The relative success of a self-help and a group-based memory training program for older adults.

This study evaluates self-help and group-based memory training programs to test for their differential impact on memory beliefs and performance. Self-help participants used a manual that presented strategies for name, story, and list recall and practice exercises. Matched content from that same manual was presented by the trainer in 2-hr weekly group sessions for the group-based trainees. Relative to a wait-list control group, most memory measures showed significant gains for both self-help and group-based training, with no significant training condition differences, and these gains were maintained at follow-up. Belief measures showed that locus of control was significantly higher for the self-help and group-based training than the control group; memory self-efficacy significantly declined for controls, increased for group-trained participants, and remained constant in the self-help group. Self-efficacy change in a self-help group may require more opportunities for interacting with peers and/or an instructor emphasizing one’s potential for memory change. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Recovery, Inc., as an adjunct to treatment in an era of managed care

As capitation increasingly limits professional mental health services, self-help organizations may play an expanding role. Recovery, Incorporated, is an internationally active mental health self-help organization developed in the late 1930s by Abraham A. Low, M.D. The author reviews concepts about mental illness and health developed since Low's time, such as locus of control, learned helplessness, defense theory, and Antonovsky's salutogenic model. He describes how these concepts support many of the principles developed by Low, in particular the idea that optimal health is achieved when a person assumes responsibility for his or her failure or success. In the structured format that Low designed for Recovery, Inc., meetings, members learn to identify self-defeating and illness-promoting thoughts and impulses and counter them with self-endorsing thoughts and wellness-promoting actions. The author suggests that professionals should become familiar with self-help organizations in their communities, promote relevant research, and facilitate referral to these groups.     

Effects of self-help guides on three consumer advocacy skills: Using personal experiences to influence public policy.

Examined the effects of self-help guides on the performance of 3 consumer advocacy skills (preparing and presenting brief personal testimony, writing letters to a newspaper editor, and writing letters to public officials) by members of a disabilities advocacy group. These guides were used as behavioral prosthetics, and no training was provided by the researchers. In Exp I, a 40-yr-old female with multiple sclerosis prepared independent living (IL) advocacy letters. Skill performance was measured by observers using behavioral checklists. Experts rated the quality and potential impact of performances. Results indicate that use of self-help guides improved performance and led to higher ratings by experts. Exp II extended these results with 10 IL group members (aged 19–57 yrs). (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Make today count: A collaborative model for professionals and self-help groups.

Presents a narrative report of a field study in which members of a self-help research team provided services of significant, positive impact to one chapter of Make Today Count, a self-help group composed of cancer patients, their spouses, and health care professionals. A collaborative model is formulated. Important elements of this model include adequate knowledge of self-help processes, enhancement of rapport through acceptance of the group, and adoption of a consultive approach. Nonproductive modes on interaction observed between other professionals and chapter members are discussed. The present results are contrasted with negative results reported previously by professionals who attempted to collaborate with a similar self-help population, but who applied a different model. (16 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Using the media to foster self-help groups.

Describes a project that consisted of putting ongoing self-help groups on the radio for 1 hr a week. The 1st half hour each week involved an actual session of a self-help group; during the 2nd half hour, calls from the audience were taken and answered by members of the group. The groups were directed at helping women cope wth motherhood, at men who abused their wives or children, and at parents of children with behavior problems. Increases in referral calls to each group were found after the self-help groups went on the air. Process recordings of the shows were useful in documenting the communication patterns employed during the shows. A panel of 12 mental health professionals judged that the programs did not provide unethical, harmful, or inaccurate information. The present project provided a demonstration of how researchers can work collaboratively with media and self-help groups in monitoring change in community-level types of interventions. (27 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Self-help interventions for smoking cessation.

Self-help interventions for smoking cessation are an important bridge between the clinical and public health approaches to smoking cessation. The current literature on self-help interventions is encouraging but incomplete. Although their quit rates are lower than those of more intensive programs, self-help interventions could have a large public health impact because of their potential for widespread distribution. Studies comparing self-help to more intensive treatment suggest that long-term cessation rates for self-help programs are potentially as high as rates for face-to-face interventions, with lower quit rates for self-help programs that are likely due to differences in program adherence. Tailored materials and personalized adjuncts (e.g., written feedback or telephone counseling) that promote program adherence may increase cessation rates. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Attributional processes in behavior change and maintenance: Smoking cessation and continued abstinence.

