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The social media platform Reddit is a contemporary context where we have an opportunity to identify problems experienced by people regarding different aspects of life. The platform is virtually anonymous which might make users discuss their problems more freely. Reddit is divided in subreddits where different subjects are discussed and the discussions are controlled by creators and moderators. I have identified a quite active subreddit targeted towards recovering addicts of benzodiazepines; r/benzorecovery.
* To analyze strategies of recovery in user narrative * To identify techniques commonly used and the how they are described * To construct metadata in order to assess how frequent the discussion of a different techniques are
Technically, what is done in this study, is adding mark-up metadata to different discussion. A rudimentary form of analysis suitable with a larger digital corpus where content metadata is added (Gilliland Swetland 2000). The metadata is constructed through a hermeneutical method in which the researcher analyses the subreddit.
Answering question like: Example: DIY-tapering; different ways to limit drug use by using less. 1) how common are discussion of taperings in relation to other subjects? 2) Is tapering commonly discussed together with other subjects and techniques?
Using a method of categorization and metadata mark-up we could gain a good understanding of the problems among recovering benzodiazepine addicts. We will also have the possibility to identify concepts that addicts themselves discuss and relate these to professional concepts thus creating better possibilities of communication between professionals and clients.
The Majid Society, at the heart of this chapter, aspires to offer development. The development approach has not, however, replaced a religious culture of aid. Instead, the chapter explores how development can be expressed through the language of Islam and financed through Islamic charity. The chapter explores the organization’s training facility, the “productive families” approach, a program tackling illiteracy among mothers, and the use of microcredit schemes, all of which the Majid Society directed at female beneficiaries of aid.
The welfare association was established in 1998 at the initiative of Prince Majid bin ʿAbd al-ʿAziz (1938–2003). This raises the question of how far royal charity organizations can be considered part of Saudi civil society. With a focus on national development and capacity building, the Majid Society resonates strongly with the public discourse of poverty as initiated and moderated by the Saudi state. The chapter critically looks at state approaches to poverty and how the Saudi state has come to dictate the ways poverty is discussed in public. This raises the question of how far charity organizations act in support of the state, complementing state efforts rather than challenging the status quo.
The relation between neutrality and the use of force is better to be kept within the law of armed conflict rather that the law on the use of force between States. This means that the right of self-defence cannot be the indispensable legal basis for the use of force between belligerents and neutrals. On the contrary it appears that neutral due diligence has been relied on as a basis to expand the scope of the right of self-defence. The latter is admissible as the basis for resort to force only in the case of resistance of a neutral State to repel belligerent violation of its territory or by a belligerent that fully complies with its duties under the law of neutrality.
Cyberspace may constitute either the exclusive area of operations or a means of conduct of hostilities in an otherwise conventional armed conflict. The basic text concerning the rules applicable in cyber warfare is the Tallinn Manual 2.0, a 'soft law' text that is not generally followed by the few States that include cyber warfare in their military manuals. However, the relevance and applicability of the law of neutrality in cyber conflict is not disputed. The proposed legal framework is in principle premised on the Hague Conventions V and XIII, though the particularities of cyberspace as a domain have admitted substantive deviations with respect to inviolability of neutral territory and neutral due diligence.
Mutual help programs are popular resources for persons with alcohol use disorder (AUD) and clinical referral to such programs is common. This chapter describes what is currently known about four established mutual help programs in the United States: Alcoholics Anonymous (AA), SMART Recovery, Women for Sobriety (WFS), and LifeRing. Strong correlational research indicates that AA is associated with increased abstinence and that this association arises in part because of increased social support, abstinence self-efficacy, and spiritual practices. There is little support that reductions in anger, selfishness, and depression account for AA-related benefit. Preliminary evidence indicates that persons reporting lower religiosity and higher education are more likely to affiliate with non-AA mutual help programs and that these programs may be efficacious. A series of recommendations are made to advance our knowledge of these mutual help programs, with an emphasis on the need for future investigations of SMART, WFS, and LifeRing.
