Self-help Approach Research Articles

PROTOCOL: The Effects Of Economic Self‐Help Group Programs On Women's Empowerment: A Systematic Review

PROTOCOL: The Effects Of Economic Self‐Help Group Programs On Women's Empowerment: A Systematic Review

An overview of the effectiveness of psychological therapy for depression and stepped care service delivery models

Depression is one of the most prevalent health disorders globally and causes significant distress and cost to the sufferer and society. Psychological therapy for depression has been recommended over a number of decades; however, access to these treatments remains limited. Cognitive behaviour therapy, behavioural activation, self-help approaches, interpersonal therapy and non-directive therapy all demonstrate moderate to large effect sizes when compared to treatment as usual. Differences between psychological interventions however are small and unstable when reviewed in meta-analyses suggesting that for most people adding complexity to treatment does not result in improved outcomes. Stepped care is one system used to organise delivery of psychological therapy that stratifies interventions across several levels of symptom severity. There is debate regarding the ideal design and operation of this complex system resulting in considerable variability in its use in clinical settings. Further research is needed to identify the most cost effective approach to the delivery of psychological therapies for depression as we need to continue to reduce the gap between demand and access to therapy.

Guided self-help for prevention of depression and anxiety in women with breast cancer.

Depression and anxiety are prevalent in women with breast cancer. We developed a self-help kit as a self-learning package of necessary preparatory information (basic knowledge on chemotherapy, side effects, and problem-solving skills). We provided an oncology nurse-guided self-help kit with a cognitive behavioral therapy approach to 46 women with breast cancer in the intervention group and usual care to 36 in the control group in outpatient chemotherapy settings. The oncology nurse monitored and facilitated the patient's progress using the diary during the patient's chemotherapy. We also provided professional-led support group programs. Depression, anxiety, and quality of life were measured at baseline, 1 week, 3 months, and 6 months. The chi-square test and t were used to examine differences between the two groups, and repeated measures analysis of variance was used to test the effects of the intervention on the measures over time. All depression and anxiety scores were improved in both the intervention and control groups, but there were no significant differences between the two groups. Further studies are needed to evaluate the effectiveness of an oncology nurse-guided self-help approach for cancer patients.

Health Deprivation in Rural Settlements of Borno State, Nigeria

Illness and burden of diseases are manifestation of health deprivation. In rural areas, most of the diseases afflicting people are in most cases outcomes of failure of public health policy and ecological incapacity. This paper addresses these issues using Borno state as the setting. The objectives of the paper are to delineate the spatial pattern of health deprivation, and identify the coping strategies for mitigating health deprivation. Data were gathered through primary (Questionnaire administration and participatory rural appraisal techniques) and secondary (Policy documents on health, water and environment) sources. A multistage sampling approach was used to select respondents from the two ecological zones in the study area out of which 630 respondents were selected from 9 local government areas. Data were analyzed through descriptive statistics and Z-score analysis. Among the findings is that about 83% of the sampled rural respondents spent between 1-2 hours to reach medical facility. Due to cost and distance to health facility about 65.26% claimed to experience deprivation. The major ailments reported include flu, malaria and typhoid fever, cerebrospinal meningitis, scabies and physiological discomfort. Spatially rural areas with health facility and clement weather conditions have low Z-score (Damboa (-5.94), Hawul (-2.24) and Konduga (-2.01) while highly deprived are settlements in Kukawa (5.11), Monguno (2.68) Kwaya-Kusar (1.26) and Mobbar (1.15).The coping strategies adopted include Praying to God; use of alternative medicine; patronizing ‘Chemists’ and migration. The conclusion is that spatial disparity in health deprivation should be addressed to improve the quality of life among rural dwellers. Recommendations include advocating self-help approach to health infrastructure provision, promotion of rain water harvesting technology and involving non-government organizations in rural health issues.

Selfhelp Community Services: Innovations Help Older Men and Women Maintain Independence in a Changing World