If individuals attribute smoking cessation to external factors, they may be less able to maintain abstinence over time. To examine the role of attributions in initial and long-term behavior change, we manipulated the externality of treatment by comparing self-help manuals with and without a drug component and by comparing the motivational orientation of three programs (intrinsic self-help, intrinsic gum, extrinsic gum). We examined attributions for success or failure with treatment, the effects of treatment on initial cessation and on long-term maintenance of nonsmoking, and the effects of attributions on maintenance. Subjects receiving nicotine gum were superior to the intrinsic self-help group in initial cessation but were inferior in maintaining abstinence. Subjects in the intrinsic self-help group made fewer external attributions for success and remained abstinent longer, thus providing support for the attributional mediation of treatment effects on maintenance. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Expanding the pluralist revolution: A comment on Omer and Strenger (1992).

Extends H. Omer and C. Strenger's (see record 1993-06514-001) position that a pluralistic revolution has occurred in the helping professions to include nonprofessional helpers. The metanarratives of self-help organizations function similarly to Omer and Strenger's metanarratives of therapy. Omer and Strenger imply that such nonprofessional narratives are as valuable as professional narratives. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A comparison of espoused theories of self- and mutual help: Implications for mental health professionals.

Nonprofessional helping organizations, known as self- or mutual-help groups, are viewed as homogeneous, varying primarily in the problem addressed. However, there is great diversity in their methods, even among groups addressing similar problems, which has important implications for referring clinicians. Results of this study, which is a content analysis of the literature of 2 internationally known organizations for the mentally ill, suggest nonprofessional helping organizations are not homogeneous. Techniques of self-help based on authority, as opposed to mutual-help based on interpersonal and spiritual growth, characterize some of the differences. Groups also differ in problems addressed and help strategies offered. Implications of these differences for mental health professionals are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Reduced substance-abuse-related health care costs among voluntary participants in Alcoholics Anonymous

OBJECTIVE: This study examined differences in outcomes, alcoholism treatment utilization, and costs between alcoholic individuals with no previous treatment history who chose to attend Alcoholics Anonymous (AA) or to seek help from a professional outpatient alcoholism treatment provider. METHODS: Participants in this three-year prospective study were recruited at alcoholism information and referral services and at detoxification units in the San Francisco Bay Area. Chi square and t tests and repeated-measures analyses of variance were used to examine data gathered from interviews with 201 participants at baseline and at one and three years. RESULTS: At baseline, participants who chose to attend AA meetings (N = 135) were not significantly different from those who chose professional outpatient treatment (N = 66) in sex, marital status, employment, race, and symptoms of alcohol dependence and depression. However, AA attendees had lower incomes and less education and experienced more adverse consequences of drinking at baseline than did those who sought outpatient care, suggesting somewhat worse prognoses for the AA group. Over the three-year study, per-person treatment costs for the AA group were 45 percent (or $1,826) lower than costs for the outpatient treatment group. Despite the lower costs, outcomes for the AA group at both one and three years were similar to those of the outpatient treatment group. CONCLUSIONS: Voluntary AA participation may significantly reduce professional treatment costs. Clinicians, researchers, and policymakers should recognize the potential health care cost offsets offered by AA and other self-help organizations.     

Planning a community-based mental health system: Perspective of service recipients.

From the perspective of individuals with experience in the ex-mental patient movement, the authors (former patients) each provide a consumer perspective on the planning of mental health systems (MHSs). Problems in the current system are addressed, and the role of self-help and of patient and ex-patient organizations in developing a community-based MHS is highlighted. Opportunities for meaningful change provided by the Mental Health Planning Act, Pub. L. 99-660, are noted. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Self-help or hype? Comments on psychology's failure to advance self-care.

