Test Anxiety

Test anxiety is a nondiagnosable anxiety problem that is often associated with a variety of other, diagnosable anxiety disorders. It refers specifically to the experience of high levels of anxiety prior to and during test-taking that can interfere with a person's ability to concentrate and to perform successfully. Test anxiety can include fear of external evaluation (social anxiety), panic attacks during the testing experience (PD), and excessive worry about the consequences of failing a test...

How Effective Is Self Help in Primary Care

Meta-analytic reviews of the efficacy of self-administered treatments (Bower, Richards, & Lovell, 2001 Cavanagh & Shapiro, 2004 Cuijpers, 1997 Gould & Clum, 1993 Scogin, Bynum, Stephens, & Calhoon, 1990) conclude that self-administered treatment is significantly more effective than no treatment for problems ranging from fears, depression, headache, insomnia, social skills, parent-child training, to sexual dysfunction. This effect extends to follow-up periods of several months....

Advantages of Self Help

Cost containment might be the most salient advantage of media-based self-help therapies and the most long-lived reason for developing such interventions. A historical account proffers that a medical self-help book of 17th-century Europe was written expressly to aid indigent people who could not afford physicians' fees (Ring, 2004). Indeed, Rosenberg (2003) highlights the inexpensiveness of the self-help materials brought to America by English settlers, noting that these could help individuals...

APAs Task Forces on Self Help Therapies

In 1977, the Committee on Scientific and Professional Ethics and Conduct of the American Psychological Association, after discussions involving the Board of Professional Affairs, invited one of us (G. Rosen) to chair a Task Force on Self-Help Therapies (APA, 1978a, 1978b). The task force was asked to consider whether ethical standards adopted by APA adequately dealt with the recent involvement of psychologists in developing and marketing self-help programs. A report was issued by the task force...

Chapter Points

Media-based self-help should be distinguished from self-help groups, the former of which is a more recent development that has received less attention in the empirical literature. Bibliotherapy is the primary means of media-based self-help, although computer-based approaches are on the rise. Many forms of bibliotherapy exist, but problem-focused approaches that prescribe cognitive-behavioral techniques have received the most empirical attention. Self-help materials may be less efficacious when...

Conclusion

The self-help approach to sexual problems has been the subject of a considerable number of empirical investigations. Bibliotherapy, video therapy, computerized sex therapy, and individualized sex therapy through the Internet were documented. The evidence needed to warrant broad applications of these approaches, however, is still scarce and fragmented. Bibliotherapy in various formats has been the venue most thoroughly researched. The results of bibliotherapy compared favorably with no treatment...

Conclusions

The diverse challenges posed by diabetes and the many influences on diabetes self-management provide a rich terrain in which to examine self-help. Diabetes, a clearly biological disease, leads to consideration of the central role of behavior in diabetes management and the broad range of influences from intrapersonal to family to community and policy on those behaviors. Within this terrain, self-help interventions emerge as ecologically framed. In diabetes, self-help does not entail gaining...

Contents

1 Self-Help Therapies Past and Present 1 2 Good Intentions Are Not Enough Reflections on Past and Future Efforts to Advance Self-Help 25 GERALD M. ROSEN, MANUEL BARRERA, JR. AND RUSSELL E. GLASGOW 3 Self-Help Interventions Mapping the Role of Self-Administered Treatments in Health Care 41 4 Self-Regulation Theory and Self-Help Therapies 59 GREG A. R. FEBBRARO AND GEORGE A. CLUM 5 Self-Help Therapies for Anxiety Disorders 77 MICHIYO HIRAI AND GEORGE A. CLUM 6 Self-Help Therapies for Depression...

Current Efforts

The fundamental concern of psychologists and allied health professionals interested in advancing self-help has remained the same throughout the years. This fundamental concern is How can professionals contribute to self-help instructional materials so that today's programs are more effective than yesterday's, and tomorrow's programs will be more effective than today's In this context, it is significant that research has continued to demonstrate the effectiveness of self-help programs. For...

Devising Effective Self Help Programs

In one real sense we have no better idea today how to write a self-help book than we did 30 years ago. Similarly, we do not know what an effective Internet-based program for changing depression or other disorders should look like and how it might differ from one that was not effective. At present no study exists that has compared different ways of presenting the same self-help material. As empiricists, therefore, we must conclude that we simply do not know how to present therapeutic content in...

Ecological Perspectives

Ecological perspectives in public health and health promotion offer an approach to understanding the factors surrounding the individual that can enhance or impede self-management. Ecological models articulate ways in which the individual and individual-level influences on behavior are embedded within several levels of social, organizational, and economic influences such as in Figure 15.1 (Stokols, 1996). Ecological perspectives and the importance of sustaining diabetes management within the...

