Resilience facilitates positive emotionality and integration of negative memories in need satisfying memory networks: An experimental study

Resilience has been associated with the capacity to experience positive emotions in the midst of negative life events or following the recall of such events. Apparently, resilient people are able to self-generate those positive emotions because they tend to integrate and associate such past negative life events with other positive past events in memory networks. However, study designs on resilience have remained either cross-sectional or longitudinal. The causal effect of resilience on these outcomes remains to be shown as a third variable or unknown factor could be at play. In this study, we used a resilience intervention from a self-help clinical program to induce resilience and compared this condition against Jacobson type relaxation and neutral music background. Results showed that the resilience intervention increased positive emotionality following the recall of a negative self-defining memory and facilitated the integration of that memory within more positive and need satisfying memory networks.     

Effects of guided immune-imagery: The moderating influence of openness to experience

It is widely believed that personality has an important role in determining the effectiveness of guided imagery (GI) interventions. The primary aim of the current study was to examine whether the effect of GI on several outcome measures was dependent upon openness to experience, a theoretically relevant variable previously unexplored as a potential moderator. Thirty-five healthy participants were randomised to an animated imagery, verbal imagery or no-intervention control group, with imagery groups receiving 10 × 20 min sessions. Pre/post-assessments of cortisol, sleep, stress and creativity were administered along with the openness to experience scale. Regression analysis indicated a significant increase in cortisol and decrease in tiredness following verbal GI, but only for those high in openness. The efficacy of GI interventions may be dependent upon openness to experience and this variable should be accounted for in future studies.     

Effects of a Self-Help Program on Depressed Mood for Women with an Unfulfilled Child Wish

This randomized controlled trial aimed to examine the effectiveness of a cognitive behavioral self-help program (CBS) with minimal coaching in improving depressed mood for women with a permanent unfulfilled child wish. Participants completed pretest, posttest, and follow-up questionnaires and were randomly allocated to CBS (n = 27) or a waiting list condition (WLC, n =27). Respondents who followed the CBS improved significantly on depression scores compared to the WLC. This positive effect remained at follow-up. This study suggests that a low-resource, low-cost self-help program could be an effective intervention in reducing depressed mood in women living with the loss of a desired child.     

Self-help interventions for adjustment disorder problems: a randomized waiting-list controlled study in a sample of burglary victims

Adjustment disorders (AjD) are among the most frequent mental disorders yet often remain untreated. The high prevalence, comparatively mild symptom impairment, and transient nature make AjD a promising target for low-threshold self-help interventions. Bibliotherapy represents a potential treatment for AjD problems. This study investigates the effectiveness of a cognitive behavioral self-help manual specifically directed at alleviating AjD symptoms in a homogenous sample of burglary victims. Participants with clinical or subclinical AjD symptoms following experience of burglary were randomized to an intervention group (n = 30) or waiting-list control group (n = 24). The new explicit stress response syndrome model for diagnosing AjD was applied. Participants received no therapist support and assessments took place at baseline, after the one-month intervention, and at three-month follow-up. Based on completer analyses, group by time interactions indicated that the intervention group showed more improvement in AjD symptoms of preoccupation and in post-traumatic stress symptoms. Post-intervention between-group effect sizes ranged from Cohen’s d = .17 to .67 and the proportion of participants showing reliable change was consistently higher in the intervention group than in the control group. Engagement with the self-help manual was high: 87% of participants had worked through at least half the manual. This is the first published RCT of a bibliotherapeutic self-help intervention for AjD problems. The findings provide evidence that a low-threshold self-help intervention without therapist contact is a feasible and effective treatment for symptoms of AjD.     

Diaries of significant events: socio-linguistic correlates of therapeutic outcomes in patients with addiction problems

The principles of narrative therapy imply that autobiographical diaries written by patients in treatment will not only facilitate but also elucidate progress. The relationship between the linguistic content of diaries and progress in treatment was examined in this study. Complete sets of daily diaries of ‘significant events’ written by 16 patients receiving treatment for drug, alcohol and food addictions at a residential centre, using the 12-step approach of the Anonymous fellowships, were typed up for analysis. Three forms of socio-linguistic enquiry were employed: narrative characterization; evaluative statement coding and computer analysis of word strategies. Results indicated that success in treatment as rated by counselling and psychiatric staff was associated with the following characteristics of diary narratives. They are (a) focused on individual progress, whether adopting a ‘positive interpretative’ or ‘negative reactive’ style; (b) less critical of self over time and more positive about others external to the treatment centre; (c) both positive about the treatment programme and critical of self; (d) using words indicative of ‘insight’ and ‘negativity’ as assessed by Pennebaker's LIWC programme. It is concluded that autobiographical material can usefully be employed to assess progress in treatment, and that its intrinsic value in effecting change should be further explored. © 1997 John Wiley & Sons, Ltd.     