INDEPENDENCE WITH DIGNITY Selfhelp is a 75-year-old, not-for-profit organization with a very specific mission: enable older adults age independently and with dignity, in their own homes despite continuous pressures and obstacles. Collectively, our wide range of services aims protect older adults' safety and independence in an ever-changing world. OUR ORIGINS To refer the mid-1930s as a time of change is a colossal understatement. It was a time of unconscionable persecution, with the Nazi regime driving thousands of men, women, and children flee Europe and seek refuge in America. A handful of concerned emigres banded together here in the United States, assembled a group of volunteers, and formed Selfhelp for German Refugees. Their goal was take in displaced persons who escaped without family, homes or money, and provide the resources enable them rebuild their lives. Moreover, their vow was, and still is, to serve as the last surviving relative victims of Nazi persecution. The organization later became Selfhelp of Emigres from Central Europe, reflect its widened scope. And in 1969, the name changed for the final time a term synonymous with what we offer an ever-expanding population base: Selfhelp Community Services. Over the years, Selfhelp earned a stellar reputation for providing the resources and support help ensure survivors' personal safety, housing, some degree of restitution, social work, health care, and socialization opportunities. We are, in fact, the largest provider of services for Holocaust survivors in North America, last year serving more than 5,300 individuals in the New York City area. Our track record in helping this fragile, vulnerable population has earned the attention of state legislators, New York City officials, and several national as well as international associations on aging. We have expanded our reach thousands more seniors, providing resources and new approaches make it possible for more men and women of all ethnicities age independently, with dignity, in their own homes. Today we serve more than 20,000 of the older adults and at-risk populations in four boroughs of New York City and in Nassau County. We build senior housing and establish services for the broad-based community. We provide home care, assistance with obtaining entitlements and benefits, legal advocacy for home-based services, and more. Perhaps our toughest challenge is identify and implement new approaches and mechanisms serve our clients in a constantly changing environment-impacted by shifting demographics in which the country's 65 years or older population will double in the next 20 years, drastic cuts in health care and home care, a shortage of affordable housing, escalating labor costs, shrinking city and state budgets for social service programs for the older adults, a global economic downturn, and the resulting philanthropic fundraising challenges that we and other not-for-profit organizations have been experiencing for years. Although we do not have a magic formula share with other organizations-one ensure resilience and nimble transformation- several of our endeavors have shown potential progress and dramatic results. The following is not so much a retelling of our chronological evolution, as it is a closer look at some of our specific programs which many of our partners, clients and contributors believe be the most innovative and successful. These three areas of innovation focus on Seniors and Technology, Pro-Independence Services at Home, and Continuing Insights and Innovations for Nazi Victims Programs. SENIORS AND TECHNOLOGY Using Technology Transform Lives, Improve Health, and Reshape our Future Since our founding, the Selfhelp approach has become known for its personalized, high-touch care and interactions with our clients. A case manager's relationship with a client often appears as close as that of a blood relative. …

Adjustment and Self-Help Approach for Improving Housing Unit Quality in Multi-Storey Housing

Multi-storey housing is one of many living space types which has been provided for low-income society in Indonesia. Occupants in multi-storey housing do adjustment process to increase housing unit quality and their dwelling space. The objectives of this study are to explore and to understand how the occupants do adjustment and improving housing unit quality with self-help approach. This study is needed to get the success providing of vertical housing for low-income society in urban areas of Indonesia. The method of this study use descriptive approach with field research at multi-storey housing in Jakarta. Result of this study gives knowledge about adjustment process in multi-storey housing with self-help approach.

An open trial of self‐help behaviours of clients with eating disorders in an online programme

The aim of this study was to evaluate the self-help behaviour of individuals with eating disorders in an Internet-based self-help programme developed in the Asia-Pacific region and to determine their compliance with the programme. Eating disorders represent a growing health problem affecting both Western and Asian countries. Without timely and adequate treatment, individuals with eating disorders are at risk of premature death. Self-help approaches for treating eating disorders offer therapeutic promise. An open trial design was used. This study, conducted from August 2006-July 2011, included 280 participants recruited from outpatient eating disorder clinics and treatment units and through a university student newspaper and Internet websites. This open trial evaluated an Internet-based self-help programme, which included components on healthy eating, family education, health assessment, motivation enhancement, self-help strategies, and psychological health promotion. The progress of participants was followed up via monthly e-mails. A tracking system was implemented to determine their compliance with the programme. A small majority of the participants (56·9%) were already undergoing treatment for their eating disorders. About 63% (n = 176) demonstrated self-help behaviour, as manifested by their completion of health assessment questionnaires, involvement in motivation enhancement exercises, or the use of self-help strategies such as monitoring, normalizing eating behaviour, and stress management. Improvements were observed in their eating disorder psychopathology, motivational stage of change and psychological health from baseline to the 1-month follow up. Internet-based self-help programmes for eating disorders are helpful adjuncts to professional treatment.