This chapter explains what avoidant/restrictive food intake disorder (ARFID) is and provides diverse and relatable case examples of each of the three prototypical ARFID presentations, including sensory sensitivity, fear of aversive consequences, and lack of interest in eating or food.
Are you a picky eater? Do you worry that food will make you vomit or choke? Do you find eating to be a chore? If yes, this book is for you! Your struggles could be caused by Avoidant Restrictive Food Intake Disorder (ARFID); a disorder characterized by eating a limited variety or volume of food. You may have been told that you eat like a child, but ARFID affects people right across the lifespan, and this book is the first specifically written to support adults. Join Drs. Jennifer Thomas, Kendra Becker, and Kamryn Eddy - three ARFID experts at Harvard Medical School - to learn how to beat your ARFID at home and unlock a healthier relationship with food. Real-life examples show that you are not alone, while practical tips, quizzes, worksheets, and structured activities, take you step-by-step through the latest evidence-based treatment techniques to support your recovery.
Post-traumatic stress disorder (PTSD) carries a high disease burden worldwide, yet significant barriers exist to providing and accessing treatment for PTSD, particularly in refugee populations and in low- and middle-income countries. There is emerging evidence that self-administered psychological therapies, such as those accessed via online and mobile applications, are efficacious for many mental illnesses and increase access to treatment. Online and mobile applications offering self-help tools for eye movement desensitisation reprocessing (EMDR) therapy, an internationally recommended treatment for PTSD, are already widely distributed to the public.
To present a commentary evaluating the potential benefits and risks of self-administered EMDR therapy: first, by conducting a search for existing peer-reviewed evidence relating to self-administered EMDR therapy; second, by presenting existing evidence for other self-help psychotherapies and evaluating what additional insight this could provide into the potential efficacy, safety, tolerability and accessibility of self-administered EMDR therapy; and, third, by describing the conflicting views of EMDR experts on the topic.
A search was conducted for articles related to internet, mobile, book or computerised self-help EMDR therapy. The following databases were searched systematically: Medline, PsycInfo, EMBASE, AMED, CINAHL, Psychology and Behavioural Sciences, Cochrane Database and the EMDR Library.
Only one small primary research study was found relating to self-administered EMDR therapy. The results indicated significantly reduced symptoms of PTSD, depression, anxiety, distress and disability between pre-treatment and 3 month follow-up. No serious adverse events were reported. However, substantial methodological issues were discovered.
There is evidence that self-administered psychotherapies, in general, can be safe, effective and highly accessible. However, controversies persist regarding the safety and potential efficacy of self-administered EMDR therapy, and more robust research is needed. It is vital that methods are found to improve worldwide access to effective PTSD treatment, particularly given the current scale of migration to flee civil unrest.
Though there are effective psychological and drug treatments for obsessive–compulsive disorder (OCD), many patients remain inadequately treated or untreated. Making effective self-treatment guidance available may increase the number of patients being helped. In this review, database and manual literature searches were performed of case studies, open and randomised controlled trials (RCTs) of bibliotherapy, self-help groups, telecare and computer-aided self-help for OCD. We found no RCTs of bibliotherapy or self-help groups for OCD. Three open studies showed the efficacy of brief exposure and ritual prevention (ERP) instructions delivered by a live therapist by phone. A vicarious ERP computer program was effective in a small open study. Fully interactive computer-aided self-help by ERP for OCD was efficacious in two open studies and a large multicentre RCT, and in a small RCT compliance and outcome with that program was enhanced by brief scheduled support from a clinician. Although more research is needed, self-help approaches have the potential to help many more patients who would otherwise remain inadequately treated or untreated. Their dissemination could save resources used by health care providers. We propose a stepped care model for the treatment of OCD.
