The acceptability and feasibility of an anxiety reduction intervention for emergency department patients with non-cardiac chest pain

Despite good physical prognosis, patients who receive a diagnosis of non-cardiac chest pain (NCCP) may experience persistent pain and distress. While cognitive-behavioural interventions have been found to be effective for this group, they are difficult to deliver in busy emergency department (ED) settings. Addressing the acceptability and relevance of self-help interventions is an important initial step in addressing this need. This study sought to examine the acceptability and relevance of an evidence-based self-help intervention for ED patients with persistent NCCP and anxiety. Patient (interviews: N = 11) and specialist chest pain nurse (focus group: N = 4) views on acceptability and feasibility were examined. Data were analysed using thematic analysis. Patients and nurses reported that there was a need for the intervention, as stress and anxiety are common among patients with NCCP, and provision of psychosocial support is currently lacking. Both patients and nurses reported that the intervention was relevant, acceptable, and potentially useful. Some changes to the intervention were suggested. Nurses reported that the intervention could be used within the existing staff resources available in an ED setting. This study represents an important first step towards developing a brief self-help intervention for ED patients with NCCP and anxiety. Further research should seek to determine the efficacy of the intervention in a pilot trial.     

App-guided exposure and response prevention for obsessive compulsive disorder: an open pilot trial

Although effective treatments for obsessive–compulsive disorder (OCD) exist, there are significant barriers to receiving evidence-based care. Mobile health applications (Apps) offer a promising way of overcoming these barriers by increasing access to treatment. The current study investigated the feasibility, acceptability, and preliminary efficacy of LiveOCDFree, an App designed to help OCD patients conduct exposure and response prevention (ERP). Twenty-one participants with mild to moderate symptoms of OCD were enrolled in a 12-week open trial of App-guided self-help ERP. Self-report assessments of OCD, depression, anxiety, and quality of life were completed at baseline, mid-treatment, and post-treatment. App-guided ERP was a feasible and acceptable self-help intervention for individuals with OCD, with high rates of retention and satisfaction. Participants reported significant improvement in OCD and anxiety symptoms pre- to post-treatment. Findings suggest that LiveOCDFree is a feasible and acceptable self-help intervention for OCD. Preliminary efficacy results are encouraging and point to the potential utility of mobile Apps in expanding the reach of existing empirically supported treatments.     

How People Can Benefit from Mental Health Consumer-Run Organizations

The goal of this study is to develop a more comprehensive theoretical understanding of the processes by which people can benefit from mental health consumer-run organizations (CROs). To accomplish this goal, the concept of roles is used to create a preliminary framework that draws connections between several established theoretical explanations. To ground theory development in empirical data, 194 CRO members from 20 CROs answered open-ended questions about what personal changes occurred as a result of their CRO involvement and what CRO participation experiences enabled personal change. Data analysis led to the identification of 18 personal change categories and 7 experiences that led to change. These categories were integrated into the preliminary theoretical framework, which needed to be extended to accommodate all categories. While inevitably tentative, the final conceptualization provides a more comprehensive understanding of the processes by which people can benefit from CRO participation.     

Two-year outcome of internet-based relapse prevention for partially remitted depression

The objective of the study was to investigate the long-term effects of internet-based relapse prevention for sufferers of partially remitted depression. Eighty-four individuals with partially remitted unipolar depression were randomized to either internet-based CBT (iCBT) or to a control group. After the ten week intervention period the participants were followed for 24 months and diagnostic interviews conducted to detect relapse. The intervention and monthly self-ratings of depressive symptoms were administered via an internet-based platform that ensured secure communication with all participants. Significantly fewer participants in the iCBT group had experienced a relapse compared with those in the control group two years after the internet-based intervention. The relapse rate in the iCBT group was 13.7% (CI 95% = 2.5–24.9) and in the control group it was 60.9% (CI 95% = 44.8–77). Furthermore, a significantly larger proportion of the iCBT group experienced remission two years after the intervention compared with the control group. Internet-based CBT seems promising for preventing relapse in sufferers of partially remitted depression.     

