Guided self-help versus pure self-help for perfectionism: a randomised controlled trial

Perfectionism is known to be a risk factor for the development and maintenance of obsessive-compulsive (OC) and depressive symptoms. The purpose of the present study was to test the effectiveness of a cognitive-behavioural self-help therapy for perfectionism, and to examine the effect of such treatment on OC and depressive symptomatology. The study compares the effectiveness of guided self-help (GSH, n=24) with pure self-help (PSH, n=25) therapy. Both GSH and PSH were found to be effective in reducing perfectionism, and also in reducing OC and depressive symptomatology. Overall, participants in the GSH condition experienced greater symptom improvement than participants in the PSH condition, and treatment gains for both groups were largely maintained at 3-month follow-up. Twenty percent of PSH participants experienced clinically significant increases in depressive symptoms over the treatment and follow-up period (compared to 0% in the GSH condition), suggesting that PSH may be a less suitable strategy than GSH in treating this population. Overall, the findings suggest that self-help for perfectionism is effective in reducing OC and depressive symptomatology in non-clinical individuals, with GSH being superior to PSH.     

The rhetorical organisation of dream‐telling

An appreciation of the ways in which clients and patients tell stories in psychotherapy is essential to an understanding of the therapeutic process. This paper reports findings arising from a programme of research into the analysis of patient narratives in psychotherapy sessions and diagnostic interviews. The focus of the current paper is on the analysis of the use of language in patient‐therapist interaction during the recounting in therapy of dream narratives. Dream‐telling follows certain rules of presentation that can be described as a set of specific rhetorical practices. The rhetoric of the dream‐teller reporting a dream is one of emotional distance, reflecting a narrative sequence which lacks a motivational framework. The report needs to be put into context by establishing a dialogue with the listener. The sharing of the dream with another, especially in the psychotherapeutic context, represents the dream‐teller's attempt to reproduce the dream experience. This attempt is made with reference to a responding and commenting other. The function — or dysfunction — of the assumption of hidden, non‐obvious, non‐recognisable wish‐fulfillment scenarios in patients' dreams is discussed. A method of working with dream material derived from narrative research is briefly described: the dramaturgical approach. This approach emphasises collaborative negotiation between client/patient and therapist, and combines the idea of free association with dream reconstruction and embedding the dream in current concerns, desires, and challenges.     

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.     

The evolution of cognition—a hypothesis

Behavior may be controlled by reactive systems. In a reactive system the motor output is exclusively driven by actual sensory input. An alternative solution to control behavior is given by “cognitive” systems capable of planning ahead. To this end the system has to be equipped with some kind of internal world model. A sensible basis of an internal world model might be a model of the system's own body. I show that a reactive system with the ability to control a body of complex geometry requires only a slight reorganization to form a cognitive system. This implies that the assumption that the evolution of cognitive properties requires the introduction of new, additional modules, namely internal world models, is not justified. Rather, these modules may already have existed before the system obtained cognitive properties. Furthermore, I discuss whether the occurrence of such world models may lead to systems having internal perspective.     

Subliminal self-help audiotapes: a search for placebo effects.

Subliminal self-help audiotapes to aid weight loss were evaluated to determine if their apparent effectiveness is due to a placebo effect. All subjects were female students or staff who were both overweight and believed in the possible effectiveness of subliminal audiotapes. Three different groups of subjects were tested: One group listened to subliminal audiotapes purchased directly from a manufacturer, the 2nd group listened to comparable placebo tapes, and the 3rd group did not listen to any tapes at all. Each subject in each group was weighed once each week for 5 weeks. All 3 groups of subjects lost weight, and the average amount of weight lost by each group was approximately equivalent. These results provide no evidence that regular use of subliminal audiotapes leads to a placebo effect. Rather, the results suggest that regular use of subliminal audiotapes may simply make subjects more conscious of their weight.     

Difference and Desire— a Queer Reading

Abstract : The 2008 Lambeth Conference of the Anglican Communion illustrated the difficulties presently facing all mainline Western churches in dealing with their internal divergencies in matters of gender, family and sexuality. Drawing on recent articles on queer theology the author argues that the Christian traditions—contrary to common assumption—have unique resources for solving not only their internal controversies in these matters, but also for contributing to the wider challenges facing the human family on how to live differently together.     