Selon les recommandations actuelles, les traitements de choix des troubles alimentaires compulsifs type boulimie et hyperphagie boulimique reposent sur plusieurs aspects. Tout d’abord, une prise en charge hygiéno-diététique ayant pour objectif de restructurer les prises alimentaires, modifier les comportements alimentaires en dehors des crises, tester les croyances erronées vis-à-vis des aliments, aider à la gestion des vomissements… Elles sont le plus souvent associées à une prise en charge psychothérapique et/ou médicamenteuse. La psychothérapie de choix est la thérapie cognitivo-comportementale (TCC). Compte tenu de leurs cibles thérapeutiques les TCC sont plutôt à réserver à des patientes euthymiques, ayant de fortes préoccupations pour la minceur. L’alternative psychothérapique peuvent être les thérapies interpersonnelles et éventuellement les thérapies psychanalytiques dans certaines situations. Le traitement médicamenteux de première ligne est la fluoxetine à dose anti-compulsive (60 mg/j). D’autres prises en charge médicamenteuses sont proposées (epitomax, naltrexone…) mais doivent être réservées à des deuxièmes lignes après avis spécialisé. Quelle que soit la prise en charge retenue, il est fondamental dans le cadre de l’hyperphagie boulimique d’expliquer aux patients que ces prises en charge n’auront pas d’effets amaigrissants En complément de ces prises en charge, des techniques de self-help devraient être systématiquement associées. Ces techniques consistent en l’utilisation de différents outils (livres, des sites Internet, CD…) qui seront utilisé par le patient seul ou accompagné par le thérapeute dans le but d’augmenter ses connaissances par rapport sa problématique et lui apporter des compétences et des outils pour diminuer les symptômes voir les faire disparaître. Ces techniques simples et pouvant être facilement utilisées par tous ont été validées scientifiquement dans plus d’une trentaine d’études y compris en population française. Certains de ces supports de self-help, actuellement disponibles en France, seront présentés.
Les programmes de gestion du stress par les thérapies comportementales et cognitives (TCC) ont été étudiés dans de nombreux pays et ont montré une efficacité sur la réduction du stress perçu, les symptômes anxieux et de la qualité de vie des patients. Compte tenu du nombre très important de patients susceptibles d’en bénéficier et ne pouvant y accéder, des programmes en self-help ont été proposés. Présentés au début sous la forme de livres (bibliothérapie) ces programmes se sont ensuite enrichis de supports informatiques et numériques. Hélas autant les programmes de gestion du stress basés sur les TCC en présentiel que ceux sur support numérique ont été très peu évalués dans notre pays. À notre connaissance le programme Seren@ctif est le premier programme self-help de gestion du stress en français proposé sur support numérique. Nous avons mené une étude de faisabilité de ce programme sur 10 patients répondant au diagnostic de trouble de l’adaptation avec anxiété selon les critères du DSM-IV. Le programme comprend 5 séances hebdomadaires que le patient suit dans notre unité à partir d’un site internet. Il bénéficie d’un contact minimal avec un membre du personnel médical avant et après chaque séance. Il est fourni au patient, dès la première séance une clé USB contenant des vidéos, des fichiers audios, un self-help book sous forme de e-guide, des carnets de suivi avec le programme des exercices à réaliser en dehors des 5 séances du module. Le patient est encouragé à pratiquer les exercices 20 minutes quotidiennement 5 à 6 jours par semaine. La faisabilité du programme a été évaluée par une échelle originale de satisfaction. La symptomatologie anxieuse a été mesurée au moyen de la forme état de l’inventaire d’anxiété de Spielberger State Trait Anxiety Inventory – forme Y (STAI-Y STAI-S). Au terme des 5 semaines du programme on retrouve de bons résultats en termes d’acceptabilité et d’attractivité. Les scores moyens au questionnaire de satisfaction sont pour tous les items au moins égal à 4 sur 5. Les scores moyens à la STAI-état ont diminué de 53,4 (ET 8,29) à l’inclusion à 44,2 (ET 7,73) en post-intervention. Le programme Seren@ctif mériterait d’être évalué dans le futur de façon contrôlée chez des patients présentant un trouble de l’adaptation avec anxiété afin de juger de son intérêt.
