Continuum between Relational and Therapeutic Models of Self-help in Mental Health: A Qualitative Approach

Self-help groups are generally described as “group[s] composed of individuals who meet on a regular basis to help one another cope with a life problem” (APA, 2019). Yet, it is challenging to find a univocal definition of self-help groups. Scholars usually use different labels to highlight various features of self-help groups, suggesting the need for further inquiry regarding commonalities and differences. The level of professional involvement is one of the most disputed factors influencing whether a group is considered to belong to the “self-help family.” The present qualitative study aimed to understand how professional support in Tuscany, Italy can influence the organizational choices of these groups (place for meetings, admission criteria, timing, etc.), as well as the personal beliefs of members. The study included 17 self-help groups. During 13 focus groups meetings, 92 participants were interviewed; then, we individually interviewed 19 facilitators and six additional key informants from mental health settings. We used a grounded theory approach, and we discussed the emerging models with participants at a public event. Results show the emergence of two theoretical models to define self-help groups, not to be interpreted as mutually exclusive. The “relational model” refers to self-help groups whose main feature is to guarantee the acquisition of specific skills (social comparison skills, active listening, and empathy), while the “therapeutic model” seems to represent a kind of assimilation of other types of interventions.     

Putting Values into Practice: Public Policy and the Future of Mental Health Consumer-run Organizations

The purpose of the paper is to reflect on value dilemmas in mental health consumer-run organizations and to discuss implications for research, policy, and practice. We review the roots of consumer-run organizations in the self-help movement and the psychiatric survivor liberation movement, focusing on the distinctive values espoused by consumer-run organizations. We also discuss evidence-based and value-based approaches to mental health policy formulation and mental health reform, noting the particular importance of value-based approaches and the role that consumer-run organizations can play in mental health reform. Based on our experiences conducting a participatory action research study of four mental health consumer-run organizations, we identify and examine several value dilemmas, discuss the lessons that we learned about these value dilemmas, and note their implications for future directions in research, policy, and practice.     

Introduction to the Special Issue on Mental Health Self-Help

Since the 1950s, people with mental illness and their families have been organizing a wide range of self-directed, mutual support oriented initiatives, including self-help groups, nonprofit organizations, and businesses. These initiatives have become increasingly widespread over the years and today mental health self-help initiatives outnumber traditional mental health organizations in the United States (Goldstrom et al., Admin Policy Mental Health Mental Health Serv Res 33:92-103, 2006). Mental health self-help embodies much of what community psychologists promote, including the self-directed organization of people to create social change and facilitate personal transformation. This special issue provides new insight into several prominent areas of inquiry surrounding these low-cost interventions including: (1) their evidence base; (2) the processes by which people benefit; (3) how they interface with the mental health system; and (4) the value dilemmas they face.     

Hmong Mental Health Needs Assessment: A Community-Based Partnership in a Small Mid-Western Community

The overall goal of this assessment was to verify the mental health needs of Hmong living in a mid-west community in order clarify the format, content, and feasibility of providing mental health services for Hmong in the future. Using a Community-Based Participatory Research (CBPR) model, we held four focus groups with 36 men, women, adolescents and professionals, all of Hmong descent, as well as interviewed 28 individual medical, mental health, education, and social service providers in the Eau Claire community. Our Hmong sample was frequently unclear about what “mental” health meant, indicating a low level of mental health literacy. Results confirmed that there are significant mental health needs in this refugee and immigrant population. Participants described problems consistent with depression, post-traumatic stress disorder (PTSD), anxiety disorders, somatoform disorders, and severe social stress and acculturation difficulties in every generation. Elder people and male adolescents were described as the most disaffected and in need of immediate services. It will be critical to address mental health literacy before designing future interventions. Treatment suggestions were provided with the intention of removing barriers and incorporating culturally sensitive methodologies, while continuing to work closely with our local mental health providers and Hmong leadership.     

Understanding How Participation in a Consumer-Run Organization Relates to Recovery

The goal of this study was to examine how different types of participation in a consumer-run organization (CRO) are related to recovery. More specifically, this study uses structural equation modeling to examine the relative impact of empowering and socially supportive participation experiences on progress towards recovery among 250 CRO members from 20 CROs. An empowering participation experience refers to involvement in leadership roles and contribution to organizational functioning. A socially supportive participation experience refers to social involvement in mutually supportive friendships with intimacy and sharing. Results indicate that both types of participation are associated with recovery, although a socially supportive participation experience maintains a stronger relationship with recovery than an empowering participation experience. Findings are consistent with the idea that CROs should encourage both types of participation. Drawing from over ten years of experience supporting CROs, the discussion section explores several strategies CROs can use to foster empowering and socially supportive participation experiences.     