Demonstrates that self-help programs are experiencing explosion growth; that psychologists are to be credited with a substantial body of research dating back to the 1970s; that this research demonstrates the potential of self-help programs; that some psychologists have failed to heed the results of studies by rushing to market with exaggerated product claims; and that the American Psychological Association has itself set a poor example and failed to advance clear standards. These points are not intended as a criticism of self-help. Rather, they serve as an observation of psychology's failure to advance self-care. Psychologists are encouraged to meet the challenge that self-care presents. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Telephone counseling for smoking cessation: Effects of single-session and multiple-session interventions.

Smokers (N?=?3,030) were randomized to receive 1 of 3 interventions: (a) a self-help quit kit, (b) a quit kit plus 1 telephone counseling session, or (c) a quit kit plus up to 6 telephone counseling sessions, scheduled according to relapse probability. Both counseling groups achieved significantly higher abstinence rates than the self-help group. The rates for having quit for at least 12 months by intention to treat were 5.4% for self-help, 7.5% for single counseling, and 9.9% for multiple counseling. The 12-month continuous abstinence rates for those who made a quit attempt were 14.7% for self-help, 19.8% for single counseling, and 26.7% for multiple counseling. A dose–response relation was observed, as multiple sessions produced significantly higher abstinence rates than a single session. The first week after quitting seems to be the critical period for intervention. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychology and self-help groups: Predictions on a partnership.

Continued growth and increased legitimacy are anticipated for the American self-help group (SHG) phenomenon. Currently estimated at six and a quarter million participants annually, self-help groups will assume a central role in the nation's mental health delivery system over the next two decades. The first part of this article illuminates the self-help group phenomenon itself. Its scope, characteristics, supporting social climate, and associated research issues are reviewed. The second part is a futuristic examination of its interface with the newly industrializing world of health care. Massive increases in mental health services are predicted, especially via the SHG format. Theory development, research sophistication, changing SHG formats, a place in public policy, and acceptance into graduate curricula are also expected, as are collaborative relationships with a variety of professional disciplines. Psychologists are urged to enhance the relevance of the profession by taking an early leadership role in these developments. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Use of self-help materials for anxiety and depression in mental health services: A national survey of psychologists in Norway.

[Correction Notice: An erratum for this article was reported in Vol 42(3) of Professional Psychology: Research and Practice (see record 2011-11548-002). The author's affiliations were listed incorrectly. The correct affiliations are in the correction.] How do psychologists in clinical practice perceive and use self-help materials for clients with anxiety and depression? The use of self-help materials with guidance from a therapist has been suggested as a way of meeting the increasing need for mental health services. The present study investigated factors relevant to the use of self-help materials for the treatment of anxiety and depression among psychologists employed in mental health services. Among 1863 eligible clinical psychologists in Norway, 815 (43.7%) participated in a national survey. A total of 93.5% of the participants had recommended self-help materials to clients, and approximately half (55.1%) had received requests from their clients regarding self-help materials. Self-help materials were recommended as an adjunct and not as an alternative to therapist contact by 73.0% of respondents, by 16.6% for relapse prevention, and by 1.2% to clients on a waiting list. Internet/computer-based programs were recommended by 2.2% of the participants. The practitioner's previous use of self-help materials to enhance his or her therapy skills and knowledge of self-help materials was related to use of self-help materials with clients. Psychologists working in child mental health services recommended self-help less often than those working in adult services. These results have implications for future efforts to disseminate effective self-help materials through increased attention toward self-help interventions in training and clinical practice. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Making self-help more helpful: A randomized controlled trial of the impact of augmenting self-help materials with implementation intentions on promoting the effective self-management of anxiety symptoms.

Objective: The effectiveness of self-help materials may be constrained by failures to undertake recommended exercises or to deploy the techniques that one has learned at the critical moment. The present randomized controlled trial investigated whether augmenting self-help materials with if–then plans (or implementation intentions) could overcome these problems and enhance the self-management of anxiety symptoms. Method: At baseline, participants who reported anxiety symptoms completed the Hospital Anxiety and Depression Scale (HADS) and the state version of the State–Trait Anxiety Inventory (STAI). Participants were then randomized via a computer program to standard self-help (n = 86), augmented self-help (n = 90), or no-intervention (n = 86) conditions. Eight weeks later, 95% (n = 249) of the participants completed the HADS and STAI again. Results: Findings showed a significant reduction in anxiety in the augmented self-help condition compared with both the standard self-help and no-intervention conditions (caseness rates on the HADS at follow-up were 21%, 49%, and 44%, respectively). Mediation analyses indicated that the benefits of augmented self-help materials were explained by improved detection of anxiety-related triggers and greater experienced benefits of the self-help techniques. Conclusions: These findings suggest that implementation intentions offer a valuable supplement to self-help materials that can enhance their impact on outcomes. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Processes of change in Alcoholics Anonymous: A review of possible mechanisms.