Elements in Therapist Administered Treatments

Modern self-help formats for sexual dysfunctions are typically based on the standard face-to-face therapies for sexual dysfunctions that began with Masters and Johnson's Human Sexual Inadequacy (1970). An important aspect of the treatment format they described is called sensate focus therapy. Elements include (a) a relational frame or reference in which sexual problems are diagnosed and treated (b) a ban on intercourse (c) a series of sensate focus exercises, used to produce a safe atmosphere,...

Feedback Approaches for Enhancing Outcome

SATs, whether delivered via books or computer-assisted programs, often incorporate continuous assessments to check on progress or the lack of progress. Stepped-care approaches require the use of constant monitoring to determine whether progress is occurring or whether a shift to more traditional treatments is required. As examined to date, SATs have utilized assessments to provide feedback to the individual being treated and to the individual conducting the study to assist with treatment...

Good Intentions Are Not Enough

Reflections on Past and Future Efforts to Advance Self-Help GERALD M. ROSEN, MANUEL BARRERA, JR. In recent years, the American Psychological Association revised its Ethical Principles of Psychologists and Code of Conduct (APA, 2002). The document begins with this general statement Psychologists are committed to increasing scientific and professional knowledge of behavior and people's understanding of themselves and others and to the use of such knowledge to improve the condition of individuals,...

Handbook of Self Help Therapies

Clum Lawrence Erlbaum Associates Taylor & Francis Group 270 Madison Avenue New York, NY 10016 Lawrence Erlbaum Associates Taylor & Francis Group 2 Park Square Milton Park, Abingdon Oxon OX14 4RN 2008 by Taylor & Francis Group, LLC Lawrence Erlbaum Associates is an imprint of Taylor & Francis Group, an Informa business Printed in the United States of America on acid-free paper 10 9 8 7 6 5 4 3 2 1 International Standard Book Number-13 978-0-8058-5171-7...

How Receptive Are Primary Care Physicians to Self Administered Treatment

Much less is known about the views concerning self-administered treatment among primary care physicians. Richards, Lovell, and McEvoy (2003) acknowledge that the general practitioner is often faced with limited remuneration or incentive for supporting self-help mental health care. Short consultations arising from pharmacological treatment are more economically rewarding. Pragmatically, primary care physicians are pressed for time, with the average primary care consultation being 15 minutes...

I

Imagery training, 222 Individualism, 9 Individualized assessment, 361, 362 Insomnia bibliotherapy for, 225, 233-235 CBT approaches to, 220-223 diagnosis of, 217-220 effectiveness of self-help for, 233-235 prevalence of, 215-217 self-help treatments for, 220-237 treatment of, 220-223 Inspirational bibliotherapy, 133, 144 Instructional manuals for children, 144-145 for parents, 145-146 Interactive voice-response systems, 402 Internet, use of, 331 Internet-based self-help treatments for anxiety...

Integrating SATs in the Delivery of Treatments for Health Problems

The principle question to be addressed here is whether any SATs have demonstrated sufficient efficacy to warrant their prescription for dealing with any health problems. A related question is how SATs are to be used in the treatment armamentarium only adjunctively with other treatments offered by a professional, as a first step in a stepped-care approach, or as a stand-alone treatment. Also critical is the question of whether the most familiar approach to using SATs should be employed (i.e.,...

L

Last Chance Diet (Linn & Stuart), 296 Learned Optimism (Seligman), 144 LEARN Program for Weight Control, 306, 314 Let's Eat Right to Keep Fit (Davis), 295-296 LifeSign program, 279-280 Long-term concerns, 62 Low-Cho diets, 298, 299-307, 308, 313-314 (Frankl), 114 Marketing, 15-16 Mass media, weight consciousness and, 294-295 McGraw, Phil, 15, 310-311 Media-based self-help see also Bibliotherapy defined,1-2 lack of research on, 15-16 Meditation, 222 Me Generation, 9 Men, prevalence of sexual...

Lessons Learned

In the 1970s, the foremost instructional modality for self-administering treatments was the self-help book. Glasgow and Rosen (1978, 1982) reviewed over 100 studies and case reports from the 1970s that evaluated behaviorally oriented self-help instructional materials. This impressive body of research generally supported the use of do-it-yourself treatments. Research findings also highlighted the multiple, cost-effective benefits of self-instructional programs. At the same time, a number of...

