It is a long-standing assumption that holotropic breathwork (HB) induces an altered state of consciousness. However, this assumption has not been empirically tested. Consequently, 32 participants were recruited for the present study, which aimed to use the Phenomenology of Consciousness Inventory (PCI) to quantify the pattern of phenomenological subsystems and Altered State of Awareness (ASA) scores associated with a HB condition relative to a comparison condition and a baseline assessment. The hypothesis that the HB group would report a different pattern of relationships among phenomenological subsystems relative to the comparison condition and baseline was partially supported. In addition, the hypothesis that, while controlling for baseline, the HB group would report higher ASA scores than the comparison group was supported. Finally, for the HB group, transliminality did not significantly improve the prediction of ASA, while controlling for baseline. Various suggestions for future research are discussed.

'Background and Objectives' Many individuals with anxiety difficulties present with co-occurring anxiety disorders yet no evidence-based guidelines exist on how to treat this presentation. The present study investigated how Australian psychologists approach treating co-occurring anxiety disorders. 'Methods' A total of 169 psychologists practicing in Australia undertook an online survey consisting of open-questions relating to the treatment of DSM-IV anxiety disorder diagnoses and reported practice in relation to two clinical vignettes. Participant responses were coded using a directed content analysis approach. 'Results' The majority of psychologists reported utilising cognitive behaviour therapy (CBT) interventions in the treatment of single and co-occurring anxiety disorders but not specific evidence-based treatment guides or protocols. The majority of the psychologists surveyed reported that they adopt a transdiagnostic approach to addressing co-occurring anxiety disorders. 'Conclusions' Psychologists typically do not follow a specific treatment guide in the treatment of anxiety disorders and judge a transdiagnostic approach incorporating CBT techniques as the best way to treat comorbidity. More effort may be needed to disseminate evidence-based interventions for anxiety disorders and for authors of empirically supported treatments to provide clear guidelines regarding treating co-occurring anxiety disorders.

A reliable and valid assessment instrument would aid clinicians in their diagnosis of spiritual crisis, or emergency. The current study investigated the structural validity and personality correlates of the 30-item Spiritual Emergency Scale (SES) (Goretzki, Thalbourne, & Storm, 2013). Participants (N 5 162) were recruited via email and social media and completed an anonymous online questionnaire. Exploratory principal axis factor analysis revealed a four-factor solution. Mysticism was correlated with SES scores, supporting convergent validity. However, the SES appears to neglect the crisis aspect of SE. As expected, results found that self-concept expanding beyond the here-and-now and mental boundaries predicted SES scores. In contrast, ego-grasping style did not predict SES scores. In conclusion, although in need of revision, the 30-item SES may be regarded as a promising measure of spiritual emergence but perhaps not emergency.

The Socratic Method has been described as an important component of CBT interventions yet an empirical case for its use has not been made. The objective of this paper is to review the role of the Socratic Method in CBT in four stages. First, a review of the literature describes how the Socratic Method is applied and defined within CBT, with assumptions regarding its proposed benefits identified. Second, a review of empirical literature demonstrates that multiple challenges to the evaluation of the Socratic Method exist and that no direct evidence supports the premise that it is beneficial in CBT. Evidence is examined which may suggest why the Socratic Method could be beneficial in therapy. Finally, the hypothesised function of the Socratic Method within therapy is discussed in reference to the Interacting Cognitive Subsystems framework. A number of avenues for future research are proposed in order to determine whether this potentially valuable therapeutic component contributes to the efficacy of CBT.

Background: Online CBT training is in its infancy. The initial studies have varied program characteristics and trainee groups, but results appear promising. At this stage, there is a need to evaluate programs with different characteristics to determine which are useful, and which are not. Method: This paper reports a preliminary evaluation of an online CBT training package, OCTC Online, which is distinguished from other online programs by its particularly strong focus on video presentations by trainers, accompanying PowerPoint slides, and video demonstrations of key clinical techniques. Participants (N = 94) completed online rating scales and questionnaires assessing (a) their satisfaction with the training; (b) their self-rated knowledge and confidence about the topics discussed (pre- and post-training); and (c) a multiple choice questionnaire (MCQ) objective test of knowledge (also pre- and post-training). Results: Results showed that on average students were highly satisfied with the online training modules, their self-rated confidence increased significantly, and so did their scores on the MCQ. Conclusions: The study has significant limitations but nevertheless contributes to the growing body of evidence that online training may have a useful part to play in enhancing therapists' knowledge of CBT theory and techniques, and their confidence in using the techniques.