Bridging professional and mutual-help: An application of the transtheoretical model to the mutual-help organization

The authors suggest that the mental health system of the nation could benefit by more fully embracing the idea of mutual-help (i.e., self-help), and this collaboration could be facilitated by the utilization of a well-established clinical theory to elucidate the psychological processes at work within mutual-help organizations. The processes of change of the transtheoretical model is offered as one potential framework. This well-established model has been used to help psychologists better understand clinical and professional phenemonena, but, to date, has been used less frequently with non-professional interventions. This article applies the ten processes of change of the transtheoretical model to mutual-help organizations, focusing on four groups, including Alcoholics Anonymous (AA), Oxford House, GROW, and Schizophrenics Anonymous. The advantages of the transtheoretical model and its potential ability to act as a common language across clinical professionals and mutual-help organizations are discussed. In addition, advantages of bolstering the present mental health system using combinations of both forms of care along the recovery continuum are described.     

公共卫生人才调查及培养的思考

对江苏省部分市、区、县级疾病预防控制中心和卫生监督所的公共卫生队伍现状、人才需求进行了调查分析,为我国公共卫生教育提供了科学的依据。认为江苏省公共卫生系统现有人员素质有待进一步提高,医学高等院校应该加强公共卫生人才的培养。     

Development of the Multicultural Mental Health Awareness Scale

The present study describes the development of an instrument to assess the multicultural competencies of mental health professionals in Australia. The scale was developed to assess the effectiveness of a multicultural mental health training program. Mental health professionals from Queensland, Australia (N = 268) participated in the study by completing a questionnaire battery. Items on the new scale were generated to parallel the Queensland Transcultural Mental Health Centre (QTMHC) training program's objectives. The results describe a 35‐item Multicultural Mental Health Awareness Scale. Factor analysis of the scale indicated three factors of multicultural counselling competencies: Awareness, Knowledge, and Skills. These factors were in line with the Sue et al. (1982) multicultural counselling competencies. The scale has satisfactory internal consistency, test–retest reliability, concurrent validity, and discriminant validity and can be used to evaluate the effectiveness of the multicultural competency training programs in mental health.     

Living,resisting, and playing the part of athlete: Narrative tensions in elite sport

ObjectivesTo explore: (i) How elite and professional sport culture might steer individuals towards particular stories, identities, and actions; (ii) How athletes navigate or respond to these cultural pressures.DesignCross-sectional qualitative methodology.MethodNarrative interviews and focus groups with 21 elite and professional athletes followed by a narrative analysis of structure and form.ResultsAthletes demonstrated one of three processes. Individuals who live the part of athlete story their life and act in ways that conform to a culturally dominant performance narrative. Here, identity is foreclosed, relationships sacrificed in the pursuit of success, and long-term wellbeing threatened. Over time, alternative narrative types may provoke moral reflection on their story and actions. Individuals who resist the part of athlete sustain a life story and identity that deviates from the performance narrative, drawing on alternative narrative types. Their resistance is typically overt as they publicly demonstrate actions that align with their multidimensional story. Individuals who play the part of athlete modify their story and actions depending on sociocultural context. These individuals covertly maintain a multidimensional life story, but silence this story when powerful others require performance stories.ConclusionsAlthough some elite/professional athletes' life stories revolve around performance outcomes, this is not a prerequisite for excellence. Other athletes achieve excellence while sustaining a multidimensional life story and identity. To do so, they navigate a culture that expects a performance focus, through overt resistance or covertly manipulating their public stories and actions.     

Relationship of religiosity to mental health literacy,stigma, social distance,and occupational restrictiveness in Ningxia Province,China

Little research has assessed the relationship between religiosity and mental health awareness in low- and middle-income countries. This study identified a representative sample of 2,425 community-dwelling adults in Ningxia, China and administered the Duke University Religion Index, the Mental Health Knowledge Questionnaire, the Mental Health Attitude Questionnaire, the Social Distance – Personal Questionnaire and the Social Restrictiveness – Occupational Questionnaire. Religious affiliation per se was not associated with mental health literacy or attitudes, but higher levels of religiosity were associated with better awareness of mental health issues and less social distance and occupational restrictiveness of those with mental health conditions. However, these relationships were substantially different in Hui ethnicity respondents (85% of whom were practicing Islam) and Han ethnicity respondents (15% of whom practiced Buddhism, Taoism or Confucianism).     

Ego involvement moderates the assimilation effect of affective expectations

Based on the affective expectations model and research on mental effort mobilization, two experiments manipulated affective expectations (no expectations versus positive expectations) and ego involvement (low versus high) and assessed participants’ affective reactions to hedonically neutral stimuli. In Experiment 1, evaluations were more positive when participants had positive expectations about neutral photos—but only when ego involvement was low. High ego involvement neutralized this affective expectation assimilation effect. Experiment 2 replicated these findings for experienced mood after reading a hedonically neutral short essay. Furthermore, high ego involvement led to longer response latencies in the affect ratings in Study 1. The findings support the idea that high ego involvement resulted in relatively high mental effort that was necessary to detect discrepancies between affective expectations and stimuli’s real affective potential and therefore moderated the assimilation effect to affective expectations.