The fifth century BCE exhibited what has generally been termed ‘gang violence’: that is, the deployment of (relatively) well-organised gangs of lower-class men by elite figures, such as Publius Clodius Pulcher and Titus Annius Milo, in their pursuit of specific political purposes. This chapter analyses this phenomenon from the larger perspectives of self-help in Rome, the political violence that had begun to affect Roman civic life in the second century BCE (intensified by the civil war of the eighties BCE), and by way of the institutional and social features of Roman life (e.g. clientele and collegia) that facilitated the creation and exploitation of gangs. It concludes with innovations introduced by Augustus which effectively brought an end to gang violence in the city of Rome.
India's agrarian history has for the most part been cast within colonial and nationalist frameworks or in analyses of modernity and development in the South Asian historiography on both sides of the independence divide. This leaves plenty of space to discuss both the vast engagement of American actors with Indian elite formations and modifications to the agrarian projects contingent upon those interactions. A focus on the Americanist drive for agrarian modernization in India allows for exploring the distinct cultural location of modernization in a long-term perspective and its engagement with colonial “development.” A study of their mutual interaction gives insights into modernization's somewhat distinct itinerary on the subcontinent and provides specificity to the history of the otherwise spatially wider American intervention in global and inter-Asian contexts.
Access to cognitive behaviour therapy for those with psychosis (CBTp) remains poor. The most frequently endorsed barrier to implementation is a lack of resources. To improve access to CBTp, we developed a brief form of CBTp that specifically targets voice-related distress. The results of our pilot trial of guided self-help CBT for voices (GiVE) suggest that the therapy is both acceptable and beneficial. The present study aims to explore the subjective patient experience of accessing GiVE in the context of a trial. We interviewed nine trial participants using the Change Interview and a mixed methods approach. Most participants reported at least one positive change that they attributed to GiVE. We extracted five themes: (1) changes that I have noticed; (2) I am not alone; (3) positive therapy experiences; (4) I want more therapy; and (5) helping myself. The themes indicate that participating in the GiVE trial was generally a positive experience. The main areas in which participants experienced changes were improved self-esteem, and the ability to cope with voices. Positive changes were facilitated by embracing and enacting ‘self-help’ and having support both in and out of the therapy sessions. The findings support the use of self-help materials with those distressed by hearing voices, but that support both within and outside the clinical setting can aid engagement and outcomes. Overall, the findings support the continued investigation of GiVE.
Key learning aims
(1) To explore participants’ experience of accessing GiVE as part of a trial.
(2) To identify what (if any) changes participants noticed over the course of the GiVE trial.
(3) To identify what participants attribute these changes to.
Demands placed on informal caregivers can result in an increased likelihood of experiencing common mental health difficulties that may affect their ability to undertake the caring role. Currently, however, few evidence-based interventions have been specifically developed for informal caregivers and available interventions are difficult to access. The Improving Access to Psychological Therapies (IAPT) programme aims to improve access to evidence-based psychological therapies for all groups and may therefore present an opportunity to meet informal caregiver needs. Located within the MRC Complex Intervention Framework, a Phase II feasibility randomised controlled trial (RCT) examines key methodological, procedural and clinical uncertainties associated with running a definitive Phase III RCT of an adapted written cognitive behavioural therapy (CBT) self-help intervention for informal caregivers of stroke survivors. Recruitment was low despite different recruitment strategies being adopted, highlighting significant challenges moving towards a Phase III RCT until resolved. Difficulties with study recruitment may reflect wider challenges engaging informal caregivers in psychological interventions and may have implications for IAPT services seeking to improve access for this group. Further attempts to develop a successful recruitment protocol to progress to a Phase III RCT examining effectiveness of the adapted CBT self-help intervention should be encouraged.
Key learning aims
After reading this article, readers should be able to:
(1) Consider key feasibility issues with regard to recruitment and attrition when running a randomised controlled trial of an adapted written cognitive behavioural therapy (CBT) self-help intervention for informal caregivers of stroke survivors.