The Socratic Method has been described as an important and distinctive component of CBT interventions. However, it has been subject to little empirical investigation and its value within therapy remains unclear. A survey of expert CBT researchers (N=13) was conducted regarding the role of the Socratic Method within evidence-based CBT interventions. Thematic analysis of responses suggests that the Socratic Method is considered a potentially useful though non-essential component of CBT. A systematic review of the literature identified five assumptions regarding the proposed benefits of employing the Socratic Method: (i) engaging patients in the Socratic Method will help reduce distress associated with, and belief in, unhelpful cognitions; (ii) engaging in the Socratic Method will allow patients to develop skills in the re-evaluation of cognitions and unhelpful processes; (iii) conclusions reached by patients through the Socratic Method are more likely to be memorable and convincing; (iv) the Socratic Method will increase patient engagement and reduce resistance in therapy; and (v) Socratic questioning will improve CBT outcome. Two experimental studies were conducted to evaluate whether assumptions (i) and (iii) were supported when comparing an online analogue of the Socratic Method versus a didactic-information giving approach. Results supported assumption (iii) and partially supported assumption (i), though the superiority of a Socratic versus didactic approach in promoting belief change was not demonstrated. The findings of the study will be discussed in terms of areas for future research and mechanisms through which the Socratic Method may be hypothesised to exert beneficial effects within therapy.

'Background': Patients with anxiety disorder diagnoses commonly have more than one anxiety diagnosis. While cognitive-behavioural interventions have proven efficacy in treating single anxiety disorder diagnoses, there has been little investigation of their efficacy in treating co-occurring anxiety disorders. 'Aims': To evaluate the efficacy of a transdiagnostic cognitive-behavioural intervention for treating co-occurring anxiety disorders. 'Method': An A-B single case study design (N = 6) was used to evaluate the efficacy of a 12 to 13-session modular transdiagnostic cognitive-behavioural intervention for treating co-occurring anxiety disorders across patients with at least two of the following diagnoses: GAD, Social Phobia, Panic Disorder and/or OCD. 'Results': Five of the six participants completed treatment. At posttreatment assessment the five treatment completers achieved diagnostic and symptomatic change, with three participants being diagnosis free. All participants who completed treatment no longer met criteria for any DSM-IV-TR Axis-I diagnosis at the 3-month follow-up assessment, and demonstrated reliable and clinically-significant improvements in symptoms. Across the participants, statistically significant improvements from pre to postintervention were found on measures of anxiety, depression and general well-being, and all improvements were maintained at 3-month follow-up. 'Conclusions': Results suggest that transdiagnostic cognitive behavioural interventions can be of benefit to patients with co-occurring anxiety disorders.

In order to enhance our understanding of the nature of poker-machine problem-gambling, a community sample of 37 poker-machine gamblers (M age = 32 years, M PGSI = 5; PGSI = Problem Gambling Severity Index) were assessed for urge to gamble (responses on a visual analogue scale) and altered state of consciousness (assessed by the Altered State of Awareness dimension of the Phenomenology of Consciousness Inventory) at baseline, after a neutral cue, and after a gambling cue. It was found that (a) problem-gambling severity (PGSI score) predicted increase in urge (from neutral cue to gambling cue, controlling for baseline; sr² = .19, p = .006) and increase in altered state of consciousness (from neutral cue to gambling cue, controlling for baseline; sr² = .57, p < .001), and (b) increase in altered state of consciousness (from neutral cue to gambling cue) mediated the relationship between problem-gambling severity and increase in urge (from neutral cue to gambling cue; K² = .40, 99 % CI [.08, .71]). These findings suggest that cue-reactive altered state of consciousness is an important component of cue-reactive urge in poker-machine problem-gamblers.