Objectives. To examine the clinical effectiveness of guided self-help (GSH) for anxiety and depression in routine clinical practice, and the role of self-efficacy, therapeutic alliance and socio-economic status in influencing that effectiveness. Design. A within-subjects repeated measures design in which participants served as their own controls by completing questionnaires across a control period prior to GSH intervention, then again at post-intervention and 3- and 6-month follow-up. Methods. GSH participants completed outcome measures for mental health (HADS) and work/social functioning (WSAS). Factors explored by regression as possible predictors of effectiveness were self-efficacy, therapeutic alliance and socioeconomic status. Results. Sixty people completed GSH, with analyses indicating effectiveness of GSH in significantly improving mental health and social functioning at post-treatment and 3-month follow-up, but not at 6-month follow-up. Effectiveness was also indicated under intent-to-treat conditions (n = 97) with medium effect sizes (≈ 0.6) for each outcome measure at post-treatment. Improvement in mental health was predicted by lower self-efficacy and greater therapeutic alliance. Completers of the intervention had significantly higher socio-economic status than non-completers. Conclusions. The current study has suggested effectiveness of GSH in routine clinical practice across different primary care services at post-treatment, but with less evidence of this at follow-up. Effectiveness has been highlighted to be influenced by self-efficacy and therapeutic alliance, suggesting the importance of considering non-specific factors when patients access GSH in primary care. This study underlines the need for further research exploring longer-term clinical effectiveness and examining for whom GSH works in order to constructively inform future evidence-based practice.

Stress and depression are popular and powerful terms within the mental health field. Although the relation between the two terms has been discussed and investigated in lay and scientific discourse, less is known about how this relation is constructed online. Individuals wanting to learn more about these topics are increasingly turning online using a search engine as an initial quick method of obtaining mental health information. The present research examines the stress and depression discourse found on self-help websites using a social constructionist epistemological framework and the methodological approach of discourse analysis. In the first manuscript, I specifically examined how stress was constructed in the causal ontology of depression in six different websites. The analysis demonstrated that many possible relations between the two terms were included. This finding suggests that, in the online context, ensuring that website users find themselves represented in the text is of maximal importance. In the second manuscript, I examined how the stress and depression terms themselves were constructed. This analysis suggests that the stress discourse often borrowed from depression discourse, constructing the two terms in similar ways. This parallel construction involved defining both terms as mental illnesses, with corresponding symptoms and clinical presentations that required treatment. The degree of overlap between the two terms suggests that engaging the website user was more important than the specific label used to label the distress in the online context. I examine the contrast between the general, fluid, and elastic constructions of the mental health terms found online with the ever-evolving need for increased precision and demarcation of mental health conditions within the fields of psychiatry and psychology.

No description available.

Objectives. To see whether a cognitive behavioural guided self-help approach can reduce mental health symptoms, which patients might benefit most, and whether such a treatment increases self-efficacy and internal locus of control. Design. Repeated measures and correlational designs were used. Methods. 173 patients were recruited at a cognitive behavioural guided self-help clinic in Edinburgh, of which 97 completed the three-session intervention. Verbal IQ was estimated with the National Adult Reading Test (NART). Measures of emotional symptoms, self-efficacy and locus of control were taken before and after treatment, with follow-up at one month and six months. Results. Patients completing the intervention made favourable gains, which were maintained at six months. Self-efficacy and locus of control measures were not robustly correlated with mental health improvement, but did show pre- to posttreatment changes in themselves. Conclusions. Guided self-help appears to be a useful treatment option for those with depression, anxiety and stress. The implications of the findings, the strengths and limitations of the study, and areas for future research are discussed.

No description available.

The main objective of this study was to study individuals experience of panic disorder. The underlying method in the study was of qualitative art, were theme based analysis were used and semi structured interviews were conducted. Six interviews were conducted with individuals that for themselves or with the help of primary care for filled the DSM-IV criteria for panic disorder. The results showed that the participants felt that their panic disorder was more or less prominent depended on the stability of the participants subsistence. The participants felt less of their panic disorder if they had a more stable subsistence and felt the panic-disorder were more prominent if the participants felt more stressed. The interviews led to four themes, The Individuals experience of panic disorder, life situation, sense of losing control and a sense of no one would understand. / Syftet med studien är att undersöka individers upplevelse av panikångest. Studien är kvalitativ och bygger på tematisk innehållsanalys, för studien har sex semistrukturerade intervjuer genomförts med individer som enligt sig själv eller sjukvården uppfyller DSM-IV kriterier för panikångest. Resultatet presenterar den enskilde individens upplevelse av panikångest. Resultatet visar att intervjupersonerna upplevde sin panikångest som mer eller mindre framträdande beroende av stabiliteten i deras tillvaro. En stabil tillvaro upplevdes av deltagara minska panikångesten och en mer stressad tillvaro, upplevdes av deltagarna att öka deras panikångest. Intervjuerna ledde fram till fyra teman, Individens upplevelse av panikångest, livssituation, känsla av total kontrollförlust samt känsla av att ingen skulle förstå.