(2) Understand potential barriers experienced by an informal caregiving population to accessing psychological interventions.
(3) Appreciate implications for clinical practice to enhance access to IAPT services and low-intensity CBT working with an informal caregiver population.
Outpatient interventions for adult anorexia nervosa typically have a modest impact on weight and eating disorder symptomatology. This study examined whether adding a brief online intervention focused on enhancing motivation to change and the development of a recovery identity (RecoveryMANTRA) would improve outcomes in adults with anorexia nervosa.
Participants with anorexia nervosa (n = 187) were recruited from 22 eating disorder outpatient services throughout the UK. They were randomised to receiving RecoveryMANTRA in addition to treatment as usual (TAU) (n = 99; experimental group) or TAU only (n = 88; control group). Outcomes were measured at end-of-intervention (6 weeks), 6 and 12 months.
Adherence rates to RecoveryMANTRA were 83% for the online guidance sessions and 77% for the use of self-help materials (workbook and/or short video clips). Group differences in body mass index at 6 weeks (primary outcome) were not significant. Group differences in eating disorder symptoms, psychological wellbeing and work and social adjustment (at 6 weeks and at follow-up) were not significant, except for a trend-level greater reduction in anxiety at 6 weeks in the RecoveryMANTRA group (p = 0.06). However, the RecoveryMANTRA group had significantly higher levels of confidence in own ability to change (p = 0.02) and alliance with the therapist at the outpatient service (p = 0.005) compared to the control group at 6 weeks.
Augmenting outpatient treatment for adult anorexia nervosa with a focus on recovery and motivation produced short-term reductions in anxiety and increased confidence to change and therapeutic alliance.
Chapter 7 examines smart contracts’ ability to self-perform, self-enforce, and self-remedy and the remaining applicability of contract law and contract remedies. Smart contracts (coupled with blockchain technology) have created visions of self-executing, self-enforcing, and self-remedying contracts that eliminate the need for courts or arbitral tribunals to apply contract law to disputes. The theory goes that, since the possibility of breach is eliminated in such contracts, contract remedies become unnecessary.
Homework assignments are generally viewed as an important factor of cognitive behaviour therapy (CBT).
This study examined whether perfectionists procrastinate homework assignments.
Thirty-eight university students attended two sessions, 7 days apart from each other. After completing perfectionism scales at the first session, they were asked to complete homework tasks from a self-help wellbeing booklet and return the booklet at session 2.
Only maladaptive facets of perfectionism correlated with most of the behavioural measures of procrastination. Moreover, those high in maladaptive perfectionism set and completed fewer planned activities to improve their mood.
These findings suggest that perfectionism may affect how clients set their homework, and perfectionism may interfere with the homework assignments of CBT.
This article examines an Arabic commentary on the American self-help pioneer Dale Carnegie's How to Stop Worrying and Start Living, written by a one-time leading intellectual of the Egyptian Muslim Brotherhood, Muḥammad al-Ghazālī. Ghazālī’s 1956 commentary was perhaps the earliest manifestation of an influential genre of literature within the Islamic world today: “Islamic self-help.” Although scholars treat Islamic self-help as an effect of neoliberalism, this article reorients the study of Islamic self-help beyond neoliberalism by showing first, that Ghazālī’s early version of it emerged through a critical engagement with several ideological forms that relate in complex ways to neoliberalism's antecedent, liberalism; and second, that his Islamic self-help is best understood in terms of an Islamic encounter with American metaphysical religion made possible by Carnegie's text. It argues that Ghazālī’s Islamic self-help constituted a radical reconfiguration of Western self-help, one that replaced the ethics of self-reliance and autonomy with Islamic ethical sensibilities clustered around the notions of human insufficiency and dependence upon God. In doing so, it highlights how scholars of contemporary Islam might fruitfully pose the question of how novel intellectual trends and cultural forms, like self-help, become Islamic, instead of limiting their analysis to how Islam is reshaped by modern Euro-American thought, institutions, and practices.