The efficacy of cognitive—behavioural therapy (CBT) for the treatment of childhood anxiety has mainly been demonstrated in university-clinic settings. This study aimed to evaluate the effectiveness of CBT for the treatment of childhood anxiety in a community mental health service, compared with standard treatments (‘Treatment as Usual’ [TAU]) 'child psychotherapy, family therapy and eclectic treatments. Fifty-four children with anxiety disorders, aged from 7 to 14 years, were randomly assigned to either a CBT or TAU group. CBT and the standard treatments were provided by 18 experienced therapists, and the mean number of treatment sessions was 12. Baseline and follow-up measures at 3, 6 and 12 months included an interview based on criteria in the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) that was conducted by a clinical psychologist who was blind to the treatment conditions, and standardised anxiety measures (parent, child and teacher reports). Significant improvements were found on all anxiety measures over time, but no significant differences were found between CBT and TAU. The challenge of conducting such research in community settings is discussed.

There is universal recognition of the need for developmentally appropriate supervised clinical experience in professional psychology training. University clinics were established to provide a bridging function for postgraduate clinical psychology students, assisting the integration of psychological theory and research into real-world clinical applications and professional identity development. The aim of training in university clinics is to provide opportunities for clinical practice and highquality supervision to monitor and shape clinical skills. The experiences gained in external practicum settings complement this initial training but cannot replace it. The recent introduction of Medicare rebates for psychology services has threatened the survival of university clinics because low-cost psychological treatment is now available from experienced practitioners. This paper provides data on Australian university clinics collected before the introduction of Medicare. Concerted efforts are needed to protect university clinics in order to maintain standards required for accreditation of clinical psychology training programs. The potential impact of the loss of university training clinics is discussed and strategies to ensure their survival are suggested.

The purpose of this article is to open discussion on the appropriate standards for training and practice in cognitive behavioural therapy (CBT) for clinical psychologists. CBT has in recent years become increasingly popular as a brief and effective psychological treatment for mental health problems. Public funding has become available for the provision of CBT for a prescribed number of sessions to people diagnosed with specific psychiatric disorders, and there has been an increasing shift in public mental health services toward more short-term and structured episodic care interventions, many of which are CBT-based. There has also been a corresponding increase in health professionals seeking CBT training and offering psychological services described as CBT. However, there is a lack of formal nationally agreed standards for clinical psychologists in relation to training and practice in CBT, and ethical concerns have been raised about the provision of 'stand-alone' brief training to professionals who do not have an undergraduate psychology degree and hence may not have an understanding of the theory and research that underlies CBT. Issues raised in this article include training and practice considerations such as levels of competence, diversity and complexity of CBT, treatment length, ethical considerations and barriers to best practice. T he purpose of this article is to open discussion on the appropriate standards for training and practice in cognitive behaviour therapy (CBT) for clinical psychologists. Over the past 20 years clinical psychologists have played a major role in the development of CBT. Thus, the College of Clinical Psychologists has a central role in maintaining the integrity of this therapeutic intervention by specifying the parameters of what constitutes CBT and promoting and supporting best practice standards in clinical psychology. A position paper is necessary to provide guidelines for the provision of training and the delivery of CBT treatment by clinical psychologists. In addition, standards developed by the College for clinical psychologists may be of assistance to a wider range of stakeholders in services for mental health problems, including administrators, service providers, medical practitioners and allied health professionals, as well as those receiving psychological services.