalities of Improving Access to Psychological Therapies (IAPT) and also with its ideology. The paper aims to discuss these issues.

This is a personal reflection of working within the IAPT system for several years. Significant statements heard or interpretations of what has been said are presented alongside an analysis of the implications.

A number of important concerns are presented. The overarching concept of the “McDonaldization” process is discussed as a way of encapsulating the IAPT experience; with its theoretical reliance on the medical model and the real world impact of tendering for services in the modern NHS. The impact of IAPT on cognitive behavioural psychotherapy is also highlighted.

A lot has been written in the press and online about IAPT. Many of the criticisms seem to derive from people outside of the IAPT system, many of whom have their own personal or professional agenda for attacking IAPT and Cognitive Behavioural Therapy (CBT); often the criticisms are uninformed. This paper is a reflection of working within the IAPT system and not just an uninformed critique of CBT. Several concerns are raised that without remedy may seriously hold back the progress that psychological therapy has made in recent years.

There is a large and increasing evidence base for cognitive behavioural therapy (CBT) for the amelioration of common mental health difficulties. In children and young people with autism, there is some evidence that CBT can be effective; however, it is unclear whether this also applies to adults with autistic spectrum disorders (ASDs). This review aimed to evaluate the evidence for the use of CBT with adults with ASDs in relation to reducing comorbid psychiatric symptoms and increasing social and communication skills.

A systematic search was conducted to identify best evidence. Comparison to predetermined inclusion and exclusion criteria identified seven relevant studies; these were subsequently critically appraised.

The results of the appraisal were mixed with no definitive evidence supporting the review question.

Basing assumptions on best evidence, it is suggested that CBT can help adults with ASDs decrease comorbid psychiatric symptomatology. However, there is little evidence that CBT can increase social and communicative functioning. The review concludes that there is a need for increased quantitative research in this area so that more substantial conclusions can be made.

This paper summarises the available evidence in relation to CBT for adults with ASD; most previous review papers have focused on children and young people. Future research directions are suggested.

The danger attending the use of the insufficiently purified waters derived from the Thames and Lea should, we think, be constantly pressed upon the attention of the Legislature and of the public. We regard it as a duty to endeavour to prevent the continued neglect of the warnings which have been put forward from time to time by those who have made a careful and unbiassed study of the subject, and which have recently been again uttered and emphasised by SIR A. BINNIE, the late Engineer of the London County Council. In the public interest it is greatly to be regretted that the system of analytical control, which was maintained by certain London Borough Councils with regard to the water supplied within the areas under their jurisdiction, has been discontinued. The local checks referred to were of the greatest value to the inhabitants of the districts concerned by affording timely warning when water of dangerous character was being supplied, thus enabling some protective measures to be taken. They also served the useful purposes of keeping public attention fixed upon the matter.

We have received a communication from Mr. A. H. Mitchell Muter, F.I.C., Public Analyst for Lambeth, with reference to the contamination of cheese as the result of it being wrapped in tinfoil.—Mr. Muter observes that the following facts are those upon which he based his remarks, re the potential danger to health arising from contamination by tin in cheese wrapped in this metal, contained in his report for the fourth quarter of 1929 to one of the Local Authorities for which he acts :—On 4th November, 1929, a Food Inspector to the Authority in question submitted an informal sample of wrapped cheese as the result of a complaint having been received from a ratepayer to the effect that he had been taken ill after partaking of it.—Mr. Muter's analysis showed it to contain 5·68 grains of tin per lb., and he therefore reported that he was of opinion that the ratepayer was fully justified in bringing the matter to the notice of the Inspector.—On 15th November a formal sample of wrapped cheese was submitted, which he found contained 6·89 grs. tin per lb., and he issued a report to this effect. As the result of this report he received on the 25th November five informal samples of various brands, all of which were found to contain tin varying from 0·28 to 6·34 grs. per lb., and a further three informal samples received on the 3rd December contained tin in quantities from 1·37 to 11·03 grs. per lb. On the 12th December a formal sample was submitted which contained as much as 14·8 grs. tin per lb.

That the health of the body is very closely connected with the nature and quantity of the food we take is a statement in the nature of a self‐evident proposition. When we desist from eating food, starvation sets in after a longer or shorter period, according to the individual; when we eat too much or drink too much, distressing symptoms as inevitably supervene. Moreover, the quantity of food or drink consumed is not the only factor. The quality also is a matter of supreme importance, as in cases of malnutrition, while the various forms of blood disease, more or less loosely classed together as anæmia, appear to be associated to some extent with the question of nourishment. Without going so far as extreme partisans do who would seek to prove that all diseases are ultimately due to the consumption of unsuitable food, as witness, for instance, the views of the more advanced vegetarians and fruitarians, who attribute cancer and other maladies to the eating of meat, it is obvious that a very close connection exists between the health of the body and the nature of our food supply.

The Mediterranean has long been celebrated for the richness, diversity, and historical depth of its cultural heritage. However, in recent years heritage and heritage practice could be said to have become a new mode of production in the region (Bianchi, 2005). There are a number of reasons for this; one has to do with the stagnation of the Mediterranean's traditional “sun, sea, and sand” tourism. As a result of this tour operators and national governments have started to push the packaging of “culture” and “heritage” for a more diversified “up-market” product to attract higher-spending tourists to the region's cities and rural hinterland. Another factor is the restructuring and liberalization of the regional economy since the closing decades of the 20th century. There has seen a shift from agriculture to services as the dominant economic sector in this region and the concomitant discovery of culture has become an economic asset for investors seeking an outlet for global capital flows (Bianchi, 2005; Daher, 2007; Nogués-Pedregal, 2002). The European Union (EU) has had an important role to play in these processes, both in driving the region's neoliberal market reforms, and in promoting the establishment of its cultural heritage economy. Cultural heritage has become a priority area in EU Mediterranean policy, with millions of euros earmarked for heritage related projects. This takes the form both of loans to private investors from the European Development Bank, and of grants for public sector cultural heritage initiatives, for example, through its Euromed Heritage programs, the fourth phase of which is underway at the time of writing (Bianchi, 2005; Euromed Heritage, n.d.).

There's been plenty of generalised comment about the reluctance of university leavers to take jobs in industry — an attitude borne out by latest recruitment figures. But what about graduates who have gone against the trend? Laura Pank talks to some of these ‘non‐conformists’ about the frustrations and fulfilments of stepping from college to factory.