The Gravity of Weight: A Clinical Guide to Weight Loss and Maintenance; Nutrition in InstitutionsThe Gravity of Weight: A Clinical Guide to Weight Loss and Maintenance KarasuSylvia R.M.D., and KarasuT. ByramM.D.; Washington, D.C., American Psychiatric Publishing, 2010, 518 pages, $66Nutrition in Institutions CrossMaria and MacDonaldBarbara; Oxford, United Kingdom, Wiley-Blackwell, 2009, 440 pages, $109.99

The Gravity of Weight: A Clinical Guide to Weight Loss and Maintenance; Nutrition in InstitutionsThe Gravity of Weight: A Clinical Guide to Weight Loss and Maintenance KarasuSylvia R.M.D., and KarasuT. ByramM.D.; Washington, D.C., American Psychiatric Publishing, 2010, 518 pages, $66Nutrition in Institutions CrossMaria and MacDonaldBarbara; Oxford, United Kingdom, Wiley-Blackwell, 2009, 440 pages, $109.99

Is your phone so smart to affect your state? An exploratory study based on psychophysiological measures

Traditional stress management techniques require significant professional training and expertise to administer as well as people, time, and resources, which can be difficult to achieve. Thanks to the recent progress and diffusion of mobile electronic devices, it is possible today to set up and test an effective self-help stress management program outside a clinical setting. Although the efficacy of mobile self-help approaches have been tested through several studies, and promising applications can be developed, as yet no study has tested the feasibility of mobile platforms to actually elicit core affective states. In this study we used an advanced approach to assess the efficacy of these mobile platforms by recording and processing many psychophysiological measures, which extend the capabilities of the standard self-report questionnaires, objectifying the subjective. Our results seem to show the efficacy of inducing positive and negative affective states, using smart phones.

Mentored Self-Help: A Promising Approach to Exploring Voices

This article explores voice-hearing experiences in the context of a mentored self-help approach to coping that used the workbook Working With Voices (Coleman & Smith, 1997) with the support of a trusted other or mentor. Casstevens, Cohen, Newman, and Dumaine (2006) found that the Brief Psychiatric Rating Scale (BPRS) factor of anxious depression improved significantly post–workbook completion relative to a comparison group, although BPRS global psychopathology scores did not change significantly (n = 27). Further exploration of available voice-hearing data was indicated, and the present study examined Topography of Voices Rating Scale (TVRS) scores and participant-reported stressors. The TVRS was completed by intervention-group participants (n = 16) without oversight, and 9 participants provided consistently complete TVRS forms that could be scored and graphed. For these participants, no connection was observed between TVRS scores and the presence or absence of reported stressors. Furthermore, pre–post difference scores for the TVRS were relatively unchanged. No evidence of harm was found, indicating that for study participants, the self-help approach reduced anxiety and depression without exacerbating voice hearing.

The Land-Use Diversity in Urban Villages in Shenzhen

China's dynamic urbanisation since 1978 has led to the proliferation of so-called ‘urban villages’ in many cities. Their development, via a self-help approach by indigenous villagers, delivers low-cost housing and various other social and economic activities. Consequently, urban villages are characterised by growing numbers of buildings and a mix of functions, including residential, industrial, commercial, and public services. These uses enable different activities in urban villages, assimilating migrants into the city by providing an alternative niche for working and living. Variations in land-use diversity in Shenzhen's 318 urban villages were analysed using 2009 data, for more than 333 000 buildings. Four statistical models, including three based on a spatial regimes analysis, are used to explain their land-use diversity. The results reveal that an urban village's land-use pattern is linked to its location in the urban fabric, its phase of development, and the development level of its environs. Different patterns are apparent inside and outside the Special Economic Zone of Shenzhen, suggesting that the current uniform redevelopment policy for urban villages may not be appropriate.

Understanding the ‘guide’ in guided self‐help for disordered eating: A qualitative process study

This study aimed to explore how guidance contributes to the outcome of self-help for disordered eating. A sample of guides and clients with a range of disordered eating was interviewed on completion of a randomized control trial and analysed using thematic framework analysis. Four themes emerged; the necessity of having a guide as a facilitator, features of the therapeutic relationship in clients with positive outcomes, features of the therapeutic relationship in clients with poor outcomes, and client suitability. These findings have implications for the delivery of guided self-help interventions for disordered eating. They suggest the value of assessing clients' readiness to change, working with clients with less severe and complex conditions, and the importance of guide qualities and skills. Guidance is a necessary adjunct to self-help approaches for the effective treatment of a range of disordered eating and can be delivered by trained non-eating disorder specialists. Guided self-help appears most appropriate for less severe, binge-related eating disorders, including eating disorders not otherwise specified (EDNOS), further work is needed for use with anorexic-type presentations. While it is important to establish and maintain a strong, open, and collaborative therapeutic relationship, client 'readiness' appears fundamental in the relationship and consequent treatment outcome.

