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It also has potential to enhance access to these treatments in publicly funded health systems and more generally addresses a key question of how behavioural interventions can be made more accessible and practical for adults with primary headache [34] and provides support for conducting a definitive trial.
The beneficial effects of these behavioural interventions can be maintained long after counseling is stopped [ 4, 5].
General practice provides a unique setting where hazardous alcohol consumption can be screened for and behavioural interventions can be implemented in a continuous care model.
Research in chronic pain [ 10] and stroke [ 11] has shown that behavioural interventions can be used to increase what an individual can do as well as what they actually do in real life.
Recent Cochrane reviews have concluded that behavioural interventions can be effective in helping women to stop smoking in pregnancy [ 66] even though there remains no evidence for the effectiveness of pharmacotherapy such as NRT in pregnancy [ 67].
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It could be argued that sleep problems in children with ADHD may be less amenable to change because of their other challenging behaviours, but trials in children with other challenging behaviours (ie learning disabilities and autism) demonstrated that behavioural sleep interventions can be effective [ 25- 27].
Psychosocial interventions for this group therefore need to target these areas and there is evidence from three groups of researchers in the USA to suggest that cognitive behavioural or social skills interventions can be successfully adapted for older people.
Behavioural gains induced by plasticity-promoting pharmacological interventions can be lost, for example, with N-methyl d-aspartate blockade or increased GABAergic tone.
Further research is needed to examine alternative means of communicating behavioural change messages and ways in which existing interventions can be expanded to integrate additional services.
Behavioural approaches to both single and multiple risk factors have been applied in general practice and the evidence suggests that brief interventions can be effective [ 17, 18].
Like effectiveness outcomes, the costs of (complex) interventions can be strongly determined by contextual factors; by the exact combination and 'dose' of intervention components; or by the behavioural predispositions of participants or providers.
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