Background: One-in-three carers of stroke survivors experience depression with no psychological treatments tailored to meet their needs, such as barriers to attending traditional face-to-face psychological services. A cognitive behavioural therapy (CBT) self-help approach may represent an effective, acceptable solution. Methods: Informed by the MRC framework (2008) for complex interventions, six studies informed development, feasibility and piloting of a CBT self-help intervention for depressed carers of stroke survivors: Study One: Systematic review and meta-analysis of psychological interventions targeting depression and anxiety in carers of people with chronic health conditions; Study Two: Interviews to understand difficulties experienced by depressed and anxious carers; Study Three: Interviews to understand positive coping strategies used by non-depressed and non-anxious carers; Study Four: Drawing on results of Studies One to Three, iterative modelling to develop the CBT self-help intervention; Study Five: Feasibility randomised controlled trial to examine methodological and procedural uncertainties for a Phase III definitive trial; Study Six: Updated systematic review and meta-analysis. Results: Study One: 16 studies identified for inclusion yielding small and medium effect sizes for depression and anxiety respectively, with trends for individually delivered treatments over shorter session durations to be more effective for depression. Six additional studies were included in Study Six, replicating Study One results; Study Two: Depressed and anxious carers experience difficulties adapting to the caring role, managing uncertainty, lack of support and social isolation; Study Three: Non-depressed and non-anxious carers utilise problem-focused coping strategies to gain balance and adapt to caring role, use assertiveness, seek social support and positive reinterpretation; Study Four: Developed a theory-driven CBT self-help intervention; Study Five: Recruited 20 informal carers in 10-months, representing 0.08% of invited carers randomised with high attrition in the intervention arm. Lack of GP recognition, gatekeeping and barriers to accessing psychological support identified as reasons for poor recruitment. Conclusions: A greater appreciation is required concerning barriers experienced by informal carers of stroke survivors to accessing support for depression and type of acceptable psychological support.

In the British welfare sector, the role of religious groups in offering faith based welfare provision is substantial and addresses a wide variety of needs. Such action is not confined to the Christian faith, since other religious faiths generate welfare initiatives of their own. Nor is faith motivated welfare provision restricted to meeting basic human needs, as it can include efforts to build community relations and also encompasses community development approaches that support citizens to come together to create self-help projects. In fact the latter themes sometimes appear linked in social policy where community development is seen as a way of generating cohesive and cooperative communities, particularly in areas where there are ethnic divides to be bridged (Pearmain and Hatamian 2011: 1-2). This thesis focusses on one aspect of faith involvement in the welfare sector. It investigates whether British churches can adopt a community development approach, and in so doing, produce the positive outcomes that are associated with community participation neighbourhood regeneration. In this chapter I show how that topic has become pertinent to today’s welfare climate and the community development profession. I introduce a number of research questions that must be answered in order to argue that churches can embrace a community development approach, and outline how these questions are addressed in my literature reviews and case studies of churches in the chapters that follow.

Thesis (M. Arch.)--Massachusetts Institute of Technology, Dept. of Architecture, 1980. / MICROFICHE COPY AVAILABLE IN ARCHIVES AND ROTCH. / Includes bibliographical references. / The concept of self-help in a site and services project is based on the assumption that given the security of land tenureship_, an owner-builder can manage the whole process of house implementation. Generally, in any sponsored site and services project this assumption is supported by "aid" ; that is, the sponsor provides some financial and/or technical assistance. while this "aid" is minimum, often provided in the form of infrastructure, serviced plots, and some cash for purchasing building materials, it is assumed that such "aid" would assist the owner-builder in implementing the dwelling on the serviced plot. It is also assumed that the planning and construction of the dwelling would be carried out throughout the dweller's own decision-making and self-help efforts. In theory, the concept is valid. It is also adopted in most of the site and services projects in East Africa. Self-help is assumed to contribute towards economic savings, mobilization of human resources, increase in community spirit and group participation and to achieve a host of other benefits. This study looks at one such site and services project in Nairobi, the capital of Kenya. Through several in-depth case histories of carefully selected allottee families from the Dandora Community Development Project, a site and services project in Nairobi, the thesis shows the actual form(s) and practice of self-help. Several allottees were interviewed to understand further the real nature of self-help. That is, who did what, when, how and at what cost. Other inquiry was on the background and characteristics of the allottees' families, their approach to house planning and construction, characteristics and economics of construction, self - help practice amongst different: groups of allottees', cost and benefits of self-help and some impact of the rules of the Dandora Community Development Department (DCDD) in house implementation. The study presents several case histories of immigrant families in the process of urbanization in Nairobi. The cases trace the path of these low-income families from squatter settlements to the site and services project, emphasizing the element of self-help underlying the process of settlement. The actual role of an owner-builder is different from some of the assumptions held on self-help housing. The hard line of economic cost and benefits, as perceived in theory, does not necessarily hold true and neither do other assumptions on self - help applications in the site and services project. Chapters 1 and 2 present some background to the study, the research method employed and some of the theoretical constructs underlying the concept of self-help. In Chapters 3, 4, 5, 6 and 7 findings of the field research are presented. Specifically, different forms of self-help, their characteristics, practice, costs and benefits, and some illustrations as observed in the site and services project are presented. All the material covered under these Chapters is an outcome of the author's intensive field research on the allottees of the Dandora Community Development Project, from later 1978 to mid 1979. In· Chapter 8 the uses, costs, and benefits of the dwellings completed by means of the various self-help forms are further articulated. In the final Chapter the findings on actual self-help practices are compared with the held on self-help. This analysis is followed by major conclusions drawn from the study. / by Praful Naran Soni. / M.Arch.

Thesis. 1977. M.Arch.--Massachusetts Institute of Technology. Dept. of Architecture. / MICROFICHE COPY AVAILABLE IN ARCHIVES AND ROTCH. / Bibliography : leaves 73-74. / by Robert J. Osten Jr. / M.Arch.