Stress and quality of life in psoriasis: an update

Psoriasis is a chronic, relapsing, cutaneous condition with 1-2% prevalence in the general population. There are many factors involved in the induction and/or exacerbation of psoriasis of which stress is a well-known trigger factor in the appearance or exacerbation of psoriasis. Stress reaction in patients with psoriasis is probably mediated by the hypothalamic-pituitary-adrenal relationship with immunologic effects. Stress response involves increased levels of neuroendocrine hormones and autonomic neurotransmitters. Psychological stress or an abnormal response to stressors has been found to modify the evolution of skin disorders such as psoriasis. It can also have substantial psychological, and psychosocial impact on a patient's quality of life. Treatment regimens include stress-reduction strategies, such as biofeedback, meditation, yoga, and self-help approaches. This review focuses the relationship between psoriasis and stress, especially relating to psychosocial, psychological, and emotional stress aspects.

Further evidence for the efficacy of association splitting as a self-help technique for reducing obsessive thoughts

Despite improved treatment options, many people with obsessive-compulsive disorder (OCD) do not seek or even actively avoid therapy due to shame or fear of stigmatization. Self-help treatment is increasingly acknowledged as a means to "treat the untreated" and to motivate patients for face-to-face psychotherapy. Our group has gathered preliminary evidence for the efficacy of a novel self-help approach entitled association splitting (AS) aimed at the reduction of obsessions. For this study, a total of 46 participants with a likely diagnosis of OCD were randomly allocated to either AS or a waitlist control (WL). Treatment consisted of the self-study of a manual sent via e-mail. At baseline and four weeks later symptoms were assessed online using the self-report version of the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS), the Obsessive-Compulsive Inventory-Revised (OCI-R), and the Beck Depression Inventory (BDI). A total of 74% of the initial sample took part in the re-assessment. Results were in accordance with prior uncontrolled data indicating that AS is a feasible approach leading to a symptom decline of approximately 25% on the Y-BOCS. The technique also exerted a positive effect on depression (BDI) and the OCI-R subscale obsessive thoughts. The study confirms the feasibility and efficacy of AS for a subgroup of patients with OCD. Ongoing studies explore whether short-term effects are maintained over time and whether therapist-guided therapy may enhance the efficacy of AS.

Commercial Weight-Loss Programs Are More Effective Than Advice from PCPs

Commercial weight-loss programs have been compared in randomized trials to other self-help approaches with enrollment of self-referred patients, but never to standard counseling in a primary care setting with enrollment of patients identified by their own physicians. With funding from Weight Watchers (WW), researchers enrolled …

Lessons from case studies of integrating mental health into primary health care in South Africa and Uganda

BackgroundWhile decentralized and integrated primary mental healthcare forms the core of mental health policies in many low- and middle-income countries (LMICs), implementation remains a challenge. The aim of this study was to understand how the use of a common implementation framework could assist in the integration of mental health into primary healthcare in Ugandan and South African district demonstration sites. The foci and form of the services developed differed across the country sites depending on the service gaps and resources available. South Africa focused on reducing the service gap for common mental disorders and Uganda, for severe mental disorders.MethodA qualitative post-intervention process evaluation using focus group and individual interviews with key stakeholders was undertaken in both sites. The emergent data was analyzed using framework analysis.ResultsSensitization of district management authorities and the establishment of community collaborative multi-sectoral forums assisted in improving political will to strengthen mental health services in both countries. Task shifting using community health workers emerged as a promising strategy for improving access to services and help seeking behaviour in both countries. However, in Uganda, limited application of task shifting to identification and referral, as well as limited availability of psychotropic medication and specialist mental health personnel, resulted in a referral bottleneck. To varying degrees, community-based self-help groups showed potential for empowering service users and carers to become more self sufficient and less dependent on overstretched healthcare systems. They also showed potential for promoting social inclusion and addressing stigma, discrimination and human rights abuses of people with mental disorders in both country sites.ConclusionsA common implementation framework incorporating a community collaborative multi-sectoral, task shifting and self-help approach to integrating mental health into primary healthcare holds promise for closing the treatment gap for mental disorders in LMICs at district level. However, a minimum number of mental health specialists are still required to provide supervision of non-specialists as well as specialized referral treatment services.