Limitations of Self Help

In a vast understatement, Ballou (1995) remarks that Self-help materials vary dramatically in quality when considering vital attributes such as thoroughness, knowledge of psychology, and responsibility to the reader (p. 56). Perhaps the biggest criticism of the self-help genre is that very few of these materials have been subjected to research and shown to be empirically valid. Starker (1989) notes that, unlike pharmacological treatments, self-help books are totally unregulated. Thus, these...

Opportunities for Further Research

Self-help for children and parents should be evaluated more rigorously given their widespread use and the potential of very cost-effective intervention. As Rosen (1987) noted, the growing proliferation of self-help treatments necessitates better research on their effectiveness. The development and integration of alternative, testable approaches to mental health care that engage families and communities have been recognized as a key area of future research in the area of child mental health...

Practice Recommendations

We have attempted to briefly summarize the research evidence of the effectiveness of self-administered treatments for depression. We now present practice recommendations for using self-help treatments with depressed individuals. Be sure to address a depressed individual's treatment preferences and attitude about self-administered treatment prior to recommending this modality to the individual. Additionally, make a point to explain the rationale behind self-administered treatment including the...

Preface

Empirically supported interventions were the hallmark of psychology in the late 1960s as the new science of behavior therapy began to take hold. This was an era characterized by a concern for the betterment of society, and behavior therapy optimistically offered a means of improving the psychological circumstances of the masses (Evans, 1997). Bolstered by the demonstrated success of these latest therapeutic techniques, George Miller, in his 1969 presidential address, encouraged members of the...

References

L. (2000). Who uses bibliotherapy and why A survey from an underserviced area. Canadian Journal of Psychiatry, 45, 645-650. Ballou, M. (1995). Bibliotherapy. In M. Ballou (Ed.), Psychological interventions A guide to strategies (pp. 55-65). Westport, CT Praeger. Evans, I. M. (1997). The effect of values on scientific and clinical judgement in behavior therapy. Behavior Therapy, 28, 483-493. Floyd, M., McKendree-Smith, N. L., & Scogin, F. R. (2004). Remembering...

Self Administered Therapies in Primary Care

WALKER AND ALAN KATZ Consumers of health services have been taking a more active approach to their own health care. For example, Sirovatka (2002) reports that 7 million hits are registered every month on the National Institute of Mental Health (NIMH) homepage. Self-administered treatment in the primary care setting is a promising approach to broaden the choice of treatments and improve the quality of service for those with a wide array of health problems. In this chapter,...

Self Harm versus Self Help

Regrettably, scant research exists on the appropriate selection and implementation of self-help materials (Pantalon, 1998). This circumstance gives rise to the concern that consumers may incur harm through misdiagnosis and misuse of these products. Diagnostically, Greenberg (1994) points to the codependence literature, largely targeted toward women, as having such a broad definition that most readers are likely to meet these criteria. He states that one book even claims a 98 infection rate for...

Self Help Therapies for Childhood Disorders

MCGRATH The past decade has seen an astonishing proliferation of self-help material for pediatric mental health and physical health conditions through books, videos, and the Internet. More than at any point in history, self-help (or self-administered) interventions are now aggressively promoted to consumers for a broad range of health conditions and disorders. There is good reason for optimism that this trend will benefit children. Self-help circumvents barriers to...

Self Help Therapies for Sexual Dysfunctions

Overt sexual behavior of humans is not observable in public as it is in other mammals. Although the promotion and depiction of sexuality by the media has raised general awareness, sexual behavior in the strict sense of genital contact is likely to be covert. Moreover, public displays of sexual behavior often elicit censure, as the example of legal consequences for exhibitionism demonstrates. Similarly, men and women with sexual problems commonly keep them hidden from others. Not only are sexual...

Summary

This chapter began with an explication of the question What is self-help In doing so, it attempted to integrate elements of various and varying definitions in order to come to a common understanding of the term. Next it revealed that the process of self-help is rarely, if ever, conducted in isolation. As Grodin (1991) explains, self-help is a relatively private act that paradoxically places users in contact with others. Although current research has begun to examine the practitioner's role in...

Summary and Conclusions

The present chapter began with an evaluation of the scope of self-help approaches to problems of medical and psychological relevance in present-day American society. While the use ofvarious self-help approaches is both undeniable and vast, much less information is available on the effectiveness of these approaches. One of the chief difficulties encountered in examining the role of SATs for reducing health problems in our society is that no information exists as to how individuals identify the...

T

28-30 Test anxiety, 96-98 Therapist-directed treatments (TDTs), 5, 6 compared with SH treatments, 82, 86-88, 91-92, 98-100, 232-233 effectiveness of, 47-50 for sexual dysfunctions, 190-193 level of contact with, 4-7, 109 role of, in self-help treatments, 151-152 Therapy, self-administered, 5 Toilet Training in Less Than a Day (Azrin & Foxx), 26-27 Trauma victims interventions for, 32 self-help treatments for, 92-94 manuals, 280-281 Treatment outcomes see also Effectiveness for depression,...