Four diverse literatures are reviewed that may illuminate potential change mechanisms in AA: (1) group therapy process factors, (2) self-help group mechanisms of change, (3) the role of ideology, and (4) commitment generation in social orders. Each is discussed, and the relevance of particular processes to AA is noted. Change in other therapy groups is compared with that of AA. The role of ideology in AA is seen as one of unification, which leads to trust. Three process clusters may account for change: supportive, expressive, and insight-oriented techniques. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

"Use of self-help materials for anxiety and depression in mental health services: A national survey of psychologists in Norway": Correction to Nordgreen and Havik (2011).

Reports an error in "Use of self-help materials for anxiety and depression in mental health services: A national survey of psychologists in Norway" by Tine Nordgreen and Odd E. Havik (Professional Psychology: Research and Practice, 2011[Apr], Vol 42[2], 185-191). The authors' affiliations were listed incorrectly. The correct affiliations are provided in the erratum. (The following abstract of the original article appeared in record 2011-08009-010.) How do psychologists in clinical practice perceive and use self-help materials for clients with anxiety and depression? The use of self-help materials with guidance from a therapist has been suggested as a way of meeting the increasing need for mental health services. The present study investigated factors relevant to the use of self-help materials for the treatment of anxiety and depression among psychologists employed in mental health services. Among 1863 eligible clinical psychologists in Norway, 815 (43.7%) participated in a national survey. A total of 93.5% of the participants had recommended self-help materials to clients, and approximately half (55.1%) had received requests from their clients regarding self-help materials. Self-help materials were recommended as an adjunct and not as an alternative to therapist contact by 73.0% of respondents, by 16.6% for relapse prevention, and by 1.2% to clients on a waiting list. Internet/computer-based programs were recommended by 2.2% of the participants. The practitioner's previous use of self-help materials to enhance his or her therapy skills and knowledge of self-help materials was related to use of self-help materials with clients. Psychologists working in child mental health services recommended self-help less often than those working in adult services. These results have implications for future efforts to disseminate effective self-help materials through increased attention toward self-help interventions in training and clinical practice. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Training clients to help themselves: Outcome effects of training college student clients in facilitative self-responding.

Used training in facilitative self-responding to help clients alter what they say to themselves. The training was compared to empathy-based individual counseling for personal-social problems. 20 undergraduates served as Ss. Treatment consisted of 6 1-hr weekly sessions. Ss were compared on posttests of empathy, regard, genuineness, and concreteness of their self-help responses and self-ratings and observer ratings of interpersonal functioning and improvement on specific counseling goal behaviors. Significant treatment and Treatment * Measures interaction effects were observed, indicating significant differences in favor of the trained group for 6 of the 8 variables. Group differences on the 2 self-rating measures were not significant. The fact that minimally facilitative levels of self-responding and positive change as rated by observers was attained only by the trained group indicated the usefulness of the technique for self-help training. (26 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

"Self-help therapies" revisited.

The Board of Professional Affairs (BPA) of the American Psychological Association (APA) clarifies certain potentially misleading remarks and implications in an article on self-help therapies by G. M. Rosen (see record 1993-42527-001). A review of all pertinent APA governance documents reveals that the task force that Rosen discussed was an informal, unfunded work group that produced only 1 formal document in 1978. This document expressed some concerns regarding self-help therapies and offered general recommendations, including suggested changes to APA's ethics code. The BPA reviewed this document and raised a number of questions for the work group, but no clarifications or revisions of the document were ever forthcoming from the work groups. The original work group's document has not been endorsed by the BPA because it has not been through any formal APA governance review. (PsycINFO Database Record (c) 2010 APA, all rights reserved)