The efficacy of a brief internet-based self-help intervention for the bereaved

Research so far has shown little evidence that written disclosure facilitates recovery from bereavement. There are good reasons to assume that written disclosure may only benefit those bereaved who are at risk for developing problems or who are experiencing significant psychological problems as a result of their loss, and only when appropriate writing instructions are used. Drawing on previous work in the area of post-traumatic stress, a writing intervention was designed to test these assumptions. Bereaved individuals, who were still significantly distressed by their loss, were randomly assigned to the intervention condition (N = 460) or a waiting-list control condition (N = 297). Both groups filled in questionnaires online at baseline, and 3 and 6 months later. The intervention was administered via e-mail immediately after baseline measurement. Results showed that writing decreased feelings of emotional loneliness and increased positive mood, in part through its effect on rumination. However, writing did not affect grief or depressive symptoms. Contrary to expectations, effects did not depend on participants' risk profile or baseline distress level. Implications of these findings are discussed.     

The Milan method—a preliminary critique*

The elegance of the techniques developed by the Milan group has tended to blind family therapists to the many problems inherent in their approach. A close reading of their work uncovers many ethical and political issues which need to be addressed. This paper is a preliminary attempt to develop a critique of the group's method which recapitulates some of the most alienating aspects of the traditional medical model. It will concentrate solely on a critical reading of Paradox and Counterparadox and will not seek to come to terms with the more recent evolution of the Milan school.     

Towards community self-help in higher education

The development of a peer counselling programme by students at the University of Birmingham and by counsellors in training at the nearby University of Aston is described. The growth and development of the programme in terms of content, structure and rationale over the past two years are outlined, as are the results and implications of the development of new communication channels that it has facilitated on campus. The project's emphasis has shifted from providing services for others to concern for self development, and the implications both of this and of the programme's contribution to community development within the campus are discussed.     

An organizational typology for self-help groups

Conclusion Several continuing obstacles have hindered the compilation of a research-based body of literature on self-help groups. Among them are the diversity of the groups and the need for appropriate research methodology. The validated typology described above was designed to address some of these problems. It provides a means of recognizing the diversity of the groups and sorting them into broad types without stating that one is better or more productive than another. It supplies a framework for examining the organizational features of a group in order to facilitate comparison with other groups. It recognizes the potential effects of time, change, and leadership on the small local units of self-help organizations. It has implications for making research more compatible with self-help groups. The use of this typology might eliminate some of the ambiguity and conflicts currently found in the literature and thereby help people — professionals and self-helpers — to more clearly understand the nature and functioning of self-help groups.     

A randomised placebo-controlled trial of a self-help Internet-based intervention for test anxiety

Test anxiety is widespread and associated with poor performance in academic examinations. The Internet, not well-proven for the treatment of anxiety, should be able to deliver highly accessible Cognitive Behavior Therapy (CBT). This study sought to test the hypothesis that CBT, available on the Internet, could reduce test anxiety. Ninety university students were randomly allocated to CBT or a control program, both on the Internet. Before and after treatment, the participants completed the Test Anxiety Inventory (TAI), an Anxiety Hierarchy Questionnaire (AHQ), the Exam Problem-Solving Inventory (EPSI), the General Self-Efficacy Scale (GSES) and the Heim reasoning tests (AH) as a measure of test performance. Of the CBT and control groups 28% and 35%, respectively, withdrew. According to the TAI, 53% of the CBT group showed a reliable and clinically significant improvement with treatment but only 29% of the control group exhibited such a change. On the AHQ, 67% of the CBT group and 36% of the control group showed a clinically significant improvement, more than two standard deviations above the mean of the baseline, a change in favour of CBT. Both groups improved on the GSES, in state anxiety during exams retrospectively assessed, and on the AH tests. The improvement on the AH tests was probably a practice effect and not a reflection of a change in capacity for academic testing. This study thus supports use of CBT on the Internet for the treatment of test anxiety.