Are Primary Care Patients Different From Those Seen in Other Health Settings

The range of problems encountered in the primary care setting is even more diverse than those seen in specialty medical and mental health settings. Table 16.1 summarizes findings concerning common physical and mental health conditions in primary care. A number of these problems have been the focus of self-administered treatment approaches. Primary care patients with mental health complaints may differ in important ways from patients seeking help in specialty mental health clinics. For example,...

The Need to Address Diversity Issues

In discussing the future of self-help therapies, we would be remiss if we did not address diversity or the current lack thereof in this field. One way that this issue may manifest itself is in terms of who is behind the development of self-help programs. While we did not systematically examine the gender, race, ethnicity, or sexual orientation of those who created the self-help programs cited throughout this text, Kissling (1995) found that most authors of the self-help books she reviewed were...

How Receptive are Primary Care Patients to Self Administered Treatment

Patients have preferences for the type of treatment that they receive and many individuals prefer behavioral over pharmaceutical methods to address health and mental health difficulties. For example, Van Schaik et al. (2004) reviewed the literature on preference in primary care for treatments of major depression. Six studies were included in the review and all showed that primary care patients preferred psychotherapy to antidepressant medication, by a factor of no less than 2 1. Arean and...

About the Editors

Patti Lou Watkins, Ph.D., is an associate professor in the Women Studies Program at Oregon State University. Her background is in psychology, having obtained her bachelor's degree from West Virginia University, her master's degree in applied behavioral analysis from the University of the Pacific, and her doctoral degree in clinical psychology from Virginia Tech. There, she began her collaboration with her former professor and current coeditor, George Clum, evaluating interventions for panic...

Conclusion and Recommendations

The research to date suggests that self-help approaches for women with eating disorders and those at risk for developing an eating disorder are widely used, feasible to deliver, and effective. Studies conducted in Europe, Canada, and the United States contribute to the generalizability of findings. However, the majority of studies sampled young, white women and recent research shows that eating disorders and body image issues occur across a broader age range and among more ethically diverse...

Types of Self Help Programs

Self-help programs for eating disorders are offered in a variety of formats. The most common format is bibliotherapy. Hundreds of self-help books on eating disorders have been published. The approaches range from empirically validated CBT (e.g., Overcoming Binge Eating Fairburn, 1995) to religiously oriented (e.g., Loving Your Body Embracing Your True Beauty in Christ Newman, 2002) to those using the popular For Dummies series format (Anorexia & Bulimia for Dummies Beck, 2004). Didactic...

Obsessive Compulsive Disorder

OCD is characterized by unwanted, repetitive, anxiety-generating thoughts, images, ideas, or urges that seem impossible to control. Often, the person with obsessions believes that catastrophic consequences are presaged by the obsessions. Compulsions, on the other hand, are repetitive behaviors or mental acts, intended to reduce anxiety associated with obsessions. Effective psychological treatments have focused on repetitive and prolonged exposure of the obsessional material, intended to reduce...

Review of Selected Manuals

Self-help manuals to quit smoking are readily available in a variety of local and Internet stores. Recently, we assessed the number of books available through an Internet retailer using stop smoking as the search term. This search returned 305 items. This points to the popularity of self-help treatment manuals for smoking and also makes daunting the possibility of reviewing all the available books on this topic. Rather, six best-selling smoking manuals found at two national booksellers were...

Self Help Bibliotherapy for Eating Disorders

Reading self-help books is commonly reported by women with eating disorders. Rorty, Yager, and Rossotto (1993) found that almost half (43 ) of women with eating disorders reported reading self-help books. The majority reported high levels of satisfaction with this approach. Although a number of studies examined self-help workbooks with modest therapist contact, to our knowledge there have been no studies that examine the efficacy of self-help books without additional intervention. In 1993,...

Bibliotherapy

The most common self-administered treatments for depression are biblio-therapies, or self-help techniques presented in the written format of a book or tract. This self-help modality already has a place in depression treatment as an adjunct to therapist-led interventions. One survey indicated that 60 to 97 of psychologists use bibliotherapy as part of their treatment for at least some of their clients (Starker, 1988). Of the available types of bibliotherapy for depression, the majority are those...