A randomized wait-list controlled pilot study of dialectical behaviour therapy guided self-help for binge eating disorder

This study examined the efficacy of guided self-help based on dialectical behaviour therapy (DBTgsh) for binge eating disorder (BED). Individuals (88.3% female; mean 42.8 years) were randomized to DBTgsh (n = 30) or wait-list (WL; n = 30). DBTgsh participants received an orientation, DBT manual, and six 20-min support calls over 13 weeks. All participants were assessed pre- and post-treatment using interview and self-report; also, DBTgsh participants were re-assessed six months post-treatment. At treatment end, DBTgsh participants reported significantly fewer past-month binge eating episodes than WL participants (6.0 versus 14.4) and significantly greater rates of abstinence from binge eating (40.0% versus 3.3%). At six-month follow-up, DBTgsh participants reported significantly improved quality of life and reduced ED psychopathology compared to baseline scores. In addition, most improvements in the DBTgsh group were maintained, although binge eating abstinence rates decreased to 30%. These preliminary positive findings indicate that DBTgsh may offer an effective, low-intensity treatment option for BED.     

Effectiveness of self-help and support groups for cancer patients: A Review

Abstract

Following the recognition of the psychological difficulties faced by cancer sufferers, there has been a rapid growth in forms of group help. There is a wide variety of types, and nomenclature is far from consistent. Evaluation studies are reviewed, and issues of potential harmfulness are considered.     

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.     

Evaluating Triple P Online: A Digital Parent Training Program for Child Behavior Problems

Triple P Online (i.e., TPOL; www2.tripleponline.net) is an online self-help parent training program aimed at reducing child behavior problems through “positive parenting practices”—available at time of review for $79.95. TPOL is comprised of 8 video-based modules that also incorporate in-session activities and homework. Randomized control trials have shown that TPOL effectively reduces child behavior problems. The program’s main strengths include very high-quality content with an abundance of relevant and easily locatable resources, an easy-to-use interface, and a professional look and feel. The program’s main weakness lies in its lack of monitoring and adaptation to the user’s state (e.g., child’s and parent’s behaviors), and real-time reminders for desired actions. Altogether, TPOL is an extremely valuable and important resource for families seeking evidence-based treatment for child behavior problems.     

Conceptual Constructs and Social Classes: A Review of Capitalizing Religion

Capitalizing Religion is a good addition to the growing number of works in the last decade that examine the intertwinings of religion, spirituality, and capitalism in the neoliberal present. Through an examination of scholarly discourses on modern religion and contemporary fiction and spirituality manuals, Martin demonstrates how, within the consumer capitalist present, the ideologies of individualism, consumption, quietism, and productivity shape conversations, habits, relationships, and fantasies. Martin tells us that the goal of social theory should be to account for how individuals and their choices are propelled by the material, historical, and structural forces that constitute them. He is a writer who has long been particularly attentive to the fact that “religion” is not some particular entity that exists “out there” that can be examined, but rather a bounded construct whose definition – through processes of inclusion and exclusion – performs works of distinction that benefit some interests, groups, and individuals to the detriment of others. Capitalizing Religion reminds us that the choices that many sociologists of religion make in dividing social formations into categories such as “religious,” “spiritual,” “institutional,” “individual,” or “paranormal” don’t just describe the world, but rather attempt to constitute it through taxonomies that are anything but natural and given.     

Dialogical journal writing as ‘self‐therapy’: ‘I matter’

Aim: This case study of one woman's (Jane's) experience of dialogical journal writing presents a way of finding a ‘compassionate image’ for self‐therapy. Various theoretical analyses are indicated with Mindfulness‐based conceptualisations at the forefront. Methodology: Based on three recorded interviews, the narrative inquiry took place over a year. Methodologically, this paper is also one contribution to an ongoing debate about different research approaches in therapeutic writing research. Participants: This study took place in Aotearoa New Zealand, where both Jane and I are migrants. Discussion: This account draws on a report of self‐directed writing for well‐being, seen as an alternative to counselling or medication for depression and anxiety. It focuses on how a particular style of writing evolved and how the motivation to write continues.