Minority Group Membership and Perceptions of Self-help: Evidence from Israel

This study explores the meanings associated with the term ‘self-help’ in the general Arab population in Israel. It compares these associated meanings across various groups created by several demographic variables. The Arab population in Israel numbers nearly one million, comprising 18% of the total population of the state. The study used a random sample of 250 participants, representative of the general Arab population in Israel. Data was collected in a telephone survey which lasted 3–7 minutes. Three themes surfaced as the most prevalent meanings associated with the concept ‘self-help’: the individual meaning, which refers to one's ability to solve one's own problems and to rely on one's own strengths and resources; helping the ‘other’; and helping the needy. Significant differences in the associated meanings of the self-help concept related to level of education, marital status, and whether the respondent had heard of the self-help concept. The significance of the findings is discussed within several frames of reference. First, they are examined within the context of a particular minority culture which is constantly interacting with Israeli Jewish cultural values and is undergoing a change from traditional systems of values to modern Western ones. Second, the universal and particular attributes of the self-help phenomenon are outlined. Third, the initial developmental stages of self-help organizations within the Arab population living in Israel are discussed.     

Giving and Receiving Help: Interpersonal Transactions in Mutual-Help Meetings and Psychosocial Adjustment of Members

The helping transactions that occur in group meetings have been theorized to be important therapeutic mechanisms within mutual-help (or self-help) groups. Hypothesized links between giving and receiving help and psychosocial adjustment were examined in a mutual-help group for individuals with serious mental illness (GROW). Participants' adjustment was assessed at two time points and helping behaviors were measured with observational coding of weekly group interactions during the period between assessments. Frequencies of helping behaviors were used to predict Time 2 adjustment after controlling for initial adjustment. Consistent with the helper therapy principle, giving help to others predicted improvements in psychosocial adjustment; giving advice was a unique predictor. Total amount of help received was not associated with adjustment, but receiving help that provided cognitive reframing was associated with better social adjustment. A predicted interaction suggested that receiving help was related to better functioning when members experienced high levels of group integration.     

Comparison of outcomes across low-intensity psychological interventions for depression and anxiety within a stepped-care setting: A naturalistic cohort study using propensity score modelling

Low-intensity interventions for common mental disorders (CMD) address issues such as clinician shortages and barriers to accessing care. However, there is a lack of research into their comparative effectiveness in routine care. We aimed to compare treatment effects of three such interventions, utilizing four years' worth of routine clinical data. Users completing a course of guided self-help bibliotherapy (GSH), internet-delivered cognitive behavioural therapy (iCBT) or psychoeducational group therapy (PGT) from a stepped-care service within the NHS in England were included. Propensity score models (stratification and weighting) were used to control for allocation bias and determine average treatment effect (ATE) between the interventions. 21,215 users comprised the study sample (GSH = 12,896, iCBT = 6862, PGT = 1457). Adherence-to-treatment rates were higher in iCBT. All interventions showed significant improvements in depression (PHQ-9), anxiety (GAD-7) and functioning (WSAS) scores, with largest effect sizes for iCBT. Both propensity score models showed a significant ATE in favour of iCBT versus GSH and PGT, and in favour of GSH versus PGT. Discernible differences in effectiveness were seen for iCBT in comparison with GSH and PGT. Given variance in delivery mode and human resources between different low-intensity interventions, building on these findings would be valuable for future service provision and policy decision making.     

Helping and change without traditional therapy: Commonalities and opportunities

The therapeutic elements of four types of helping interactions (friends/family, religion, cinematherapy/bibliotherapy, and self-help groups), and their commonalities with traditional psychotherapy are explored. Empirical findings in these areas are discussed, along with suggestions for process and outcome research. Recommendations for the integration of self-help and paraprofessional counseling with professional therapy are presented.     

Rapid response predicts binge eating and weight loss in binge eating disorder: findings from a controlled trial of orlistat with guided self-help cognitive behavioral therapy

OBJECTIVE: It is important to find ways to predict response to treatments as this may inform treatment planning. We examined rapid response in obese patients with binge eating disorder (BED) who participated in a randomized placebo-controlled study of orlistat administered with cognitive behavioral therapy delivered by guided self-help (CBTgsh) format. METHODS: Fifty patients were randomly assigned to 12-week treatments of either orlistat+CBTgsh or placebo+CBTgsh, and were followed in double-blind fashion for 3 months after treatment discontinuation. Rapid response, defined as 70% or greater reduction in binge eating by the fourth treatment week, was determined by receiver operating characteristic curves, and was then used to predict outcomes. RESULTS: Rapid response characterized 42% of participants, was unrelated to participants' demographic features and most baseline characteristics, and was unrelated to attrition from treatment. Participants with rapid response were more likely to achieve binge eating remission and 5% weight loss. If rapid response occurred, the level of improvement was sustained during the remaining course of treatment and the 3-month period after treatment. Participants without rapid response showed a subsequent pattern of continued improvement. CONCLUSION: Rapid response demonstrated the same prognostic significance and time course for CBTgsh as previously documented for individual CBT. Among rapid responders, improvements were well sustained, and among non-rapid responders, continuing with CBTgsh (regardless of medication) led to subsequent improvements.