A poor start for the Health Education Authority.

communication skills for couples and families, parenting, and many others. Recent advances have added anxiety management training, cognitive therapy, and training in problem solving. Manyprogrammes-both for patientsand for professionals have now been evaluated.9 The consensus is that short term gains are easy to obtain but maintaining the skills and generalising them to new circumstances are difficult. Researchers have now, however, developed pointers for improving the effectiveness of social skills training. One is to teach not only the skills themselves but also the competence to generate new skills. This includes training in how to improve perception of social cues and effective performances by others; how to select and implement alternative responses; and how to overcome emotional and cognitive blocks. Social skills training is becoming increasingly available in the National Health Service and social services and is available to general practitioners mainly-through departments of clinical psychology, community based hostels, and jointly organised community teams. Such services are currently being set up-for example, in Solihull as part of the joint National Demonstration Service in Rehabilitation. These services can accept not only patients with acute problems -such as social anxiety, depression, and addiction disorders -but also those with chronic problems, including schizophrenia and mental handicap. PETER TROWER