Does Self Help Work for Children

Discussing the advantages and limitations of alternative forms of health care is moot if these modalities are ineffectual. Self-help for childhood disorders has a somewhat weak evidence base. For some formats and some health conditions, the data are very encouraging. But for other combinations of formats and health conditions, few if any data are available to indicate that effects are anything more than placebo. We now turn to the state of the evidence for self-help interventions for children...

Types of Self Help for Sexual Dysfunctions

Self-help interventions for sexual dysfunctions can be grouped by type of venue and further examined by amount of therapist contact. Bibliotherapy, video therapy, and computer-assisted sex therapy can be conducted with little or no therapist involvement using a program installed on a home computer. Telephone therapy, conducted by itself or as an adjuvant to bib-liotherapy or video therapy, and Internet therapy using e-mail communication, requires some therapist involvement. These different...

Application of Self Regulation to Self Help Treatments

Self-help books (SH), as well as other venues for presenting SH programs, can be classified in terms of their intent. Some are designed to encourage, to provide hope for individuals who are without hope, or to raise the aspiration bar higher than previously dared. Such books often use first-person accounts of someone overcoming adversity previously thought intractable or of achieving at a level previously unimagined. Other books seek to establish a goal as well as to provide information on how...

Blueprint for Developing Effective Self Help Programs

As yet unanswered is the question of how to sequence treatment modules for programs that, as a whole, have demonstrated effectiveness. Which elements are necessary and which merely fillers To begin to answer this question requires an analysis of effective programs developed to date, an examination of self-regulatory elements that have been found efficacious, and a logical analysis of how to sequence various treatment elements. With considerable humility and with the expectation of being proven...

Available Self Help Materials and Target Audience

A search of the Amazon.com Web site using the keywords self-help and sleep produced over 40 hits. Included in the top-selling books were No More Sleepless Nights (Hauri, 1996), Can't Sleep, Can't Stay Awake A Woman's Guide to Sleep Disorders (Kryger, 1999), Say Good Night to Insomnia (Jacobs, 1999), and Seven Days to a Perfect Sleep (Gordon, 2003). The majority of available materials come in book form. Audio media (tapes or compact disks) comprise the remaining commercially available titles....

Specific Phobia

SP is diagnosed when an individual experiences persistent and irrational fear of particular objects or situations and actively avoids contact with such objects or situations. Specific phobia is one of the most common anxiety disorders. In the United States, approximately 11 of people will suffer from SP at some point in their lives (Kessler et al., 1994). Four subtypes are specified including animal, natural environment, situ-ational, and blood-injection-injury types. Ample evidence exists that...

Social Phobia Social Anxiety

SoP refers to a fear of social situations that leads to avoidance of those situations or that, when entered into, is accompanied by intense anxiety. When the situations producing the fear are avoided to the extent that the avoidance interferes with social or occupational functioning, the problem merits a diagnosis of SoP. Because of the nature of the disorder, treatments have often included exposure to social situations, either by being conducted in a group context, or by contriving exposures...

About the Authors

Anderson, Ed.D., is an assistant research professor of psychology specializing in community- and Internet-based health behavioral research with diverse populations. Her research interests include the evaluation of the theoretical foundations of behavior and interventions, computer-based measurement, and multivariate approaches to analysis. Manuel Barrera, Jr., Ph.D., is a professor of psychology and director of clinical training at Arizona State University. He also is an adjunct...

Self Regulation Theory and Self Help Therapies

CLUM Self-help treatments for emotional and physical disorders often utilize, implicitly or explicitly, principles of self-regulation that are used to produce and maximize change. An examination of these principles and the theoretical frameworks that organize them help us to understand how best to maximize change and how self-directed change comes about. Theories of self-regulation have emerged from a variety of disciplines, including psychology, sociology,...

Advantages and Disadvantages of the Self Help Approach

As with many other physical and mental problems, self-help approaches for sexual dysfunctions have been pursued throughout human history. Examples include herbal and animal medicines that have been passed on through generations and were believed to enhance male potency and female erotic responsiveness, to delay male ejaculation, or to relieve sexual pain. General models of help-seeking behavior (Dean, 1989 Wills & DePaulo, 1991) have been applied to sexual dysfunctions (Catania et al.,...

Dieting and Weight Loss

The 2000 Behavioral Risk Factor Surveillance System BRFSS data shows that up to 46 of U.S. women and 33 of U.S. men are presently trying to lose weight Bish et al., 2005 . Currently, the weight-loss charge is practiced most frequently by Hispanic 50 , Caucasian and African-American 45-46 women, followed by Hispanic 34 , Caucasian 32 , and African-American 31 men based on data from over 180,000 participants in the BRFSS 2000 Bish et al., 2005 . Weight-loss strategies included eating fewer...