Knock, and it will be opened to you? An evaluation of meridian-tapping in obsessive-compulsive disorder (OCD)

Meridian-tapping (MT) is a body-oriented therapeutic technique which among other psychological problems targets anxiety disorders. Despite bold claims by some of its advocates that it brings lasting success in the vast majority of patients with anxiety disorders, solid empirical evidence for its effectiveness is scarce and its theoretical foundations are refuted by many scientists. The present study tested the effectiveness of a published MT self-help approach for obsessive-compulsive disorder (OCD). Following a baseline assessment over the internet including standard outcome measures for OCD (Y-BOCS, OCI-R) and depression (BDI-SF), 70 participants with OCD were randomly allocated to MT or to progressive muscle relaxation (PMR). Four weeks after the dispatch of the self-help manuals (including video demonstrations of the technique), participants were requested to take part in a post assessment. Whereas subjects found MT more helpful than PMR in retrospect (39% versus 19%) and would continue to use it in the future (72% versus 48%) there was no evidence for a stronger decline of OCD symptoms under MT on any of the psychometric measures. Moreover, Y-BOCS scores did not significantly change across time for both interventions. The present study does not support bold claims about the effectiveness of MT as a stand-alone technique. Cognitive-behavioral therapy remains the treatment of choice for OCD. While self-help MT may enhance the well-being of a subgroup of participants, its potential for OCD appears to be small. Exaggerated success claims on the effectiveness of MT in conjunction with degrading appraisals of conventional psychotherapy as made by some of its leading figures may in our view foster fatalism in patients not experiencing major symptom relief by MT.

ESTIMASI PARAMETER PENDIDIKAN KESEHATAN MASYARAKAT HASIL INTERVENSI COOPERATIVE SELF HELP DI PROVINSI DIY

Pre-post test with control group experimental research design, applied on 30 dasa wisma groups in 3 public health center work areas of Bantul regency, with main purpose to find out the estimation number of parameter of public health education as a result of cooperative self help intervention and to construct the model which suitable for dasa wisma woman, resulting: a) Action aspect shows the highest estimation number is 0,73, and b) Model of cooperative self-help approach is suitable to be applied on dasa wisma

Progressive housing approaches in the current Peruvian policies

Since 1961, Peruvian governments promoted progressive housing construction as a way to cope with the huge housing deficits resulting from accelerated urbanization, a process which inspired John Turner for a pragmatic approach for progressive housing in poor countries: the self-help approach. The Peruvian political reforms of the 1990s, however, eliminated the support to progressive housing. The housing sector was reformed to promote access by: (a) facilitating mortgage credit as the way to overcome the large housing deficits, and (b) providing land titles in informal neighbourhoods to incorporate the properties to the formal housing market. Programmes for affordable housing were initiated in 2003, which coupled with the uplift of the economy have produced a construction boom and delivered affordable housing. On the other hand, COFOPRI, the programme to regularize land in informal neighbourhoods – considered the world's largest of its type and a model to other countries – has granted more than 1.8 million land titles. Since the main benefits seemed confined to certain groups during the first years, the government of García – installed in July 2006 – reoriented the housing policies towards lower-income groups. In this context, this study explores the role of progressive housing approaches in the new policies and their effects on the housing situation of the poor.

Pathways to Recovery (PTR): Impact of peer-led group participation on mental health recovery outcomes.

This study examined the positive effects on recovery outcomes for people with severe and persistent mental illness using peer-led groups based on Pathways to Recovery: A Strengths Recovery Self-Help Workbook (PTR). PTR translates the evidence-supported practice of the Strengths Model into a self-help approach, allowing users to identify and pursue life goals based on personal and environmental strengths. A single-group pretest-posttest research design was applied. Forty-seven members in 6 consumer-run organizations in one Midwestern state participated in a PTR peer-led group, completing a baseline survey before the group and again at the completion of the 12-week sessions. The Rosenberg Self-Esteem Scale, the General Self-Efficacy Scale, Multidimensional Scale of Perceived Social Support, the Spirituality Index of Well-Being, and the Modified Colorado Symptom Index were employed as recovery outcomes. Paired Hotelling's T-square test was conducted to examine the mean differences of recovery outcomes between the baseline and the completion of the group. Findings revealed statistically significant improvements for PTR participants in self-esteem, self-efficacy, social support, spiritual well-being, and psychiatric symptoms. This initial research is promising for establishing PTR as an important tool for facilitating recovery using a peer-led group format. The provision of peer-led service has been emphasized as critical to integrating consumers' perspectives in recovery-based mental health services. Given the current federal funding stream for peer services, continued research into PTR and other peer-led services becomes more important.