Objective. To determine the efficacy of behavioral management counseli
ng in the treatment of persistent, excessive infant crying (>3 hours p
er day). Design. Two treatments, one no treatment control group. Infan
ts were group-matched according to baseline fuss/cry levels, sociodemo
graphic, and infant variables. Treatments were carried out sequentiall
y by the same counselors. Setting. Telephone counseling by volunteers
(mothers) of CRY-SIS, a national support group for the parents of cryi
ng infants. Patients and interventions. Sequential sample of 27 mother
-infant pairs receiving treatment 1 (Tr1, empathy: talking through the
problem), 21 receiving treatment 2 (Tr2, behavioral management: speci
fic care taking suggestions) and 44 receiving no treatment (C, control
s). Infants were between 1 to 5 months of age. Measurements and result
s. Mother-infant pairs had a pretreatment baseline assessment and a po
sttreatment follow-up (3 months after baseline) using 1-week diaries.
Total fuss/cry duration reduced significantly more in the behavioral m
anagement group (by 51%) than the empathy group (37%) or the control g
roup (35%). This was mainly due to significantly reduced evening fussi
ng/crying in Tr2 (67%) compared with Tr1 (45%) and C (42%). No differe
nces in total number of fuss/cry bouts/day were found. However, the nu
mber of fuss/cry bouts reduced significantly more in the evening in Tr
2 (by 55%) compared with Tr1 (27%) and C (32%). Behavioral management
mothers evaluated the same counselors as more sympathetic, knowledgeab
le, and understanding. Tr2 was also perceived by mothers to have helpe
d them more in reducing the crying problem, coping with the infant, an
d improving the relationship with their infant than Tr1. No effects of
treatment on infant difficult temperament were found. Conclusions. Be
havioral management was more effective in reducing fussing/crying than
spending time with the mother talking through the problem or just wai
ting for spontaneous remission. Treatment by suitably but briefly trai
ned lay counselors is an inexpensive and successful treatment option.