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.     

Competitive Memory Training (COMET) for OCD: A Self-treatment Approach to Obsessions

Competitive Memory Training (COMET) is a cognitive intervention that aims to change the maladaptive cognitive-emotional networks underlying obsessive-compulsive disorder (OCD). COMET has not been previously tried as a self-help intervention. The present study tested the preliminary feasibility, acceptability, and effectiveness of COMET for OCD implemented as a self-help intervention. Sixty-five participants with OCD recruited through online OCD self-help fora completed an online baseline assessment including measures of OCD symptoms, self-esteem, and depression. Participants were randomly assigned to either COMET or a wait-list control group. All participants were approached 4 weeks later to complete an online post-assessment. There was no evidence for a greater decline of OCD symptoms or depression under COMET. When analyses were limited to only those participants who reported reading the entire manual at least once, self-esteem was higher at post-assessment in the COMET group. Although 78.1% of patients in the COMET group rated it as appropriate for self-administration, only 56.5% performed COMET exercises regularly and 26.4% read the entire manual at least once. The feasibility and effectiveness of COMET as a self-help internet intervention for OCD was not supported in this study. Further work is needed to better understand if modifications to our implementation of COMET may yield improved outcomes.