父母离异对子心理发展的影响:计票式文献分析途径的研究

采用计票式文献分析技术对国内1994-2005年间关于离异家庭子女心理特点的35篇研究进行了系统回顾,发现所有研究都报告了父母离异对子女心理发展存在消极影响。他们存在更多躯体化、强迫、焦虑、敌对、孤独、冲动等心理健康问题;行为问题发生率高于完整家庭对照组,主要表现为孤僻、退缩、抑郁、社交不良等行为问题;在人格方面更具神经质特征,表现出更强的掩饰性,人格倾向性容易出现过分内向或过分外向的两极化趋势;在自我意识方面更消极;在学业方面表现较差;知觉到更强的压力而且采用更消极的应对方式,有着更高的犯罪率和自杀意念。对目前研究方法上的不足之处进行了探讨,对国内外研究内容和结果上的差异进行了分析,对未来的研究方向提出了意见和建议。     

The Structure of Social Exchange in Self-help Support Groups: Development of a Measure

Self-help support groups are indigenous community resources designed to help people manage a variety of personal challenges, from alcohol abuse to xeroderma pigmentosum. The social exchanges that occur during group meetings are central to understanding how people benefit from participation. This paper examines the different types of social exchange behaviors that occur during meetings, using two studies to develop empirically distinct scales that reliably measure theoretically important types of exchange. Resource theory informed the initial measurement development efforts. Exploratory factor analyses from the first study led to revisions in the factor structure of the social exchange scales. The revised measure captured the exchange of emotional support, experiential information, humor, unwanted behaviors, and exchanges outside meetings. Confirmatory factor analyses from a follow-up study with a different sample of self-help support groups provided good model fit, suggesting the revised structure accurately represented the data. Further, the scales demonstrated good convergent and discriminant validity with related constructs. Future research can use the scales to identify aspects of social exchange that are most important in improving health outcomes among self-help support group participants. Groups can use the scales in practice to celebrate strengths and address weaknesses in their social exchange dynamics.     

The Intensive Mental Health Program: Development and Structure of the Model of Intervention for Children with Serious Emotional Disturbances

In order to meet the challenging needs and behaviors of children with Serious Emotional Disorders (SED), a school and community based Intensive Mental Health Program (IMHP) was developed and evaluated. We describe the conceptual framework, treatment principles, and model for service delivery for psychological and educational interventions under the umbrella of the IMHP. The program illustrates a model of comprehensive services for children with SED.     

The Italian version of the Social Comparison Rating Scale and the Submissive Behaviour Scale: Reliability and validity in a sample of adolescents

Social rank theory argues that social comparison and submissive behaviour are mechanisms by which humans and animals form themselves into social ranks. Design: this study assesses the psychometric properties of Italian versions of the Social Comparison Rating Scale—SCRS and Submissive Behaviour Scale—SBS in a sample of adolescents. The samples consisted of a clinical group (N = 200) and a non-clinical group (N = 1991). The non-clinical group allowed us to obtain two random samples used for the EFA and the CFA; moreover, we also extracted a Retest sample consisting of 219 subjects. Internal consistency was satisfactory and the factor structures were similar to the original version of the measures. The SBS and SCRS were significantly correlated with all the symptom profiles on the SCL-90-R, in both populations. Clinical populations had higher correlations with these measures. Statistical analyses showed a good fit to the data, replicating the constructs of the original scales. These results confirm that submissive behaviour and social comparison are associated with mental health problems.     

The relationship between pulmonary function and suicidal ideation in Korean adults: a nationwide survey

Controversy surrounds the association between lung function and mental health in the general population, and previous reported results were confounded by the effect of other chronic illnesses. This study aimed to investigate whether reduced lung function was related to mental health issues, taking into consideration the relevant potential confounders. We used data from the 2008–2013 Korean National Health and Nutrition Examination Survey to examine the relationship between lung function and three mental issues (recognized stress, depressive mood, and suicidal ideation) among 22,068 Korean adults. A multiple logistic regression with adjustment for potential covariates including chronic illnesses revealed that a .5-L decrement of forced vital capacity increased the risk for suicidal ideation in both genders, but there was no significant association with recognized stress or depressive mood. We found an inverse relationship between lung function and suicidal ideation in the Korean general population.     

入世出世心理对压力和心理健康的中介作用

以319名大一学生为被试研究入世出世心理对压力和心理健康的中介作用,结果发现：（1）平常心对压力和生活满意度起部分中介作用,拼搏精神对压力和自尊起部分中介作用。（2）平常心对压力和心理症状总分、自卑、网络成瘾、敌对起部分中介作用,拼搏精神对压力和人际过敏、抑郁起部分中介作用。说明拼搏精神与平常心能缓减压力对心理健康的消极影响,培养拼搏精神和平常心是应对压力的有效途径。     

Coping with Crisis Across the Lifespan: The Role of a Telephone Hotline

We describe over 300,000 crisis calls made to a large national hotline over a 5-year period. Callers consisted of males and females between the ages of 10 and 89. Overall, a slight majority of callers were first time callers (52%) and most (73%) sought assistance with issues related to parenting, youth concerns, and mental health. Across the lifespan, issues dealing with loneliness increased with age whereas depression-related calls decreased. Additionally, females were more likely than their male counterparts to call the hotline by over a 2- to 1-margin. Findings lend preliminary support to the efficacy of crisis call centers to utilize a flexible, yet well-defined problem-solving approach to assist those of all ages calling with the wide range of problems.